Efficacy and safety analysis of Saccharomyces boulardii-assisted Vonoprazan quadruple regimen for the radical treatment of Helicobacter pylori infection
-
摘要: 目的 研究布拉氏酵母菌辅助伏诺拉生四联方案根治幽门螺杆菌(Helicobacter pylori，HP)感染的疗效及安全性。方法 选择2022年1月—2024年1月收治的100例HP感染患者，按随机数表法分为对照组、试验组，每组各50例。对照组应用伏诺拉生四联方案，试验组在对照组基础上加用布拉氏酵母菌治疗，比较两组的疗效，观察两组治疗后的胃肠道症状(上腹痛、反酸、恶心、嗳气)缓解率、HP根除率及3个月内的复发率；比较两组的不良反应(腹泻、便秘、头痛、荨麻疹、药物性皮炎)情况。结果 治疗后，试验组的治疗总有效率、胃肠道症状缓解率及HP根除率均高于对照组(均P < 0.05)，HP复发率低于对照组(P < 0.001)；试验组的不良反应率低于对照组(P < 0.05)。结论 布拉氏酵母菌辅助伏诺拉生四联方案利于增强对HP感染的疗效，改善疾病症状及提高HP根除率，减少HP复发，治疗安全性较高，值得临床推广。Abstract: Objective To evaluate the efficacy and safety of the Saccharomyces boulardii-assisted Vonoprazan quadruple regimen for the eradication of Helicobacter pylori (HP) infection.Methods We enrolled 100 patients with HP infection at our hospital between January 2022 and January 2024. Participants were randomly assigned, using a random number table method, to either a control group or an experimental group (n=50 per group). The control group received a standard quadruple regimen with Vonoprazan, while the experimental group received the same regimen in addition to Saccharomyces boulardii. We compared the efficacy of the two groups, assessing the relief rate of gastrointestinal symptoms (epigastric pain, acid reflux, nausea, belching), the HP eradication rate, and the recurrence rate within three months. Additionally, we compared the number of cases of adverse reactions (diarrhea, constipation, headache, urticaria, drug dermatitis) between the two groups during the treatment period.Results After treatment, the experimental group showed a significantly higher total effective rate, a higher relief rate of epigastric pain, acid reflux, nausea, and belching symptoms, and a higher HP eradication rate compared to the control group (P < 0.05). The recurrence rate of HP was also significantly lower in the experimental group (P < 0.001). Furthermore, the experimental group experienced significantly fewer adverse reactions during the treatment period compared to the control group(P < 0.05).Conclusion The Saccharomyces boulardii-assisted Vonoprazan quadruple regime enhances the efficacy of HP eradication, improves disease symptoms, reduces HP recurrence, and demonstrates a high degree of therapeutic safety. This regimen is a promising candidate for widespread clinical adoption.
-
Key words:
- Saccharomyces boulardii /
- Vonoprazan /
- Helicobacter pylori /
- efficacy /
- safety
-
-
表 1 两组患者的临床疗效比较
例(%) 组别 例数 痊愈 有效 无效 总有效 试验组 50 21(42.00) 24(48.00) 5(10.00) 45(90.00) 对照组 50 15(30.00) 21(42.00) 14(28.00) 36(72.00) χ2 5.263 P 0.022 
下载: 导出CSV
表 2 治疗后两组患者的胃肠道症状缓解情况比较
例(%) 组别 例数 上腹痛 反酸 恶心 嗳气 例数 缓解 例数 缓解 例数 缓解 例数 缓解 试验组 50 40 36(90.00) 38 34(89.47) 43 39(90.70) 35 32(91.43) 对照组 50 42 31(73.81) 36 24(66.67) 40 30(75.00) 37 27(72.97) χ2 18.980 15.169 7.792 11.971 P < 0.001 < 0.001 0.005 0.001
下载: 导出CSV
表 3 治疗后两组患者的HP根除、复发情况比较
例(%) 组别 例数 HP根除 HP复发 试验组 50 47(94.00) 3(6.00) 对照组 50 38(76.00) 12(24.00) χ2 12.706 14.881 P < 0.001 < 0.001
下载: 导出CSV
表 4 两组患者的不良反应情况比较
例(%) 组别 例数 腹泻 便秘 头痛 荨麻疹 药物性皮炎 总不良反应 试验组 50 1(2.00) 1(2.00) 1(2.00) 0 0 3(6.00) 对照组 50 7(14.00) 6(12.00) 2(4.00) 2(4.00) 1(2.00) 18(36.00) χ2 5.316 P 0.021
下载: 导出CSV
-
[1] Pulaski M, Dungan M, Weber M, et al. Low prevalence of gastric intestinal metaplasia and Helicobacter pylori on surveillance upper endoscopy in Lynch syndrome[J]. Fam Cancer, 2024, 23(1): 23-27. doi: 10.1007/s10689-023-00354-z
[2] White BE, Wu RM. Isolated jejunal Helicobacter pylori ulcer identified by single-balloon enteroscopy and post-treatment video capsule endoscopy follow-up[J]. Gastrointest Endosc, 2024, 99(5): 855-856. doi: 10.1016/j.gie.2023.10.053
[3] Sugiyama T, Nanjo S, Nakajima T, et al. Helicobacter pylori Reinfection Diagnosed by Endoscopic and Histologic Recurrence in a Patient with Gastric Mucosa-Associated Lymphoid Tissue Lymphoma[J]. Case Rep Gastroenterol, 2023, 17(1): 41-48. doi: 10.1159/000527380
[4] Mohtasham N, Saghravanian N, Zare R, et al. Tumor tissue Helicobacter pylori and human papillomavirus infection in head and neck squamous cell carcinoma patients and association with clinicopathological indices: A cross-sectional medical survey[J]. Dent Res J(lsfahan), 2022, 19: 8. doi: 10.4103/1735-3327.336693
[5] 张国新, 钱海声. 伏诺拉生用于幽门螺杆菌根除的研究进展[J]. 中国实用内科杂志, 2023, 43(4): 277-281.
