摘要
目的探讨双歧杆菌四联活菌片辅助治疗老年幽门螺杆菌(helicobacter pylori,Hp)阳性胃溃疡患者的疗效及对肠道菌群和炎症因子的影响。方法回顾性纳入2022年1月至2024年12月安阳市人民医院消化内科收治的360例老年胃溃疡(Hp阳性)患者,将采用含铋剂四联疗法的182例患者分入四联组,将采用含铋剂四联疗法+双歧杆菌四联活菌片的178例患者分入联合组。两组均治疗2周,治疗结束后3个月,比较两组临床疗效、治疗前及治疗后3个月的肠道菌群数(粪肠球菌、嗜酸乳杆菌、双歧杆菌、酵母菌)、血清炎症因子(基质金属蛋白酶9、白细胞介素6、肿瘤坏死因子α)水平。结果联合组的总有效率为89.89%(160/178),高于四联组[74.73%(136/182)](χ^(2)=14.153,P<0.001)。治疗后,联合组的粪肠球菌、嗜酸乳杆菌及双歧杆菌数量[分别为(10.86±1.23)CFU/g、(7.38±0.95)CFU/g、(8.91±1.32)CFU/g],高于四联组[分别为(8.76±0.89)CFU/g、(4.87±0.63)CFU/g、(6.45±0.96)CFU/g],而酵母菌数量、血清基质金属蛋白酶9、白细胞介素6及肿瘤坏死因子α水平[分别为(4.45±0.58)CFU/g、(11.59±1.74)ng/L、(9.43±1.42)ng/L、(6.05±0.90)ng/L],低于四联组[分别为(5.66±0.74)CFU/g、(15.12±2.26)ng/L、(12.72±2.03)ng/L、(8.41±1.26)ng/L](t=18.589、29.605、20.255、17.242、16.580、17.782、20.410,均P<0.001)。联合组不良反应发生率为5.62%(10/178),低于四联组[17.58%(32/182)](χ^(2)=12.500,P<0.001)。结论对老年胃溃疡(Hp阳性)患者予以双歧杆菌四联活菌片辅助联合四联疗法可提升临床疗效,有效改善肠道菌群结构并降低血清炎症因子水平,同时减少相关不良反应。
Objective To explore the efficacy of Bifidobacterium Tetravalent Live Bacteria Tablets as adjuvant therapy in elderly patients with Helicobacter pylori(H.pylori)-positive gastric ulcers and its impact on intestinal flora and inflammatory factors.Methods A total of 360 elderly patients with H.pylori-positive gastric ulcers were retrospectively enrolled from January 2022 to December 2024 at Anyang People’s Hospital,with 182 assigned to the quadruple therapy group(bismuth-containing quadruple therapy)and 178 to the combination group(bismuth-containing quadruple therapy plus Bifidobacterium Tetravalent Live Bacteria Tablets).Both groups were treated for 2 weeks.The clinical efficacy at 3 months post-treatment,the levels of fecal microbiota(including Bifidobacterium,Lactobacillus acidophilus,Enterococcus faecalis,and Saccharomyces cerevisiae)and serum inflammatory markers(such as matrix metalloproteinase(MMP)-9,interleukin(IL)-6,and tumor necrosis factor(TNF)-α)at baseline and 3 months post-treatment were compared between the two groups.Results The total effective rate of the combination group was 89.89%(160/178),higher than that of the quadruple therapy group(74.73%(136/182))(χ^(2)=14.153,P<0.001).After treatment,the quantities of Enterococcus faecalis,Lactobacillus acidophilus and Bifidobacterium in the combination group((10.86±1.23)CFU/g,(7.38±0.95)CFU/g,(8.91±1.32)CFU/g,respectively)were higher than those in the quadruple therapy group((8.76±0.89)CFU/g,(4.87±0.63)CFU/g,(6.45±0.96)CFU/g,respectively),while the quantities of yeast,serum MMP-9,IL-6 and TNF-α((4.45±0.58)CFU/g,(11.59±1.74)ng/L,(9.43±1.42)ng/L,(6.05±0.90)ng/L,respectively)were lower than those in the quadruple therapy group((5.66±0.74)CFU/g,(15.12±2.26)ng/L,(12.72±2.03)ng/L,(8.41±1.26)ng/L,respectively)(t=18.589,29.605,20.255,17.242,16.580,17.782,20.410,all P<0.001).The incidence of adverse reactions in the combination group was 5.62%(10/178),lower than that in the quadruple therapy group(17.58%(32/182))(χ^(2)=12.500,P<0.001).Conclusion The administration of Bifidobacterium Tetravalent Live Bacteria Tablets as an adjunctive therapy to quadruple therapy in elderly patients with H.pylori-positive gastric ulcers can enhance clinical efficacy,effectively improve intestinal microbiota structure,reduce serum inflammatory factors,and simultaneously decrease the incidence of related adverse reactions.
作者
王娟
孟敏
黄宏春
WANG Juan;MENG Min;HUANG Hongchun(Department of Gastroenterology,Anyang People’s Hospital,Anyang 455000,China)
出处
《中国药物应用与监测》
2025年第9期1528-1532,共5页
Chinese Journal of Drug Application and Monitoring
关键词
胃溃疡
老年
双歧杆菌四联活菌片
疗效
肠道菌群
炎症因子
gastric ulcer
elderly
Bifidobacterium Tetravalent Live Bacteria Tablets
efficacy
intestinal flora
inflammatory factors
