【摘要】 目的观察益生菌联合四联补救疗法作为根除幽门螺杆菌失败后二线治疗辅助方案的临床疗效。方法将165例幽门螺杆菌首次根除治疗失败且经胃镜和病理学检查证实的胃十二指肠溃疡患者随机分入3组,每组55例。预防用药组、巩固用药组分别在标准四联疗法的前后给予双歧三联活菌制剂治疗,对照组仅予标准四联疗法治疗,3组患者均给予保护胃黏膜治疗。所有患者于停药1个月后复查胃镜和¹⁴C呼气试验。比较3组患者的幽门螺杆菌根除率、临床症状改善总有效率、溃疡愈合率和不良反应发生率。结果预防用药组、巩固用药组的幽门螺杆菌根除率分别为86.5%（45/52）和88.7%（47/53）,均显著高于对照组的68.0%（34/50,P值均<0.05）;溃疡愈合率分别为88.5%（46/52）和88.7%（47/53）,均显著高于对照组的70.0%（35/50,P值均<0.05）;不良反应率分别为11.5%（6/52）和11.3%（6/53）,均显著低于对照组的30.0%（15/50,P值均<0.05）。预防用药组与巩固用药组间的幽门螺杆菌根除率、溃疡愈合率和不良反应发生率,以及3组间的临床症状改善总有效率的差异均无统计学意义（P值均>0.05）。结论两种含益生菌的四联补救疗法均能提高幽门螺杆菌首次根除治疗失败的患者的幽门螺杆菌根除率和溃疡愈合率,并能降低不良反应发生率。更多还原

【Abstract】 Objective To observe the clinical efficacy of complementary second-line rescue therapy by probiotics in combination with quadruple therapy on failed eradication of Helicobacter pylori（H.pylori）.Methods A total of 165 patients,who were diagnosed as gastric or duodenal ulcer by histopathology and endoscopy and failed in eradication of H.pylori,were allocated randomly into three groups（n=55）.Quadruple therapy was used in control group.Bifid triple viable powder was given before quadruple therapy in prophylactic group and given after quadruple therapy in consolidation group,respectively.Gastric mucosal protective drugs were given in all the three groups.Gastroscopy and ¹⁴C breath test were performed at least four weeks after medication was discontinued.The eradication rate of H.pylori,improvement of symptoms,healing rate of peptic ulcers and incidence of drug side effects were compared between three groups.Results The eradication rates of H.pylori were 86.5%（45/52）and 88.7%（47/53）in prophylactic group and consolidation group,respectively,which were significantly higher than that in the control group（68.0%,34/50,both P<0.05）.The healing rates of peptic ulcer were 88.5%（46/52） and 88.7%（47/53） in prophylactic group and consolidation group,which were also higher than that in the control group（70.0%,35/50,both P<0.05）.The incidence of drug side effects were 11.5%（6/52） and 11.3%（6/53） in prophylactic group and consolidation group,which were significantly lower than that in the control group（30.0%,15/50,both P<0.05）.There were no significant differences between the prophylactic group and consolidation group with regard to H.pylori eradication rate,healing rate of peptic ulcer or incidence of drug side effects（all P>0.05）.There were no significant differences in the improvement of symptoms between three groups（all P>0.05）.Conclusion The eradication rate of H.pylori and healing rate of peptic ulcer can be increased and incidence of adverse drug reaction can be decreased when probiotics is used both before and after quadruple therapy on first failure of eradication of H.pylori.更多还原