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Influence of different timing of Saccharomyces boulardii combined with bismuth quadruple therapy for Helicobacter pylori eradication


Influence of different timing of Saccharomyces boulardii combined with bismuth quadruple therapy for Helicobacter pylori eradication



Zhonghua Yi Xue Za Zhi 99(22): 1731-1734



ISSN/ISBN: 0376-2491

PMID: 31216821

目的: 评价不同时机加用布拉氏酵母菌(S.Boulardii)散剂联合四联疗法根除幽门螺杆菌(H.pylori)的有效性和安全性。 方法: 共300例H.pylori阳性患者纳入本前瞻性研究,随机分为3组,四联组:泮托拉唑40 mg+枸橼酸铋钾220 mg+阿莫西林1 000 mg+呋喃唑酮100 mg,口服,2次/d,疗程14 d;同期益生菌组:泮托拉唑40 mg+枸橼酸铋钾220 mg+阿莫西林1 000 mg+呋喃唑酮100 mg+S. Boulardii散剂500 mg,口服2次/d,疗程14 d;后期益生菌组:在四联组14 d结束后第1天开始,加用S. Boulardii散剂500 mg,2次/d,口服14 d。观察患者不良反应,疗程结束4周后观察H.pylori根除率。 结果: 四联组、同期益生菌组、后期益生菌组H.pylori根除率按方案(PP)分析分别为89.0%、90.4%、91.3%,差异无统计学意义(P=0.870);按意向性(ITT)分析分别为81.0%、85.0%、84.0%,差异无统计学意义(P=0.732);同期益生菌组、后期益生菌组不良反应的总体发生率及腹泻、恶心的发生率均低于四联组(P<0.05),差异有统计学意义。同期益生菌组不良反应的总体发生率以及腹泻发生率低于后期益生菌组(P=0.021,P=0.007),差异有统计学意义。 结论: 同时期或根除治疗后加用S. Boulardii散剂联合四联疗法均不能提高H.pylori根除率,但均可降低不良反应总体发生率和腹泻、恶心的发生率;同时期较根除治疗后加用S. Boulardii散剂联合四联疗法更安全。.

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