Abstract:Objective: To explore the clinical effect of colloidal bismuth pectin triple therapy and quadruple therapy in the treatment of refractory peptic ulcer and the influence on intestinal microflora, Helicobacter pylori (Hp) eradication rate and adverse reactions. Methods: 120 patients with refractory peptic ulcer admitted to our hospital from October 2017 to December 2017 were selected as the study subjects. All the patients were divided into control group and observation group by simple random grouping method, 60 cases in each group. The control group was treated with pectin bismuth triple therapy, while the observation group was treated with pectin bismuth quadruple therapy. The curative effect of the two groups was compared, the distribution of intestinal microflora was measured before and after treatment, the eradication rate of HP was counted, and the incidence of adverse reactions was observed. Results: The total effective rate of treatment in the observation group was higher than that in the control group (96.67% vs 86.67%) (P<0.05). Before treatment, there was no significant difference in intestinal microflora between the two groups (P>0.05). The amount of prevotella, lactobacillus, clostridium leptum, bacteroides fragilis and enterobacteriaceae in the observation group at 4 weeks after drug withdrawal was higher than that in the control group, while the amount of Clostridium was lower than that in the control group (P<0.05). The Hp eradication rate in observation group at 4 weeks after drug withdrawal was higher than that in control group (96.67% vs 85.00%) (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: The total effective rate of colloidal bismuth pectin quadruple therapy is high in the treatment of refractory peptic ulcer, and the Hp eradication rate is also high. It can adjust the intestinal microecological balance with low incidence of adverse reactions, and it can be tolerated by patients.
陶东红,刘明成. 果胶铋三联与四联疗法治疗难治性消化性溃疡临床疗效观察及对患者肠道微生物Hp根除率不良反应的影响[J]. 河北医学, 2018, 24(11): 1804-1807.
TAO Donghong, LIU Mingcheng. Clinical Observation of Pectin-Bismuth Triple Therapy and Quadruple Therapy in the Treatment of Refractory Peptic Ulcer. HeBei Med, 2018, 24(11): 1804-1807.
[1] 王波玲,高峰.标准三联与四联方案根除幽门螺杆菌感染成本-效果分析[J].中国全科医学,2016,19(11):1237~1241. [2] Shavakhi A,Tabesh E,Yaghoutkar A,et al.The effects of multistrain probiotic compound on bismuth-containing quadruple therapy for Helicobacter pylori infection:a randomized placebo-controlled triple-blind study[J].Helicobacter,2013,18(4):280~284. [3] 汪官富,徐颖鹤,苏杭,等.双歧杆菌四联活菌片联合三联疗法治疗幽门螺杆菌阳性消化性溃疡的疗效[J].中华医院感染学杂志,2013,23(9):2074~2076. [4] 杨忠兰,吴云峰,田茂超.雷贝拉唑联合抗生素序贯疗法治疗幽门螺杆菌阳性消化性溃疡疗效及预后分析[J].中国现代医学杂志,2015,25(18):91~94. [5] 张维丰.双歧四联活菌制剂联合三联疗法根除幽门螺杆菌的疗效观察[J].中国临床药理学杂志,2014,30(3):182~184. [6] Liou J M,Chen C C,Chang C Y,et al.Sequential therapy for 10 days versus triple therapy for 14 days in the eradication of Helicobacter pylori in the community and hospital populations:a randomised trial[J].Gut,2015,65(11):1784~1792. [7] 段和力,张杰,汪海涛.含铋剂序贯疗法治疗幽门螺杆菌感染的疗效观察[J].中国医院药学杂志,2012,32(11):876~879. [8] 郑小丽,许乐.含呋喃唑酮四联疗法对幽门螺杆菌多次根除失败患者的效果[J].中华医学杂志,2013,93(44):3496~3499. [9] Liao J,Zheng Q,Liang X,et al.Effect of fluoroquinolone resistance on 14-day levofloxacin triple and triple plus bismuth quadruple therapy.[J].Helicobacter,2013,18(5):373~377. [10] 刘希,成虹,高文,等.含阿莫西林和呋喃唑酮四联疗法补救治疗幽门螺杆菌感染的效果及安全性[J].中华医学杂志,2014,94(8):567~571. [11] 郝瑞家,刘有平,梁宁,等.根除幽门螺旋杆菌四联疗法中奥美拉唑对比格犬铋吸收的影响[J].中国药理学与毒理学杂志,2013,27(2):222~226. [12] 罗清甜,朱庆,谢俊锋,等.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[J].山东医药,2017,57(1):91~93. [13] 张宏,侯波,严江.常规三联与四联疗法治疗幽门螺杆菌阳性消化道溃疡的疗效比较[J].中国药房,2017,28(3):321~323. [14] Zhou L,Zhang J,Chen M,et al.A comparative study of sequential therapy and standard triple therapy for helicobacter pylori infection:a randomized multicenter trial[J].American Journal of Gastroenterology,2014,109(4):535~541.