A Clinical Study Of Bifid Triple Viable In The Adjuvant Treatment For Peptic Ulcer Patients

Objectives:To discuss the value of probiotics in the treatment of adult peptic ulcer,we compared the difference of the treatment effect between the bifid triple viable combined standard therapy and standard therapy for peptic ulcer?PU?patients who were with or without helicobacter pylori?H.pylori?infection.Methods:150 patients who were treated and diagnosed as acute peptic ulcer via gastroscopy from August 2016 to July 2017 in the gastroenterology department of Longgang District Central Hospital of Shenzhen were randomly divided into two groups:the control group?n=75?and the bifid triple viable group?n=75?.The patients in the bifid triple viable group were given bifid triple viable,esomeprazole and hydrotalcite.In addition,if the patients in this group had positive H.pylori infection,amoxicillin and clarithromycin were added.The patients in the control group were given esomeprazole and hydrotalcite.In addition,if the patients in this group had positive H.pylori infection,amoxicillin and clarithromycin were added.The remission rate of clinical symptoms and the incidence of adverse reactions were observed during the treatment.All the patients received gastroscopy examination within 1 week at the end of the treatment.The ulcer healing condition was evaluated by white light imaging?WLI?at first,followed by the determination of the stage of scar by magnifying endoscopy combining with narrow band imaging?ME-NBI?.After 4 weeks of treatment,the H.pylori eradication was re-observed by ¹⁴C-urea breath test(¹⁴C-UBT).The collected data were statistically analyzed by using SPSS 22.0 software.Results:A total of 143 patients completed the study.In the bifid triple viable group,72patients completed the study,2 patients did not complete the whole course of treatment,1patient was lost.In the control group,71 patients completed the study,1 patient did not complete the whole course of treatment,3 patients were lost.There was no statistically significant difference in age,sex,H.pylori positive rate,the proportion of duodenal ulcer and gastric ulcer,ulcer size and other general data between the two groups?P>0.05?.?1?The remission rate of clinical symptoms:after 2 weeks of treatment,the remission rate of clinical symptoms was 91.67%?66/72?in the bifid triple viable group,which was91.55%?65/71?in the control group,there was no statistically significant difference between the two groups?P=0.980?.?2?The incidence of adverse reactions:the incidence of adverse reactions was 15.28%?11/72?in the bifid triple viable group,which was 29.58%?21/71?in the control group,there was statistically significant difference between the two groups?P=0.040?.?3?The ulcer healing under WLI observation mode:the ulcer healing rate was 91.67%?66/72?in the bifid triple viable group,which was 90.14%?64/71?in the control group,there was no statistically significant difference between the two groups?P=0.751?.The ulcer healing rate with H.Pylori infection in the bifid triple viable group was 92.73%?51/56?,which was 88.89%?48/54?in the control group,there was no statistically significant difference between the two groups?P=0.949?.The rate of ulcer healing without H.Pylori infection in the bifid triple viable group was 93.75%?15/16?,which was 94.12%?16/17?in the control group,there was no statistically significant difference between the two groups?P=1.000?.?4?The healing of ulcer under ME-NBI observation mode:The rate of Sc stage healing was 44.44%?32/72?in the bifid triple viable group,which was 25.35%?18/71?in the control group,there was statistically significant difference between the two groups?P=0.017?.This suggested that the quality of ulcer healing in the bifid triple viable group was better than that in the control group.The rate of Sc stage healing with H.pylori infection in the bifid triple viable group was 42.86%?24/56?,which was 25.93%?14/54?in the control group,there was no statistically significant difference between the two groups?P=0.062?.The rate of Sc stage healing without H.pylori infection in the bifid triple viable group was 50%?8/16?,which was 23.53%?4/17?in the control group,there was no statistically significant difference between the two groups?P=0.157?.?5?The eradication rate of H.pylori infection:the eradication rate of H.pylori in the bifid triple viable group was 82.14%?46/56?,which was 64.80%?35/54?in the control group and the difference between the two groups was statistically significant?P=0.039?.Conclusions:Bifid triple viable combined with esomeprazole,hydrotalcite can improve the rate of Sc stage healing,the quality of ulcer healing and the H.pylori eradication rate,meanwhile,it also can reduce the incidence of adverse reactions among these drugs,which was worth of application in the clinical practice.