Grgov Saša, Tasić Tomislav, Radovanović-Dinić Biljana, Benedeto-Stojanov Daniela
Vojnosanit Pregl. 2016 Nov;73(11):1044-9. doi: 10.2298/VSP150415127G.
BACKGROUND/AIM: Some studies suggest the benefit of applying different probiotic strains in combination with antibiotics in the eradication of Helicobacter pylori (H. pylori) infection. The aim of this study was to evaluate the effect of co-administration of multiple probiotic strains with triple H. pylori eradication therapy.
This prospective study included 167 patients with dyspeptic symptoms and chronic gastritis who were diagnosed with H. pylori infection and randomized into two groups. The group I of 77 patients underwent triple eradication therapy, for 7 days, with lansoprazole, 2 × 30 mg half an hour before the meal, amoxicillin 2 × 1.000 mg per 12 hours and clarithromycin 2 × 500 mg per 12 hours. After the 7th day of the therapy, lansoprazole continued at a dose of 30 mg for half an hour before breakfast for 4 weeks. The group II of 90 patients received the same treatment as the patients of the group I, with the addition of the probiotic cultures in the form of a capsule comprising Lactobacillus Rosell-52, Lactobacillus Rosell-11, Bifidobacterium Rosell-1755 and Saccharomyces boulardii, since the beginning of eradication for 4 weeks. Eradication of H. pylori infection control was performed 8 weeks after the therapy by rapid urease test and histopathologic evaluation of endoscopic biopsies or by stool antigen test for H. pylori.
Eradication of H. pylori infection was achieved in 93.3% of the patients who received probiotics with eradication therapy and in 81.8% of patients who were only on eradication therapy without probiotics. The difference in eradication success was statistically significant, (p < 0.05). The incidence of adverse effects of eradication therapy was higher in the group of patients who were not on probiotic (28.6%) than in the group that received probiotic (17.7%), but the difference was not statistically significant.
Multiple probiotic strains addition to triple eradication therapy of H. pylori achieves a significantly better eradication success, with fewer side effects of antibiotics.
背景/目的:一些研究表明,联合应用不同益生菌菌株与抗生素有助于根除幽门螺杆菌(H. pylori)感染。本研究旨在评估多种益生菌菌株与三联疗法联合用于根除幽门螺杆菌的效果。
本前瞻性研究纳入了167例有消化不良症状和慢性胃炎且诊断为幽门螺杆菌感染的患者,并将其随机分为两组。77例患者的第一组接受为期7天的三联根除疗法,即饭前半小时服用兰索拉唑,每次2×30mg,阿莫西林每12小时2×1000mg,克拉霉素每12小时2×500mg。治疗第7天后,兰索拉唑以30mg的剂量在早餐前半小时继续服用4周。90例患者的第二组接受与第一组患者相同的治疗,自根除治疗开始起4周内,额外添加包含罗塞尔氏乳杆菌-52、罗塞尔氏乳杆菌-11、罗塞尔氏双歧杆菌-1755和布拉酵母菌的胶囊形式的益生菌培养物。治疗8周后,通过快速尿素酶试验、内镜活检的组织病理学评估或幽门螺杆菌粪便抗原检测来控制幽门螺杆菌感染的根除情况。
接受益生菌联合根除治疗的患者中,93.3%实现了幽门螺杆菌感染的根除,而仅接受无益生菌根除治疗的患者中这一比例为81.8%。根除成功率的差异具有统计学意义(p<0.05)。未使用益生菌的患者组根除治疗的不良反应发生率(28.6%)高于接受益生菌的患者组(17.7%),但差异无统计学意义。
在三联根除幽门螺杆菌治疗中添加多种益生菌菌株可显著提高根除成功率,且抗生素副作用更少。