CAJ | 학술논문

背景：幽门螺杆菌（Hp）感染与慢性胃炎、消化性溃疡、胃黏膜相关淋巴样组织淋巴瘤和胃癌等疾病的发生有关。有研究显示，联合使用嗜酸乳杆菌能提高 Hp 根除率，并降低治疗过程中的不良反应。目的：探讨复方嗜酸乳杆菌片联合含铋剂四联疗法对首次根除失败的 Hp 感染的疗效。方法：将180例经标准三联疗法首次根除失败的Hp 阳性的消化性溃疡患者随机分为试验组和对照组，试验组患者给予复方嗜酸乳杆菌片1 g tid，餐后服用，疗程14 d，然后给予雷贝拉唑10 mg bid ＋阿莫西林1000 mg bid ＋呋喃唑酮100 mg bid ＋枸橼酸铋钾300 mg qid，疗程10 d。对照组患者给予雷贝拉唑10 mg bid ＋阿莫西林1000 mg bid ＋呋喃唑酮100 mg bid ＋枸橼酸铋钾300 mg qid，疗程10 d。治疗结束至少4周后行13 C-尿素呼气试验，评估 Hp 根除率和不良反应。结果：试验组 PP 根除率和ITT 根除率与对照组相比均无明显差异（PP：81．2％对78．2％，χ2＝0．241，P ＝0．623；ITT：76．7％对75．6％，χ2＝0．031，P ＝0．861）。试验组恶心呕吐（2．4％对11．5％）、腹泻（0对9．2％）的发生率明显低于对照组（P ＜0．05）。结论：复方嗜酸乳杆菌片联合含铋剂四联疗法对首次标准三联疗法根除失败的 Hp 患者疗效较好，同时可有效减少不良反应。
배경：유문라간균（Hp）감염여만성위염、소화성궤양、위점막상관림파양조직림파류화위암등질병적발생유관。유연구현시，연합사용기산유간균능제고 Hp 근제솔，병강저치료과정중적불량반응。목적：탐토복방기산유간균편연합함필제사련요법대수차근제실패적 Hp 감염적료효。방법：장180례경표준삼련요법수차근제실패적Hp 양성적소화성궤양환자수궤분위시험조화대조조，시험조환자급여복방기산유간균편1 g tid，찬후복용，료정14 d，연후급여뢰패랍서10 mg bid ＋아막서림1000 mg bid ＋부남서동100 mg bid ＋구연산필갑300 mg qid，료정10 d。대조조환자급여뢰패랍서10 mg bid ＋아막서림1000 mg bid ＋부남서동100 mg bid ＋구연산필갑300 mg qid，료정10 d。치료결속지소4주후행13 C-뇨소호기시험，평고 Hp 근제솔화불량반응。결과：시험조 PP 근제솔화ITT 근제솔여대조조상비균무명현차이（PP：81．2％대78．2％，χ2＝0．241，P ＝0．623；ITT：76．7％대75．6％，χ2＝0．031，P ＝0．861）。시험조악심구토（2．4％대11．5％）、복사（0대9．2％）적발생솔명현저우대조조（P ＜0．05）。결론：복방기산유간균편연합함필제사련요법대수차표준삼련요법근제실패적 Hp 환자료효교호，동시가유효감소불량반응。
Background:Helicobacter pylori (Hp)infection is correlated with the development of chronic gastritis,peptic ulcer, mucosa-associated lymphoid tissue lymphoma and gastric cancer.Studies showed that Lactobacillus acidophilus could improve the eradication rate of Hp and reduce the occurrence of side-effects.Aims:To evaluate the efficacy of compound Lactobacillus acidophilus tablets combined with bismuth-containing quadruple therapy for the treatment of failed eradiction of Hp infection.Methods:One hundred and eighty patients with Hp-positive peptic ulcer in whom standard triple therapy failed were enrolled and then randomly assigned into experimental group and control group.Patients in experimental group received compound Lactobacillus acidophilus tablets 1 g tid for 14 days,followed by rabeprazole 10 mg bid +amoxicillin 1 000 mg bid +furazolidone 100 mg bid +bismuth 300 mg qid for 10 days.Patients in control group received rabeprazole 10 mg bid +amoxicillin 1 000 mg bid +furazolidone 100 mg bid +bismuth 300 mg qid for 10 days.13 C-urea breath test was conducted at least 4 weeks after completion of the course,Hp eradication rate and side-effects were evaluated. Results:No significant differences in PP eradication rate and ITT eradication rate were found between experimental group and control group (PP:81.2% vs.78.2%,χ2 =0.241,P =0.623;ITT:76.7% vs.75.6%,χ2 =0.031,P =0.861).Incidences of nausea and vomiting (2.4% vs.11.5%),diarrhea (0 vs.9.2%)in experimental group were significantly decreased than those in control group (P <0.05).Conclusions:Compound Lactobacillus acidophilus tablets combined with bismuth-containing quadruple therapy is efficient for Hp-positive patients with failed standard triple therapy and can reduce side-effects.