Efficacy of probiotics in the treatment of Helicobacter pylori positive gastric ulcer and its effect on intestinal flora distribution and serum inflammatory factors
WANG Huixia ZHANG Caifeng ZHANG Chaoqun JI Juanjuan HAN Yu
Department of Gastroenterology, the First Affiliated Hospital of Xinxiang Medical University, He’nan Province, Weihui 453100, China
Abstract Objective To explore the effect of probiotics on the distribution of intestinal flora and serum inflammatory factors in patients with Helicobacter pylori (Hp) positive gastric ulcer. Methods A total of 170 patients with Hp positive gastric ulcer admitted to the First Affiliated Hospital of Xinxiang Medical College from May 2016 to October 2019 were selected and divided into observation group (85 cases) and control group (85 cases) according to the random number table method. The control group was given quadruple therapy, and the observation group was treated with Bifidobacterium and Lactobacillus triple live bacteria tablets on the basis of the control group. The clinical efficacy, Hp eradication rate, intestinal flora distribution, serum C-reactive protein (CRP), procalcitonin (PCT) and serum amyloid A (SAA) levels before and after treatment and the incidence of adverse reactions were compared between the two groups. Results The clinical effective rate of the observation group was significantly higher than that of the control group (P ＜ 0.05). The eradication rate of Hp in the observation group was significantly higher than that in the control group (P ＜ 0.05). Four weeks after completion of treatment, the intestinal Bifidobacterium and Lactobacillus in the observation group were significantly higher than those in the control group (P ＜ 0.05). Four weeks after completion of treatment, the levels of serum CRP and SAA in the two groups were lower than those before treatment, and those in the observation group were significantly lower than those in the control group (P ＜ 0.05). There was no significant difference in the serum PCT of the two groups (P ＞ 0.05). There was no significant difference in incidence of adverse reaction between two groups (P ＞ 0.05). Conclusion Probiotics combined with quadruple therapy can improve the curative effect of Hp positive gastric ulcer patients, and its mechanism may be related to the regulation of intestinal flora and reduction of inflammatory reaction.
WANG Huixia ZHANG Caifeng ZHANG Chaoqun JI Juanjuan HAN Yu. Efficacy of probiotics in the treatment of Helicobacter pylori positive gastric ulcer and its effect on intestinal flora distribution and serum inflammatory factors[J]. 中国医药导报, 2021, 18(12): 154-158.
[1] Ford AC，Gurusamy KS，Delaney B，et al. Eradication therapy for peptic ulcer disease in Helicobacter pylori-positive people[J]. Cochrane Database Syst Rev，2016，4（4）：CD003840.
[2] Fontes LES，Martimbianco ALC，Zanin C，et al. N-acetylcysteine as an adjuvant therapy for Helicobacter pylori eradication [J]. Cochrane Database Syst Rev，2019，2（2）：CD012357.
[3] Malfertheiner P，Megraud F，O’morain CA，et al. Management of Helicobacter pylori infection-the Maastricht V/Florence Consensus Report [J]. Gut，2017，66（1）：6-30.
[4] 刘文忠，谢勇，陆红，等.第五次全国幽门螺杆菌感染处理共识报告[J].中华内科杂志，2017，56（7）：532-545.
[5] Wang F，Feng J，Chen P，et al. Probiotics in Helicobacter pylori eradication therapy：Systematic review and network meta-analysis [J]. Clin Res Hepatol Gastroenterol，2017， 41（4）：466-475.
[6] 刘晓政.5种质子泵抑制剂联合健胃愈疡胶囊治疗消化性溃疡的成本-效果分析[J].中国现代医学杂志，2018， 28（4）：105-110.
[7] Goli YD，Moniri R. Efficacy of probiotics as an adjuvant agent in eradication of Helicobacter pylori infection and associated side effects [J]. Benef Microbes，2016，7（4）：519-527.
[8] Hooi JKY，Lai WY，Ng WK，et al. Global prevalence of Helicobacter pylori infection：systematic review and meta-analysis [J]. Gastroenterology，2017，153（2）：420-429.
[9] Guevara B，Cogdill AG. Helicobacter pylori：A Review of Current Diagnostic and Management Strategies [J]. Dig Dis Sci，2020，65（7）：1917-1931.
[10] Saracino IM，Pavoni M，Zullo A，et al. Antibiotic Resistance and Therapy Outcome in H. pylori Eradication Failure Patients [J]. Antibiotics （Basel），2020，9（3）：121.
