布拉氏酵母菌对Hp感染患者的Hp根除率及肠道菌群的影响

Effect of Saccharomyces boulardii on Hp eradication rateand intestinal flora in patients with Hp infection

    摘要
  • 摘要:
    目的  探究布拉氏酵母菌用于治疗幽门螺杆菌（Hp）感染的疗效，及其对Hp感染患者肠道菌群的影响。
    方法  选取2024年11月－2025年7月间因Hp感染于邢台医学院第二附属医院诊疗的患者280例作为研究对象，使用随机数字表法将所有患者平均分为A、B、C、D共4组，每组70例，4组患者均口服四联抗Hp药物两周。A组患者治疗期间不再服用其他药物；B组患者治疗期间合并使用布拉氏酵母菌散，0.13 g 2次/天，服用两周；C组患者治疗期间合并使用布拉氏酵母菌散，0.25 g 2次/天，服用两周；D组患者治疗期间合并使用布拉氏酵母菌散，0.50 g 2次/天，服用两周。比较4组患者治疗两周后的疗效，治疗前、治疗一周和治疗两周时的肠道菌群分布、胃部指标和免疫指标水平与治疗中的不良反应。
    结果  服药结束38 d后A、B、C、D组根除率分别为82.86%（58/70），91.43%（64/70），94.29%（66/70），95.71%（67/70），差异有统计学意义（P=0.036）。A、B、C、D组患者的疗效评分别为（0.96±0.26）分，（0.75±0.30）分，（0.61±0.15）分，（0.60±0.20）分，差异有统计学意义（P＜0.001）。时间因素对患者消化球菌属、食物谷属菌、明串珠菌属、疣微菌属、毛螺菌属、硝化螺旋菌属及胃部指标和炎症因子水平的影响与治疗方案相关。4组不良事件发生率差异无统计学意义（P=0.523）。
    结论  布拉氏酵母菌（0.50 g 2次/天，服用两周）可有效提高Hp感染患者的根除治疗率和疗效评价，同时改善Hp患者的肠道菌群分布、胃部指标和免疫指标水平。

     

    Abstract:
    OBJECTIVE  To investigate the efficacy of Saccharomyces boulardii in the treatment of Helicobacter pylori （Hp） infection and its impact on the intestinal flora of patients with Hp infection.
    METHODS  A total of 280 patients diagnosed with Hp infection at the Second Affiliated Hospital of Xingtai Medical College from Nov. 2024 to Jul. 2025 were selected as the study subjects. A random number table method was used to divide all patients into 4 groups: A, B, C, D, with 70 patients in each group. During the two-week treatment, all four groups were treated with the oral quadruple anti-Hp medication, group A did not receive any additional medication, group B received S. boulardii powder, 0.13 g twice daily, group C received S. boulardii powder, 0.25 g twice daily and group D received S. boulardii powder, 0.5 g twice daily. The efficacy after two weeks of treatment, intestinal flora distribution, gastric indicators and immune indicator levels before treatment, at one week and two weeks of treatment, and adverse reactions during treatment were compared among the four groups.
    RESULTS  The eradication rate was 82.86% （58/70） in group A, 91.43% （64/70） in group B, 94.29% （66/70） in group C and 95.71% （67/70） in group D after the drug administration for 8 days, with statistically significant differences （P=0.036）. The efficacy scores were （0.96±0.26） points in group A, （0.75±0.30） points in group B, （0.61±0.15） points in group C and （0.60±0.20） points in group D, with statistically significant differences （P＜0.001）. The effects of time on the levels of Peptococcus, Victivallis, Leuconostoc, Verrucomicrobium, Lachnospira, Nitrospira, gastric indicators and inflammatory factors in patients were related to the treatment regimen. There was no statistically significant difference in the incidence of adverse events among the four groups （P=0.523）.
    CONCLUSIONS  S. boulardii （0.50 g twice daily for two weeks） can effectively improve the eradication treatment rate and efficacy evaluation of patients with Hp infection. Meanwhile, it can improve the intestinal flora distribution, gastric indicators and immune indicator levels in patients with Hp infection.

     

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