The Effect Of Helicobacter Pylori Eradication On Chronic Non-atrophic Gastritis: A Prospective Multi-center Control Study In China

Background and aimsH. pylori is a spiral-shaped bacterium that colonizes the human gastric mucosa.Epidemiologic and clinical studies have provided convincingevidence thatH. pylori infection is the cause of chronic gastritis, peptic ulcer disease, low grade gastric mucosa associated lymphoid tissue (MALT) lymphoma and gastric adenocarcinoma. Atpresent,a large mount of specialist approve that H. pylori infected patients especiallythose with atrophy and metaplasia should receive intense eradication therapy. Eradication reverses the atrophic changes in the gastric mucosa and the genetic instabilityand may prevent the development of gastric cancer.But people have no idea if H. pylori infected patients with non-atrophy gastritis should receive eradication therapy.In view of the above, the aims of this study were to identify whether H. pylori eradication has any effect on dyspeptic symptoms,erosion,pathology,and inflammatory factor in patients with non-atrophy gastritis infected with H. pylori. Materials and MethodsThis was a multiple-center, prospective, randomization,cohort study conducted at4 Endoscopy Center (Hospitals) in China, Three hundred-eleven patients from 4 centres with non-atrophy gastritis were randomized into 3 equal groups:sequential group received a 10-day sequential therapy with lansoprazole 20mg plus amoxycillin 1 g (all twice daily) for the first 5 days, followed by lansoprazole20mg,clarithromycin 500mg, and Tinidazole 500mg (all twice daily) for the remaining 5 days.no-eradication group and H. pylori negative group received either daily 3g Talcid for 8 weeks.211 patients were reevaluated by 13C-urea breath test or endoscopy after 8 weeks from completion of treatment.Statistical Analysis:The patients'baseline characteristics were presented as descriptive data. We used Fisher's Exact Test. Kruskal-Wallis Statistics, Wilcoxon rank sum to compare categorical data. Dates were analysised by SAS. ResultsTwo hundred-eleven patients were enrolled in this study. There is significant difference found in dyspeptic symptoms,erosion,pathology,and inflammatory factor compared to baseline(P<0.05). Dyspeptic symptoms,pathology,and inflammatory factor of sequential group was significantly lower than that of no-eradication group group(P< 0.05),But there is no significant difference found in erosion score compared to no-eradication group (P>0.05). Compare no-eradication group and H. pylori negative group, there is no significant difference found in dyspeptic symptoms, erosion scor e,pathology,and inflammatory factor (P>0.05)ConclusionIn this prospective multiple-center case-control study, we have demonstrated H. pylori infected patients with non-atrophy gastritis should receive eradication therapy early, especially the elderly and those Patients with atrophy and metaplasia.That was important for clinical gastrointestinal practice.