【摘要】：目的:探討益生菌聯(lián)合鉍劑四聯(lián)療法治療老年Hp陽性患者的療效,并觀察治療過程中出現(xiàn)的不良反應(yīng),以探討該方案在老年Hp陽性人群中的療效及安全性。方法:本實驗為前瞻性研究,采用隨機對照實驗設(shè)計。對象為2015年10月至2017年2月就診于我院的老年Hp陽性患者,符合納入標準者128例,通過完全隨機化的方法分為實驗組(64例)、對照組(64例)。實驗組給予:枸櫞酸鉍鉀220mg,2次/d,餐前半小時服;泮托拉唑腸溶片40mg,2次/d,餐前半小時服;阿莫西林膠囊1000mg,2次/d,餐后即服;克拉霉素片500mg,2次/d,餐后即服;益生菌(雙歧桿菌乳桿菌三聯(lián)活菌片)4片,2次/d;對照組:不用益生菌,其余治療方法同實驗組。療程均為10天。治療結(jié)束4周后復查13C或14C尿素呼氣試驗,結(jié)果為陰性者視為Hp根除成功。治療期間記錄患者不良反應(yīng)發(fā)生的情況。結(jié)果:128例老年Hp陽性患者中,107例根除成功。意向性分析實驗組根除率為84.4%(54/64),對照組根除率為82.8%(53/64),P0.05,兩組根除率比較差異無統(tǒng)計學意義;按方案分析實驗組根除率為87.1%(54/62),對照組根除率為86.9%(53/61),P0.05,兩組根除率比較差異無統(tǒng)計學意義。不良反應(yīng)發(fā)生率實驗組低于對照組(23.4%比39.1%),兩組的差異有統(tǒng)計學意義(P0.05)。結(jié)論:益生菌(雙歧桿菌三聯(lián)活菌片)聯(lián)合四聯(lián)療法治療老年Hp陽性患者并不能提高Hp的根除率,能降低治療過程中不良反應(yīng)的發(fā)生率。
[Abstract]:Objective: to investigate the efficacy and safety of probiotics combined with bismuth in the treatment of elderly patients with HP positive. Methods: this experiment was a prospective study and was designed as a randomized controlled trial. From October 2015 to February 2017, 128 elderly patients with HP positive were divided into experimental group (n = 64) and control group (n = 64) by complete randomization. The experimental group was given bismuth potassium citrate 220 mg / d twice a day, half an hour before meal; Pam Tora enteric-coated tablet 40 mg / d, half an hour before meal; amoxicillin capsule 1000mg / 2 / d, after meal; clarithromycin tablet 500mg / g twice / d, after meal; Probiotics (bifidobacterium lactobacillus triple live bacteria tablets) 4 / d; control group: no probiotics, other treatment methods are the same as the experimental group. The course of treatment was 10 days. After 4 weeks of treatment, 13 C or 14 C urea breath test was reexamined and the negative patients were considered as successful HP eradication. Adverse reactions were recorded during treatment. Results 107 out of 128 elderly HP positive patients were successfully eradicated. The eradication rate of the experimental group was 84.4% (54 / 64), and that of the control group was 82.8% (53 / 64) P0.05.The eradication rate of the experimental group was 87.1% (54 / 62) according to the scheme, and the eradication rate of the control group was 86.9% (53 / 61) P 0.05. There was no significant difference in the eradication rate between the two groups. The incidence of adverse reactions in the experimental group was lower than that in the control group (23.4% vs 39.1%), and the difference between the two groups was statistically significant (P0.05). Conclusion: probiotics (bifidobacterium triple live bacteria tablets) combined with tetralogy therapy can not improve the eradication rate of HP and reduce the incidence of adverse reactions in the course of treatment.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R573

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