[11] Albaa C，Blancoa A，Alarco NT. Antibiotic resistance in Helicobacter pylori [J]. Curr Opin Infect Dis，2017，30（5）：489-497.
[12] Boltin D. Probiotics in Helicobacter pylori-induced peptic ulcer disease [J]. Best Pract Res Clin Gastroenterol，2016，30（1）：99-109.
[13] Hu Y，Zhu Y，Lu NH. Recent progress in Helicobacter pylori treatment [J]. Chinese Med J，2020，133（3）：335-343.
[14] Fang HR，Zhang GQ，Cheng JY，et al. Efficacy of Lactobacillus-supplemented triple therapy for Helicobacter pylori infection in children：a meta-analysis of randomized controlled trials [J]. Eur J Pediatr，2018，178（1）：7-16.
[15] 于佳鹭，李在玲.儿童幽门螺杆菌根除治疗过程中肠道菌群的变化[J].临床儿科杂志，2020，38（6）：426-431.
[16] Rizzatti G，Ianiro G，Gasbarrini A. Antibiotic and Modulation of Microbiota：A New Paradigm? [J]. J Clin Gastroenterol，2018，52 Suppl 1，Proceedings from the 9th Probiotics，Prebiotics and New Foods，Nutraceuticals and Botanicals for Nutrition & Human and Microbiota Health Meeting，held in Rome，Italy from September 10 to 12，2017：S74-S77.
[17] Yoon H，Kim N，Kim JY，et al. Effects of multistrain probiotic-containing yogurt on second-line triple therapy for Helicobacter pylori infection [J]. J Gastroenterol Hepatol，2011，26（1）：44-48.
[18] Bouihat N，Burucoa C，Benkirane A，et al. Helicobacter pylori Primary Antibiotic Resistance in 2015 in Morocco：A Phenotypic and Genotypic Prospective and Multicenter Study [J]. Microbial Drug Resistance，2017，23（6）：727-732.
[19] Wang ZH，Gao QY，Fang JY. Meta-Analysis of the Efficacy and Safety of Lactobacillus-containing and Bifidobacterium-containing Probiotic Compound Preparation in Helicobacter pylori Eradication Therapy [J]. J Clin Gastroenterol，2013，47（1）：25-32.
[20] Wang YH，Huang Y. Effect of Lactobacillus acidophilus and Bifidobacterium bifidum supplementation to standard triple therapy on Helicobacter pylori eradication and dynamic changes in intestinal flora [J]. World J Microbiol Biotechnol，2014，30（3）：847-853.
[21] Chen YH，Tsai WH，Wu HY，et al. Probiotic Lactobacillus spp. act Against Helicobacter pylori-induced Inflammation [J]. J Clin Med，2019，8（1）：90.
[22] 莫雅娴.益生菌联合三联疗法治疗幽门螺杆菌相关性慢性胃炎的临床效果[J].中国医药导报，2015，12（21）：122-125.
[23] 周义，李昌平.益生菌在幽门螺杆菌根除治疗中的应用进展[J].海南医学，2017，28（20）：3364-3367.
[24] 罗雪平，袁南贵.降钙素原、C反应蛋白、白细胞计数和中性粒细胞百分比在血流感染中的诊断价值[J].中国医药指南，2017，15（29）：135-136.
[25] 蒋全，李杨亮，程华明.血清降钙素原与血流感染的相关性分析[J].蚌埠医学院学报，2017，42（8）：1120-1121.
[26] 陈玉兰，杨秀芳，陈简，等.血清SAA、IL-6、PCT水平检测在新生儿宫内感染性肺炎早期诊断中的应用价值[J].检验医学与临床，2020，17（18）：2626-2629.
[27] 李朝辉，胡雅，叶健翔，等.血清淀粉样蛋白A和超敏C反应蛋白联合检测在小儿呼吸道感染性疾病早期鉴别诊断中的临床应用价值及相关性分析[J].中国医药科学，2020，221（5）：170-174.
[28] 冼肖英，丁燕玲.血清淀粉样蛋白A检测在肺炎支原体肺炎中的诊断价值[J].中国医药导报，2020，537（7）：174-177.
[29] 杨汉才，莫家金，林秋平.血清降钙素原和血清淀粉样蛋白A在细菌性肺炎诊断和疗效评价中的应用价值[J].中国当代医药，2019，26（21）：155-157.
