The Role Of Bifico In The Intragastric Dysbacteriosis During Anti-helicobacter Pylori Therapy

Objective:To observe the role of Bifico in the intragastric dysbacteriosis during anti-H.pylori therapy。Methods:Divide 120 H.pylori positive patients with peptic ulcer into two groups randomly.Treat the control group with the triple therapy, Esomeprazole magnesium+Amoxicillin+Furazolidone.Treat the treatment group with the same triple therapy plus Bifico.At gastroscopy,the gastric juice was obtained for power of hydrogen(pH) measurement and bacterial culture before the pretherapy and after a 14-day-treatment respectively for observing the changes of the gastric juice pH value and intragastric bacterial flora,the therapy-related side effects and the ulcer and erosive healing rate.Re-examination the ¹⁴C urea-breath test(¹⁴C-UBT)and evaluate H.pylori eradication rates four weeks after the treatment.Result:(1)Changes of the fasting gastric juice pH values:The fasting gastric juice pH values were 1.45±0.42 before treatment and 4.00±1.02 after treatment in the control group.the fasting gastric pH values were 1.48±0.35 before treatment and 3.93±0.98 after treatment in the treatment group.After anti-Helicobacter pylori therapy,both the gastric juice pH values were significantly higher(P＜0.05)in the two groups。 There is no statistical significance of the difference between the two groups before and after the treatment.(2)The change of the intragastric bacterial flora:The presence of intragastric bacterial overgrowth was related to the increase of the fasting gastric juice pH values.The gastric juice bacterial cultures were negative in the two groups before treatment. After treatment the bacterial culture positive rates were 46.7%,63.3% respectively in the treatment group and control group.The difference between the two groups was not significant(P＞0.05).Whlie the fasting gastric juice pH values above 4,the bacterial culture positive rates were 80.0%,97.4%respectively in the treatment group and in the control group.In the treatment group the bacterial culture positive rate were lower than that of control group(P＜0.05).And in the treatment group the gastric juice bacterial concentration was significantly lower than that of control group(P＜0.05).Some intragastric isolated strains are resistance to antisiotics in the two groups,the mainly by gram-negative bacteria.Gram-negative bacteria are resistance to antisiotics such asβ-lactam and sulfonamide antisiotics.(3)The H.pylori eradication rates were evaluated by intention-to-treat(ITT)and per-protocol(PP)analysis. The ITT analysis show 68.3%and 55.0%respectively in the treatment group and control group.The ITT analysis between the two groups was not significant(P＞0.05).The PP analysis show 80.4%and 62.4% respectively in the treatment group and control group.The PP analysis of the treatment group was significantly higher than that of control group(P＜0.05).The addition of Bifico to triple therapy improved H.pylori eradication rates significantly.(4)The adverse effects:The adverse effects rates were 11.7%in treatment group,which was lower than 30% in control group(P＜0.05).Probiotics Bifico show a positive impact on H. pylori therapy-related side effects.(5)The gastroscopy reviewed after two weeks traetment,the ulcer and erosion healing rate:The ulcer and erosion healing rate was 80%and 68.7%in treatment group,and 73.3% and 40.7%in control group.The ulcer healing rate has no significant difference in the two groups,while erosion healing rate of treatment group was higher than that of control group(P＜0.05).Conclusion:Our study demonstrates that after anti-H.pylori treatment the gastric juice pH values were significantly raised and intragastric bacterial overgrowth(IBO).When the gastric juice pH values above 4,the prevalence and density of the non-H.pylori bacterial flora in the gastric juice of the treatment group had lower significantly than that of control group.The Bifico reduces the prevalence and density of the non-H.pylori bacterial flora in the gastric juice also the therapy-related side effects.It improves the anti-H.pylori eradication rate, promotes the ulcer and erosion healing.