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[目的]观察枯草杆菌二联活菌联合四联疗法对幽门螺杆菌(Hp)的根治效果。[方法]105例诊断为慢性糜烂性胃炎伴有Hp感染的患者随机分为A组(35例)、B组(36例)、C组(34例)。A组用三联疗法(泮托拉唑40mg,bid+阿莫西林1 000mg,bid+克拉霉素500mg,bid),B组用四联疗法(果胶铋+三联疗法),C组用枯草杆菌二联活菌0.5,tid+四联疗法,各组疗程均为14d。疗程结束后至少间隔4周行13 C尿素呼气实验评估治疗结果。记录治疗期间和治疗后不良反应发生情况。[结果]A组、B组、C组患者Hp根除率按意图治疗(ITT)分析分别为62.9%、86.1%、91.2%,按方案(PP)分析分别为68.8%、88.6%和93.9%。B组、C组的疗效明显优于A组(P<0.05);A组、B组、C组的不良反应发生率分别为18.7%、20.0%、3.0%。C组的不良反应发生率明显低于A组、B组(P<0.05)。[结论]四联疗法对Hp根除率高于三联疗法;四联疗法加枯草杆菌二联活菌尽管不能显著提升Hp根除率,但能有效的减少治疗过程中的不良反应发生率。
[Objective] To observe the curative effect of Bacillus subtilis viable combined with quadruple therapy on Helicobacter pylori (Hp). [Method] A total of 105 patients with chronic erosive gastritis and Hp infection were randomly divided into group A (35 cases), group B (36 cases) and group C (34 cases). A group with triple therapy (pantoprazole 40mg, bid + amoxicillin 1000mg, bid + clarithromycin 500mg, bid), B group with quadruple therapy (pectin bismuth + triple therapy), C group with Bacillus subtilis Live bacteria 0.5, tid + quadruple therapy, each course of treatment were 14d. Treatment at least 4 weeks after the end of the course of 13 C urea breath test evaluation of the results. Record the incidence of adverse reactions during and after treatment. [Results] The Hp eradication rates in groups A, B and C were 62.9%, 86.1% and 91.2% respectively according to the intent-to-treat (ITT) analysis and 68.8%, 88.6% and 93.9% respectively according to the protocol (PP). The efficacy of group B and group C was significantly better than that of group A (P <0.05). The incidences of adverse reactions in groups A, B and C were 18.7%, 20.0% and 3.0%, respectively. Adverse reactions in group C were significantly lower than those in group A and group B (P <0.05). [Conclusion] The quadruple therapy is superior to triple therapy in Hp eradication rate. The quadruple therapy combined with Bacillus subtilis viable can not significantly improve the eradication rate of Hp, but it can effectively reduce the incidence of adverse reactions in the course of treatment.