Cremonini Filippo, Di Caro Simona, Covino Marcello, Armuzzi Alessandro, Gabrielli Maurizio, Santarelli Luca, Nista Enrico C, Cammarota Giovanni, Gasbarrini Giovanni, Gasbarrini Antonio
Department of Internal Medicine, Università Cattolica del Sacro Cuore, Policlinico Gemelli, Roma, Italy.
Am J Gastroenterol. 2002 Nov;97(11):2744-9. doi: 10.1111/j.1572-0241.2002.07063.x.
Several studies show that probiotics may prevent side effects during therapy against Helicobacter pylori (H. pylori). Other reports indicate competitive interaction between some probiotics and H. pylori. We compared efficacy of two different probiotics and one probiotic combination with placebo for preventing anti-H. pylori therapy-related side effects and for improving the eradication rate.
A total of 85 H. pylori positive, asymptomatic patients were randomized in four groups to receive probiotic or placebo both during and for 7 days after a 1-wk triple therapy scheme (rabeprazole 20 mg b.id., clarithromycin 500 mg b.i.d., and tinidazole 500 mg b.i.d.). Group I (n = 21) received Lactobacillus GG; group II (n = 22), Saccharomyces boulardii; group III (n = 21), a combination of Lactobacillus spp. and biphidobacteria; and group IV (n = 21), placebo. Subjects filled in weekly symptom questionnaires for 4 wk. Blinded investigators collected and analyzed data. H. pylori status was rechecked after 5-7 wk.
Side effects occurred mainly during the eradication week. None of them caused therapy discontinuation. In all probiotic-supplemented groups, there was a significantly lower incidence of diarrhea and taste disturbance during the eradication week with respect to the placebo group. Overall assessment of tolerability was significantly better in the actively treated patients than in the placebo group. No differences in the incidence of side effects between the probiotic groups were observed. The H. pylori eradication rate was almost identical between the probiotic and placebo groups.
All the probiotics used were superior to placebo for side effect prevention, but were not associated with better compliance with antibiotic therapy. The effect of probiotic supplementation on side effects during anti-H. pylori regimens seemed to be independent of the probiotic species used.
多项研究表明，益生菌可能预防幽门螺杆菌（H. pylori）治疗期间的副作用。其他报告指出某些益生菌与幽门螺杆菌之间存在竞争性相互作用。我们比较了两种不同益生菌及一种益生菌组合与安慰剂在预防抗幽门螺杆菌治疗相关副作用及提高根除率方面的疗效。
总共85例幽门螺杆菌阳性的无症状患者被随机分为四组，在为期1周的三联疗法方案（雷贝拉唑20毫克，每日两次；克拉霉素500毫克，每日两次；替硝唑500毫克，每日两次）期间及之后7天接受益生菌或安慰剂治疗。第一组（n = 21）接受鼠李糖乳杆菌GG；第二组（n = 22）接受布拉酵母菌；第三组（n = 21）接受乳酸杆菌属和双歧杆菌的组合；第四组（n = 21）接受安慰剂。受试者连续4周每周填写症状问卷。盲法研究者收集并分析数据。5 - 7周后复查幽门螺杆菌状态。
副作用主要发生在根除周期间。无一例导致治疗中断。与安慰剂组相比，所有补充益生菌的组在根除周期间腹泻和味觉障碍的发生率显著更低。积极治疗患者的总体耐受性评估明显优于安慰剂组。未观察到益生菌组之间副作用发生率的差异。益生菌组和安慰剂组的幽门螺杆菌根除率几乎相同。
所有使用的益生菌在预防副作用方面均优于安慰剂，但与抗生素治疗的更好依从性无关。补充益生菌对抗幽门螺杆菌治疗期间副作用的影响似乎与所使用的益生菌种类无关。
