Bin Zhang, Ya-Zheng Xu, Zhao-Hui Deng, Bo Chu, Li-Rong Jiang, Vandenplas Yvan
Department of Digestion, Shanghai Children's Medical Center, Medical College of Shanghai Jiao Tong University, Shanghai, China.
Department of Pediatrics, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
Pediatr Gastroenterol Hepatol Nutr. 2015 Mar;18(1):17-22. doi: 10.5223/pghn.2015.18.1.17. Epub 2015 Mar 30.
This study aims to investigate Saccharomyces boulardii CNCM I-745 during Helicobacter pylori eradication in children.
One hundred ninety-four H. pylori positive children were randomized in two groups. Therapy (omeprazole+clarithromycin+amoxicillin or omeprazole+clarithromycin+metronidazole in case of penicillin allergy) was given to both groups during two weeks. In the treatment group (n: 102) S. boulardii was added to the triple therapy, while the control group (n: 92) only received triple therapy. The incidence, onset, duration and severity of diarrhea and compliance to the eradication treatment were compared. A (13)C urea breath test was done 4 weeks after the end of eradication therapy in two groups of 21 patients aged 12 years and older to test the H. pylori eradication rate.
In the treatment group, diarrhea occurred in 12 cases (11.76%), starting after 6.25±1.24 days, lasting 3.17±1.08 days, and compliance to eradication treatment was 100%. In the control group, diarrhea occurred in 26 cases (28.26%), starting after 4.05±1.11 days, lasting 4.02±0.87 days, and in six cases eradication treatment was stopped prematurely (p<0.05). The (13)C urea breath test showed successful H. pylori eradication in 71.4% of the patients in the treatment and in 61.9 % in the control group (not significant).
S. boulardii has a beneficial effect on the prevention and treatment of diarrhea during H. pylori eradication in children. Although S. boulardii did only slightly increase H. pylori eradication rate, compliance to eradication treatment was improved.
本研究旨在调查布拉氏酵母菌CNCM I - 745在儿童幽门螺杆菌根除治疗期间的作用。
194名幽门螺杆菌阳性儿童被随机分为两组。两组均接受为期两周的治疗（奥美拉唑+克拉霉素+阿莫西林，青霉素过敏者用奥美拉唑+克拉霉素+甲硝唑）。治疗组（n = 102）在三联疗法基础上加用布拉氏酵母菌，而对照组（n = 92）仅接受三联疗法。比较两组腹泻的发生率、起病时间、持续时间和严重程度以及根除治疗的依从性。在两组年龄≥12岁的21名患者完成根除治疗4周后进行¹³C尿素呼气试验，以检测幽门螺杆菌根除率。
治疗组有12例（11.76%）发生腹泻，于6.25±1.24天后起病，持续3.17±1.08天，根除治疗依从性为100%。对照组有26例（28.26%）发生腹泻，于4.05±1.11天后起病，持续4.02±0.87天，6例患者提前终止根除治疗（p<0.05）。¹³C尿素呼气试验显示，治疗组幽门螺杆菌根除成功率为71.4%，对照组为61.9%（差异无统计学意义）。
布拉氏酵母菌对儿童幽门螺杆菌根除治疗期间腹泻的防治具有有益作用。虽然布拉氏酵母菌仅轻微提高了幽门螺杆菌根除率，但改善了根除治疗的依从性。
