枯草杆菌二联活菌肠溶胶囊联合铋剂四联疗法治疗十二指肠球部溃疡的临床疗效

发布时间：2019-03-12 19:33

【摘要】：目的探讨枯草杆菌二联活菌肠溶胶囊联合铋剂四联疗法对十二指肠球部溃疡患者幽门螺旋杆菌(Hp)根除率、不良反应以及免疫功能的影响。方法选取160例Hp阳性的十二指肠球部溃疡患者随机分为两组各80例。对照组给予铋剂四联(阿莫西林+克拉霉素+雷贝拉唑+枸橼酸铋钾)治疗,观察组在铋剂四联疗法基础上加用枯草杆菌二联活菌肠溶胶囊,疗程均为2周,治疗结束后4周复查13C尿素呼气试验及胃镜,分别观察两组Hp根除率、溃疡愈合率、不良反应发生情况以及外周血IL-6、IL-10、Ig A、Ig G水平变化。结果 160例患者中共148例按方案完成治疗。对照组及观察组十二指肠球部溃疡愈合率分别为65.3%、80.3%,观察组愈合率高于对照组(P0.05)。按照意愿分析计算,观察组Hp根除率(85.00%)明显高于对照组(72.50%)(P0.05)。观察组不良反应发生率(31.25%)低于对照组(50.0%)(P0.05)。治疗后观察组外周血IL-6水平较对照组下降,Ig A水平较观察组升高(P均0.05)。结论枯草杆菌二联活菌肠溶胶囊联合铋剂四联疗法能提高Hp根除率,降低不良反应,此机制可能与枯草杆菌二联活菌参与体内免疫调节有关。
[Abstract]:Aim to investigate the effects of Bacillus subtilis combined with bismuth tetra-therapy on the eradication rate, side effects and immune function of Helicobacter pylori (HP) in patients with duodenal ulcer. Methods 160 cases of duodenal ulcer with positive Hp were randomly divided into two groups: 80 cases in each group. The control group was treated with bismuth tetracycline (amoxicillin clarithromycin rabeprazole bismuth potassium citrate), the observation group was treated with bismuth tetracycline plus Bacillus subtilis enteric-coated capsules, the course of treatment was 2 weeks, and the control group was treated with bismuth potassium bismuth citrate. After 4 weeks of treatment, 13C urea breath test and gastroscopy were performed to observe the Hp eradication rate, ulcer healing rate, side effects and the changes of IL-6,IL-10,Ig-A and IgG levels in peripheral blood of the two groups. Results A total of 148 cases of 160 patients were treated according to the plan. The healing rate of duodenal ulcer in the control group and the observation group was 65.3% and 80.3%, respectively. The healing rate in the observation group was higher than that in the control group (P0.05). The Hp eradication rate in the observation group (85.00%) was significantly higher than that in the control group (72.50%) (P0.05). The incidence of adverse reactions in the observation group (31.25%) was lower than that in the control group (50.0%) (P0.05). After treatment, the level of IL-6 in peripheral blood of the observation group was lower than that of the control group, and the level of, Ig A was higher than that of the observation group. Conclusion Bacillus subtilis enterolytic capsule combined with bismuth tetra-combination therapy can improve the eradication rate of Hp and reduce the adverse reaction. This mechanism may be related to the involvement of Bacillus subtilis in the immune regulation in vivo. [WT5 "HZ] conclusion [WT5" BZ] [WT5 "BZ]
【作者单位】：赣州市人民医院;
【分类号】：R573.1

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