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丁酸梭菌和凝结芽孢杆菌在幽门螺杆菌根除治疗中的疗效和安全性:一项开放标签、单臂试点研究。

The efficacy and safety of Clostridium butyricum and Bacillus coagulans in Helicobacter pylori eradication treatment: An open-label, single-arm pilot study.

作者信息

Zhang Jian, Guo Jingzhi, Li Dan, Chen Min, Liu Jie, Feng Chenchen, He Qi, Zhao Jing, Zhang Luyao, Chen Jie, Shi Yongquan

机构信息

State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases.

Northern theatre air force Hospital.

出版信息

Medicine (Baltimore). 2020 Nov 6;99(45):e22976. doi: 10.1097/MD.0000000000022976.

Abstract

BACKGROUND

Helicobacter pylori (H pylori) infection plays a critical role in gastritis-associated diseases, gastroduodenal ulcers, and even gastric cancer. Studies have shown that probiotics may exhibit antagonistic activity against H pylori.

METHODS

This study aimed to assess the efficacy and safety of monotherapy with Clostridium butyricum (C butyricum) and Bacillus coagulans (B coagulans) for H pylori treatment. Our research was an open-label, single-arm pilot study of H pylori eradication. Subjects diagnosed with H pylori infection as outpatients at Xijing Hospital were randomized (1:1:1) to receive 8 weeks of therapy with C butyricum (group A), B coagulans (group B), or C butyricum plus B coagulans (group C). H pylori status was assessed 1 to 2 weeks after treatment. The H pylori eradication rate according to intention-to-treat and per-protocol analyses was the primary outcome of study, and the delta over baseline score, adverse events, and compliance were the secondary outcomes. This study was registered at ClinicalTrials.gov (NCT03857425).

RESULTS

A total of 150 subjects were consecutively enrolled from February 2019 to August 2019. The ITT analysis demonstrated that the 3 groups achieved similar eradication rates (18%, 20%, and 26%, respectively, P = .597). The PP analysis yielded a similar result (24.3%, 26.3%, and 32.5%, respectively, P = .703). None of the subjects reported adverse events during treatment. The 3 groups had comparable compliance rates (74% vs 76% vs 80%, P > .05).

CONCLUSION

C butyricum and B coagulans may effectively inhibit H pylori to some extent, with rare adverse events, and thus may reduce the burden of antibiotic resistance.

摘要

背景

幽门螺杆菌(H pylori)感染在胃炎相关疾病、胃十二指肠溃疡甚至胃癌中起着关键作用。研究表明,益生菌可能对幽门螺杆菌具有拮抗活性。

方法

本研究旨在评估丁酸梭菌(C butyricum)和凝结芽孢杆菌(B coagulans)单药治疗幽门螺杆菌的疗效和安全性。我们的研究是一项关于幽门螺杆菌根除的开放标签、单臂试点研究。在西京医院门诊被诊断为幽门螺杆菌感染的受试者被随机分为(1:1:1)三组,分别接受8周的丁酸梭菌治疗(A组)、凝结芽孢杆菌治疗(B组)或丁酸梭菌加凝结芽孢杆菌治疗(C组)。治疗后1至2周评估幽门螺杆菌感染状况。意向性分析和符合方案分析的幽门螺杆菌根除率是研究的主要结局,基线差值评分、不良事件和依从性是次要结局。本研究已在ClinicalTrials.gov注册(NCT03857425)。

结果

2019年2月至2019年8月共连续纳入150名受试者。意向性分析表明,三组的根除率相似(分别为18%、20%和26%,P = 0.597)。符合方案分析得出类似结果(分别为24.3%、26.3%和32.5%,P = 0.703)。治疗期间没有受试者报告不良事件。三组的依从率相当(74%对76%对80%,P>0.05)。

结论

丁酸梭菌和凝结芽孢杆菌在一定程度上可能有效抑制幽门螺杆菌,不良事件罕见,因此可能减轻抗生素耐药负担。

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