| Objective: To observe the improvement of clinical symptoms after Helicobacter pylori (HP) eradication treatment in different subgroups of functional dyspepsia (FD) patients.Methods: 222 FD patients were collected and divided into postprandial distress syndrome (PDS) group and epigastric pain syndrome (EPS) group. Rapid urease test and histopathological staining method were used in detection of HP. Patients with HP infection were randomly allocated into two groups: Eradication group and non-eradication group. Eradication group was randomly given two therapeutic schemes: triple therapy (Esomeprazole 20 mg + clarithromycin 500mg + amoxicillin 1.0g, bid×10days), sequential therapy (Esomeprazole 20mg + amoxicillin 1.0g, bid×5days;Esomeprazole 20mg + clarithromycin 500mg + tinidazole 500mg, bid×5days). Non-eradication group and HP non-infection group were treated with Domperidone 10mg (PDS group) or Talcid 1.0g (EPS group), tid×10days. HP re-examined by using 14C-Urea Breath Test (14C-UBT) in the detection of HP infection in eradication group one month after treatment. Clinical symptoms were evaluated before treatment and 4, 8, 12, 26, 52 weeks after treatment, respectively.Results: 1.The prevalence of HP in FD patients in our study was 63.5%. 2. HP eradication rate was 71.6%. 70.6% and 72.7% in the treatment-groups of triple therapy and sequential therapy, and 71.9% and 71.4% in the PDS group and EPS group, respectively (P>0.05). 3. Before and 4w, 8w, 12w, 26w and 52w after treatment, according to a comparison between HP successful-eradication group and HP non-eradication group in two subgroups, a significant symptomatic improvement could be found in every week after successful HP-eradication in EPS group (P<0.05). But in PDS group, symptoms relived in 4w, 8w, 12w and 26w after HP eradication, while not evident in 52w (P=0.520). 4. Therapeutic effect is poorer every week after treatment in HP non-eradication group than HP negative group in two subgroups, with all P<0.05. 5. There was no significant difference in improvement of clinical symptoms between triple-therapy regime and sequential-therapy regime.Conclusions: 1.We found a high of 63.5% HP infection in FD patients. 2. HP is one of the important pathogenic factors of FD and great beneficial can be obtained after eradication treatment whatever triple-therapy regime or sequential-therapy regime, especially in EPS patients, PDS patients can only obtain a short-time relive. 3. Considering the high prevalence of HP and benefits after HP eradication in FD patients, HP detection is necessary when patients consultation. Objective: To investigate the situation of antibiotic-resistance of Helicobacter pylori (HP) in functional dyspepsia (FD), and whether differences exist between two subtypes of postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS).Methods: A total of 141 HP strains were isolated from FD patients who underwent gastroscopy and diagnosed with HP infection in part 1, and tested for their susceptibility to antimicrobials using E-test method by Chinese center of disease control and prevention. Resistance was defined by minimal inhibitory concentration (MIC)≥1mg/L for amoxicillin,≥1 mg/L for clarithromycin,≥8 mg/L for metronidazole,≥4 mg/L for tetracycline,≥1 mg/L for levofloxacin,≥1 mg/L for moxifloxacin,≥4 mg/L for rifampicin,≥1 mg/L for azithromycin,≥8 mg/L for gentamicin. The results of the drug resistance were assessed with chi-square statistics.Results: 1.The positive rate of HP culture was 53.0% (67/141) in this study. 2. The prevalence of resistance of HP strains isolated from the FD patients were 0.0% for amoxicillin, 38.8% for clarithromycin, 43.3% for azithromycin, 71.6% for metronidazole, 37.3% for levofloxacin, 37.3% for moxifloxacin, 0.0% for tetracycline, 3.0% for rifampicin, 1.5% for gentamicin (P<0.01). Moreover, 41 multi-drug resistance strains were found. 3. No associations were detected between HP resistant strains and FD subgroups of PDS and EPS (P>0.05). 4. There was also no statistically significant difference between drug resistance rate and gender (P>0.05).Conclusions: 1. There was no statistically significant difference between drug resistance rate and FD subgroups of PDS and EPS, and the same between drug resistance rate and gender (P>0.05). 2. We can conclude that the resistance rates of HP isolates to metronidazole, clarithromycin, azithromycin, moxifloxacin and levofloxacin were high; then drug susceptibility test can be conducted when necessary. With a low resistance to rifampicin, gentamicin and tetracycline of the HP isolates, these antibiotics can be as an alternative choice to serve as the second-line therapy or the first-line therapy when necessary. |
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