Observation On The Efficacy Of Clostridium Butyricum Combined With Bismuth Quadruple Therapy In The Treatment Of Hp Infection

Objective: To observe the clinical efficacy and safety of the addition of Clostridium butyricum in the treatment of sputum quadruple therapy to provide a safer and more effective treatment for Hp.Methods: This study was selected from December 2017 to December2018,and was treated in the Department of Gastroenterology,The People's Hospital of Xiang xi.The gastroscopic examination confirmed the diagnosis of gastric,duodenal ulcer or chronic gastritis with 14 C urea breath test(14C-UBT).120 patients were positive,and patients who met the criteria were randomly divided into probiotics group(group A),ie,Clostridium brocollii live tablets combined with bismuth-containing agent:rabeprazole enteric-coated tablets(10 mg Bid)+ Bismuth colloidal pectin dry suspension(150mg Qid)+ amoxicillin capsules(1000 mg Bid)+clarithromycin capsules(500mg Bid)+ Clostridium butyricum live bacteria Tablets(700mg Tid);tincture quadruple group(group B): rabeprazole enteric-coated tablets(10 mg 2 times / day)+ Bismuth colloidal pectin dry suspension(150mg Qid)+ Amoxicillin capsules(1000 mg Bid)+clarithromycin capsules(500 mg Bid).Both groups were treated for 14 days.Record the patient's existing symptoms of gastrointestinal discomfort(upper abdominal pain,bloating,acid reflux,heartburn,early satiety,hernia,nausea,vomiting,etc.)before treatment.Follow-up patients with improvement of gastrointestinal symptoms during treatment and whether there is new Symptoms,withdrawal after the end of the treatment,1 monthreview 14C-UBT assessment of Hp eradication.Results: In the 120 patients,7 patients were lost to follow-up.The results of intentional analysis(ITT)of Hp eradication rate in group A and B showed that the eradication rate of probiotic group(group A)and tincture group(group B)were respectively 83.3%,80.0%,the difference between the two groups was not statistically significant(P=0.637);the Hp eradication rate of the A and B groups was followed by the study protocol analysis(PP)results: probiotics group(group A),The eradication rates of the four groups(group B)were 87.7% and 85.7%,respectively,and the difference between the two groups was not statistically significant(P=0.753).During the treatment,the patient's adverse reactions(headache,mouth pain,abdominal pain,nausea,diarrhea,constipation,rash)were observed.There were 10 cases of adverse reactions in the probiotic group,including 1 case of headache,2 cases of mouth pain,2 cases of abdominal pain.3 cases of nausea,0 cases of diarrhea,2 cases of constipation,0 cases of rash,and 22 cases of adverse reactions in the quadruple group,0 cases of headache,1 case of rash,2 cases of mouth pain,nausea 4 For example,4cases of abdominal pain,5 cases of constipation and 6 cases of diarrhea,the incidence of adverse reactions were statistically different(P=0.01 <0.05).The improvement of clinical efficacy in the two groups: 34 patients in the group A were followed up,34 were effective,17 were effective,6 were ineffective,the total effective rate was 89.4%;56 patients in group B,33 were effective,16 were effective There were 7 cases with ineffectiveness and the total effective rate was 87.5%.There was no significant difference in the improvement of clinical efficacy between the two groups(P=0.943>0.05).Conclusion: 1.There was no significant difference in the eradication rate of Hp between the two groups in the efficacy of Clostridium butyricum combined with Bismuth quadruple therapy and Bismuth quadruple therapy.2.Bismuth quadruple therapy combined with Clostridium butyricum can significantly reduce the incidence of adverse reactions,especially diarrhea,and improve patient compliance.3.Clostridium butyricum tablets combined with bismuth quadruple therapy can improve the clinical symptoms,but there is no significant difference.