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[目的]比较益生菌、铋剂分别联合标准三联疗法(埃索美拉唑片20mg克拉霉素片0.5g阿莫西林胶囊1.0g每日2次)与标准三联疗法根除幽门螺杆菌(Hp)的效果。[方法]选取186例Hp阳性的初治患者,随机分为益生菌组、铋剂组和三联组各62例,三联组:采用标准三联疗法;益生菌组:标准三联疗法基础上+嗜酸乳杆菌0.5g每日3次;铋剂组:标准三联疗法基础上+胶体果胶铋胶囊0.1g每日2次;3组疗程均为10d。疗程结束后观察3组对Hp的根除率,比较3组患者临床症状缓解情况、药物不良反应及成本疗效比。[结果]益生菌组、铋剂组、三联组对Hp根除率分别为83.87%、90.32%、72.58%,铋剂组Hp根除率高于益生菌组、三联组(P<0.05);3组患者临床症状均呈明显缓解趋势,铋剂组症状缓解显著优于益生菌组、三联组(P<0.05);益生菌组、铋剂组、三联组不良反应发生率分别为9.68%、33.87%、22.58%,益生菌组与铋剂组不良反应发生率比较差异有统计学意义(P<0.05),三联组与铋剂组、益生菌组比较差异无统计学意义(P>0.05);成本效果分析显示,铋剂组单位效果成本最低。[结论]铋剂联合标准三联疗法对Hp根除率高,单位效果成本低,可作为根治Hp的一线方案。
[Objective] To compare probiotics and bismuth with standard triple therapy (esomeprazole tablets 20mg clarithromycin tablets 0.5g amoxicillin capsules 1.0g twice daily) and standard triple therapy to eradicate Helicobacter pylori (Hp) Effect. [Method] A total of 186 Hp-positive untreated patients were randomly divided into probiotics group, bismuth group and triple group of 62 patients in each group, triple group: standard triple therapy; probiotics group: standard triple therapy + acidophilus Lactobacillus 0.5g 3 times a day; bismuth group: standard triple therapy + gel colloidal bismuth capsules 0.1g 2 times a day; 3 courses of treatment were 10d. After the course of treatment, the eradication rate of Hp in the three groups was observed. The clinical symptom relief, drug adverse reactions and cost-effectiveness were compared among the three groups. [Result] The eradication rates of Hp in probiotics group, bismuth group and triple group were 83.87%, 90.32% and 72.58% respectively. The eradication rate of Hp in bismuth agent group was higher than that in probiotics group and triple group (P <0.05) The symptom of patients in bismuth group was significantly better than those in probiotics group and triple group (P <0.05). The rates of adverse reactions in probiotics group, bismuth group and triple group were 9.68% and 33.87% respectively, , 22.58% respectively. There was significant difference in the incidence of adverse reactions between probiotics and bismuth (P <0.05), but there was no significant difference between the three groups and the bismuth and probiotics (P> 0.05) The result shows that the unit cost of bismuth is the lowest. [Conclusion] The bismuth combined with standard triple therapy has a high eradication rate of Hp and low unit cost, which can be used as a first-line plan to cure Hp.