[6] Piljukov VJ, Sillamaa S, Sedman T, et al. Mitochondrial Irc3 helicase of the thermotolerant yeast Ogataea polymorpha displays dual DNA- and RNA-stimulated ATPase activity[J]. Mitochondrion, 2023, 69: 130-139. doi: 10.1016/j.mito.2023.02.004
[7] Ru Z, Yu M, Zhu Y, et al. Immmunoinformatics-based design of a multi-epitope vaccine with CTLA-4 extracellular domain to combat Helicobacter pylori[J]. FASEB J, 2022, 36(4): e22252.
[8] 朱进华, 冯祥, 华召来, 等. 胃癌高发地区40~69岁人群幽门螺旋杆菌感染与胃部疾病关联分析[J]. 中华肿瘤防治杂志, 2023, 30(13): 765-772.
[9] 陈辉华. 《细说幽门螺杆菌》出版: 儿童幽门螺旋杆菌感染非侵入性检测方法及应用进展研究[J]. 介入放射学杂志, 2022, 31(12): 1263.
[10] 杜亚青, 李向英, 张丽晓, 等. 健脾和降法联合督灸治疗脾胃虚寒型胃癌前病变合并幽门螺旋杆菌感染临床疗效[J]. 中华中医药学刊, 2023, 41(2): 250-254.
[11] 陈金香, 高小俊, 罗茂. 微小RNA调控细胞自噬在幽门螺旋杆菌感染过程中的研究进展[J]. 中国病理生理杂志, 2023, 39(8): 1509-1516.
[12] Li M, Zhang T, Li C, et al. Semi-rationally designed site-saturation mutation of Helicobacter pylori α-1, 2-fucosyltransferase for improved catalytic activity and thermostability[J]. Int Biol Macromol, 2024, 259(Pt 2): 129316.
[13] Satoshi K, Kotaro S, Noriyuki H, et al. Clinicopathologic differences of gastric neoplasms between Helicobacter pylori-infected and-naïve patients: a multicenter retrospective analysis[J]. J Gastroenterol, 2024, 59(1): 1-10. doi: 10.1007/s00535-023-02050-2
[14] Yeh JA, Huang HK, Chou AL, et al. Helicobacter pylori eradication with high-dose proton pump inhibitor-amoxicillin dual therapy: A systematic review and meta-analysis[J]. Int J Antimicrob Agents, 2024, 63(6): 107159. doi: 10.1016/j.ijantimicag.2024.107159
[15] Zhong H, Barrientos A. The zinc finger motif in the mitochondrial large ribosomal subunit protein bL36 m is essential for optimal yeast mitoribosome assembly and function[J]. Biochim Biophys Acta Mol Cell Res, 2024, 1871(4): 119707. doi: 10.1016/j.bbamcr.2024.119707
[16] Ze WU, Peng C, Qingwei M, et al. Effect of Yeast Culture on Plasma Biochemical Indexes and Metabolomics of First-Parity Gilts during Lactation[J]. Chin J Anim Nutr, 2022, 34(4): 2221-2228.
[17] Tang Q, Pollard LW, Homa KE, et al. Acetylation of fission yeast tropomyosin does not promote differential association with cognate formins[J]. Cytoskeleton(Hoboken), 2023, 80(3-4): 77-92.
[18] Abdulrazzaq AI, Khalil KA. Optimization of Skim Milk Based Medium for Biomass Production of Probiotic Lactobacillus Acidophilus ATCC 4356 Using Face Central Composite Design-Response Surface Methodology Approach[J]. J Asian Sci Res, 2022, 12(1): 1-11.
[19] Oruc C, Celik-Bozdo an A, Kurt-Gür G, et al. Determination of the Optimum Annealing Temperature in the Production of CuO Nanoparticles with Antimicrobial Properties[J]. Nano, 2022, 17(2): 2250014. doi: 10.1142/S179329202250014X
[20] Ma J, Godana EA, Yang Q, et al. Effect of the antagonistic yeast Hannaella sinensis on the degradation of Patulin[J]. Biol Control, 2023, 178: 105134. doi: 10.1016/j.biocontrol.2022.105134
[21] Kumar AA, Priyadharshini T, Ragunathan P, et al. Analyzing the interaction of Helicobacter pylori GAPDH with host molecules and hemin: Inhibition of hemin binding[J]. Biophys Chem, 2024, 307: 107193.
[22] 李明, 包鹏云, 陶韦, 等. 混合益生布拉氏酵母菌对刺参幼参生长, 消化酶活力和免疫反应的影响[J]. 广东海洋大学学报, 2022, 42(4): 23-30.
-
计量
- 文章访问数: 431
- 施引文献: 0