酪酸梭菌联合四联疗法治疗幽门螺杆菌阳性胃溃疡的作用

吴水清 黄建成 张蕾

【摘要】 目的：探讨酪酸梭菌（Cb）联合四联疗法治疗幽门螺杆菌（Hp）阳性胃溃疡的作用。方法：选择笔者所在医院消化内科2017年1月-2018年12月收治的100例Hp阳性胃溃疡患者，随机分为两组，每组50例，对照组采用四联疗法，观察组采用四联疗法联合酪酸梭菌，比较临床疗效、Hp根除率、症状改善情况、血清炎症因子指标、生活质量评分、不良反应。结果：观察组临床总有效率、Hp根除率均高于对照组，各症状缓解时间均短于对照组，差异均有统计学意义（P<0.05）。治疗后，观察组血清CRP、TNF-α、IL-6、PCT均低于对照组，GQOLI-74评分高于对照组，差异均有统计学意义（P<0.05）。两组不良反应发生率比较差异无统计学意义（P>0.05）。结论：酪酸梭菌联合四联疗法用于Hp阳性胃溃疡治疗中，具有良好的临床疗效和用药安全性。

【关键词】 消化内科; 胃溃疡; 幽门螺杆菌; 四联疗法; 酪酸梭菌

doi：10.14033/j.cnki.cfmr.2019.27.016 文献标识码 B 文章编号 1674-6805（2019）27-00-03

Effect of Clostridium Butyricum Combined with Quadruple Therapy on Helicobacter Pylori Positive Gastric Ulcer/WU Shuiqing，HUANG Jiancheng，ZHANG Lei.//Chinese and Foreign Medical Research，2019，17（27）：-38

【Abstract】 Objective：To investigate the effect of Clostridium butyricum （Cb） combined with quadruple therapy on HP （Hp） positive gastric ulcer.Method：From January 2017 to December 2018，100 patients with Hp positive gastric ulcer were selected from the Department of Gastroenterology of the authors hospital，and were randomly divided into two groups，with 50 cases each group.The control group was treated with Quadruple therapy，while the observation group was treated with Quadruple therapy combined with Clostridium butyricum.The clinical efficacy，eradication rate of Hp，improvement of symptoms，serum inflammatory factors，quality of life score and adverse reactions were compared.Result：The clinical total effective rate and the eradication rate of Hp in the observation group were higher than those in the control group（P<0.05）.The remission time of each symptom was shorter than that in the control group（P<0.05）.After treatment，the serum CRP，TNF-α，IL6 and PCT in the observation group were lower than those in the control group，and the GQOLI-74 score was higher than that in the control group，the differences were statistically significant（P<0.05）.There was no significant difference in the overall incidence of adverse reactions between the two groups（P>0.05）.Conclusion：Clostridium butyricum plus tetrad has therapy satisfactory efficacy in functional dyspepsia and safety in the treatment of Hp-positive gastric ulcer.

【Key words】 Gastroenterology ; Gastric ulcer; Helicobacter pylori; Quadruple therapy; Clostridium butyricum

First-authors address：Mindong Hospital Affiliated to Fujian Medical University，Fuan 355000，China

胃潰疡是指在各种致病因子作用下，胃黏膜发生炎症、坏死、脱落，最终形成溃疡[1-2]。临床表现为上腹痛、腹胀、反酸、恶心、呕吐等症状，引发消化道出血、穿孔、癌变等并发症。Hp感染是最常见的致病因素，故临床上需对Hp阳性胃溃疡予以规范抗Hp治疗，促进溃疡愈合，预防胃溃疡复发。我国第5次Hp感染处理共识中推荐四联疗法抗Hp治疗[3]。近年来，酪酸梭菌被逐渐用于Hp阳性胃溃疡治疗中，取得了一定的成效[4-5]。本研究为探讨酪酸梭菌联合四联疗法治疗Hp阳性胃溃疡的作用，针对消化内科100例Hp阳性胃溃疡患者开展研究，具体如下。

1 资料与方法

1.1 一般资料

选择笔者所在医院消化内科2017年1月-2018年12月收治的100例Hp阳性胃溃疡患者。纳入标准：符合胃溃疡、Hp感染的诊断标准，确诊为Hp阳性胃溃疡[1-3]。……