Clinical Study Of Quadruple Therapy Combined With Microecological Agents For The Eradication Of Helicobacter Pylori Infection

Objective: Helicobacter pylori(Hp)is a gram-negative bacterium that colonizes human gastric mucosa.About 50% of the global population suffers from Hp,which is a major risk factor for gastric cancer.China is a high incidence area of Hp,the infection rate is 42%-64%,with an average of 55%.Proton pump inhibitors(PPI),amoxicillin,clarithromycin,or metronidazole used to be the standard triple regimen for Hp eradication,but over a long period of medication,the resistance rate of metronidazole and clarithromycin gradually increased,resulting in a significant decline in the eradication rate of standard triple therapy.The fifth Hp guideline recommends bismuth quadruple therapy,which consists of PPI and bismuth combined with two antibiotics,and has become the preferred treatment.However,due to antibiotic resistance,compliance,long treatment cycle and individual factors,3%-24% of patients still have treatment failure.Therefore,the need to find new drugs to supplement or replace antibiotics in the treatment of Hp infection has important clinical significance.Studies have shown that antibacterial treatment to eradicate HP will break the homeostasis of intestinal flora,resulting in the disturbance of intestinal flora leading to the occurrence of infectious inflammatory diseases.Because probiotics regulate the composition of intestinal flora,adjuvant therapy can reduce the imbalance of intestinal flora caused by eradication,which may reduce the use of antibiotics or reduce the side effects.However,there is still a lack of consistent conclusions on the clinical efficacy and the influence of microecological preparations on intestinal flora in HP eradication treatment at home and abroad.Based on this,the randomized controlled clinical trial was carried out in this study to analyze the effect of quadruple therapy combined with microecological preparations containing amoxicillin and furazolidone on radical treatment of Helicobacter pylori infection and its influence on intestinal microecology.To observe and analyze the therapeutic effect of HP and the changes of intestinal microecology,so as to provide certain reference for the clinical application of microecological preparations in the treatment of Hp.Method: A total of 110 initial treatment patients with positive Hp infection admitted to the First People’s Hospital of Tancheng County from January 2022 to December 2022 were selected as study objects.A prospective and random numerical control method was used to divide them into two groups.Control group(n=55)was treated with quadruple therapy containing amoxicillin and furazolidone,including rabeprazole sodium enteric capsule and bismuth gel pectin capsule.Amoxicillin,furazolidone,observation group(n=55),combined with bifidobacterium lactobacillus triad viable tablets on the basis of control group,14 days of continuous treatment after the two groups compared Hp eradication rate,clinical efficacy,intestinal microecological level,the incidence of adverse reactions.Results: The eradication rate of ITT was 90.91(50/55)in the observation group and 76.36(42/55)in the control group,χ~2=4.251,P=0.039.The PP eradication rate was 96.15(50/52)in the observation group and 84.00(42/50)in the control group,χ~2=4.258,P=0.039.The eradication rate of Hp in observation group was higher than that in control group,and the difference was statistically significant(P<0.05).The total effective rate of the observation group(98.18%)was higher than that of the control group(87.27%),with statistical significance(P>0.05).Comparison of Lactobacillus,bifidobacterium and enterococcus between the two groups before treatment(P>0.05).After treatment,Lactobacillus,bifidobacterium and enterococcus decreased significantly in the control group,while no abnormal changes were observed in the observation group,and the number of bacteria was higher than that in the control group,the difference was statistically significant(P<0.05).Among 110 patients,21 adverse reactions occurred,with a total incidence of 19.09%(21/110).There were 6 cases in the observation group(10.91%,6/55)and 15 cases in the control group(27.27%,15/55).The total incidence of adverse reactions in the observation group was lower than that in the control group,χ~2=4.767,P=0.029,and the difference was statistically significant(P<0.05).Conclusion: Quadruple therapy containing amoxicillin and furazolidone combined with microecological preparation can increase the radical treatment rate of Hp,significantly improve clinical symptoms,and has good therapeutic effect,can increase the number of beneficial bacteria probiotics,reduce the incidence of adverse reactions,good safety,and can be used as the choice of first-line eradication therapy for Hp.