布拉酵母菌联合三联疗法根除幽门螺杆菌疗效研究

目的探讨布拉酵母菌（S．Boulardii）散剂联合标准三联疗法根除幽门螺杆菌（Helicobacterpylori，H．pylori）的有效性和安全性。方法将210例初次接受根除治疗的Hpylori阳性患者随机分为2组，A组：口服埃索美拉唑＋阿莫西林＋呋喃唑酮，每日2次，疗程10d；B组：与A相同的三联10d疗法，加s．Boulardii散剂口服500mg／次，2次／d，共用药14d。观察患者不良反应发生情况及对药物耐受情况，停药4周后检测H．pylori根除率。结果A、B组Hpylori根除率按方案（PP）分析分别为70．7％、86．3％，按意向性（ITT）分析分别为66．7％、83．8％，B组PP和ITT根除率均高于A组，差异有统计学意义（P〈0．05）；B组不良反应发生率低于A组（8．8％vs 28．3％，P〈0．05）；在药物耐受程度方面，B组明显优于A组（P〈0．05）。结论S．Boulardii散剂联合标准三联疗法作为初次根除Hpylori治疗时可提高根除率，降低不良反应，增加药物耐受程度。

Therapeutic effect of Saccharomyces boulardii Sachets combined with triple therapy for Helicobacter pylori eradication

Objective To assess the efficacy and safety of Saccharomyces boulardii （ S. Boulardii） Sachets com- bined with standard triple therapy for Helicobacter pylori （H. pylori） eradication. Methods A total of 210 H. py- lori-infected patients were enrolled and randomly assigned into two groups. Both groups received esomeprazole ＋ amoxicillin ＋ furazolidone, bid, for 10 days. Group B received in addition S. Boulardii Sachets （500 rag, hid） for 14 days. During the therapy, the adverse reactions and drug tolerance in patients were observed. Four weeks af- ter the course of treatment, the H. pylori eradication rates were assessed. Results The H. pylori eradication rates in groups A and B were 70.7% and 86.3% by Per-protocol （PP） analysis, respectively, and 66.7% and 83.8% by intention-to-treat （ITF） analysis, respectively. The H. pylori eradication rates in group B was significantly higher than that in group A by PP and ITT analyses （P 〈 O. 05 ）. The incidence of adverse reactions was signifi- cantly lower in group B than that in group A （ 8.8% vs 28.3% , P 〈 0. 05 ）. The degree of drug tolerance in group B was significantly higher than that in group A （ P 〈 0. 05 ）. Conclusion S. Boulardii Sachets combined with Standard Triple Therapy can increase the eradication rate of H. pylori with lower adverse reactions and higher de- gree of drug tolerance.