Cindoruk Mehmet, Erkan Gulbanu, Karakan Tarkan, Dursun Ayse, Unal Selahattin
Department of Gastroenterology, School of Medicine, Gazi University, Ankara, Turkey.
Helicobacter. 2007 Aug;12(4):309-16. doi: 10.1111/j.1523-5378.2007.00516.x.
Recent studies indicate a potential role of Saccharomyces boulardii in the prevention of Helicobacter pylori treatment-related side-effects and also in improvement of eradication rate. Our aim is to investigate the efficacy and safety of S. boulardii in the prevention of side-effects related to H. pylori eradication. The secondary aim of the study was to define the effect of S. boulardii on the eradication success of anti-H. pylori therapy.
One hundred and twenty-four patients with H. pylori infection (male/female: 44/80, mean age: 48 +/- 14.25 year) receiving 14 days of triple therapy (clarithromycin 500 mg b.i.d., amoxicillin 1000 mg b.i.d., and lansoprazole 30 mg b.i.d.) were randomly assigned to S. boulardii or placebo. Dyspeptic symptoms were recorded by using modified Glasgow Dyspepsia Questionnaire (GDQ). Side-effect profile and tolerability were assessed using a symptom-based questionnaire. H. pylori status was rechecked after 6 weeks after completion of eradication therapy.
H. pylori eradication rate, although higher in the treatment group, was statistically similar in treatment and control groups: 71% (44/62) versus 59.7% (37/62), respectively (p > .05). Nine (14.5%) patients in the treatment group and 19 (30.6%) patients in the placebo group experienced diarrhea (p < .05). Epigastric discomfort was more frequent in the control group [9 (14.5%) versus 27 (43.5%), respectively (p < .01)]. Diffuse abdominal pain, abdominal gas, taste disturbance, urticaria, nausea symptoms were similar in both groups. GDQ scores after treatment were significantly better for treatment group (mean +/- SD, range: 1.38 +/- 1.25 (0-5) vs. 2.22 +/- 1.44 (0-6), respectively; p < .01).
S. boulardii improved anti-H. pylori antibiotherapy-associated diarrhea, epigastric discomfort, and treatment tolerability. In addition, S. boulardii supplement decreased post-treatment dyspepsia symptoms independent of H. pylori status. However, S. boulardii had no significant affect on the rate of H. pylori eradication.
近期研究表明，布拉氏酵母菌在预防幽门螺杆菌治疗相关副作用以及提高根除率方面可能发挥作用。我们的目的是研究布拉氏酵母菌在预防幽门螺杆菌根除相关副作用方面的疗效和安全性。该研究的次要目的是确定布拉氏酵母菌对抗幽门螺杆菌治疗根除成功率的影响。
124例幽门螺杆菌感染患者（男/女：44/80，平均年龄：48±14.25岁）接受为期14天的三联疗法（克拉霉素500mg，每日2次；阿莫西林1000mg，每日2次；兰索拉唑30mg，每日2次），被随机分为布拉氏酵母菌组或安慰剂组。使用改良的格拉斯哥消化不良问卷（GDQ）记录消化不良症状。使用基于症状的问卷评估副作用情况和耐受性。根除治疗完成6周后复查幽门螺杆菌状态。
幽门螺杆菌根除率在治疗组虽较高，但治疗组和对照组在统计学上相似：分别为71%（44/62）和59.7%（37/62）（p>.05）。治疗组有9例（14.5%）患者出现腹泻，安慰剂组有19例（30.6%）患者出现腹泻（p<.05）。上腹部不适在对照组更常见[分别为9例（14.5%）和27例（43.5%），（p<.01）]。两组弥漫性腹痛、腹胀、味觉障碍、荨麻疹、恶心症状相似。治疗后治疗组的GDQ评分明显更好（平均值±标准差，范围：分别为1.38±1.25（0 - 5）对2.22±1.44（0 - 6）；p<.01）。
布拉氏酵母菌改善了与抗幽门螺杆菌抗生素治疗相关的腹泻、上腹部不适和治疗耐受性。此外，补充布拉氏酵母菌可降低治疗后消化不良症状，且与幽门螺杆菌状态无关。然而，布拉氏酵母菌对幽门螺杆菌根除率无显著影响。
