荆花胃康胶丸联合双歧杆菌四联活菌根除幽门螺杆菌对服用抗血小板药物老年患者消化道出血的影响
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摘要
目的:观察荆花胃康胶丸联合双歧杆菌四联活菌根除幽门螺杆菌(HP)感染治疗对服用抗血小板药物老年患者消化道出血的影响。方法:320例60～80岁每日服用100 mg阿司匹林、14C-尿素呼气试验(14CUBT) HP阳性的老年患者均分为联合组(采用荆花胃康胶丸联合双歧杆菌四联活菌片及四联疗法)及单一组(采用四联疗法),分别在治疗前、治疗2周时检测血清白细胞介素-8(IL-8)、IL-10及C反应蛋白(CRP)水平,比较治疗2周时的HP根除率及症状缓解率、记录治疗过程中的不良反应,比较HP阴性组(治疗后成功根除HP患者)和HP阳性组(根除HP治疗失败患者)随访1年的消化道出血发生率。结果:治疗2周时,联合组及单一组患者血清IL-8、IL-10及CRP水平显著低于治疗前(P <0. 05),联合组血清IL-8、IL-10及CRP水平显著低于单一组(P <0. 05);联合组患者HP根除率(91. 25%)高于单一组(79. 38%,P <0. 01),不良反应发生率(16. 25%)低于单一组(31. 88%,P <0. 01),临床症状缓解率(90. 62%)高于单一组(73. 12%,P <0. 01); HP阴性组随访1年的消化道出血发生率(4. 03%)低于HP阳性组(12. 77%,P <0. 05)。结论:荆花胃康胶丸与双歧杆菌四联活菌片联合四联疗法根除HP治疗对服用抗血小板药物、同时有HP感染的老年患者的效果优于单一四联疗法,根除HP感染可以有效降低服用抗血小板药物老年人消化道出血的风险。
Objective: To investigate the effect of Jinghua Weikang capsules combined with Bifidobacterium quadruplet on Digestive tract Hemorrhage in elderly patients with Anti-Platelet drugs and infection of Helicobacter pylori( HP). Methods: 320 60-80-year-old patients with 100 mg aspirin daily and 14 C-urea breath test( 14 C-UBT) HP positive were divided into two groups: combination group( Jinghua Weikang capsules combined with Bifidobacterium quadruplet active bacterial tablets and quadruple therapy) and single group. Serum levels of interleukin-8( IL-8),IL-10 and C-reactive protein( CRP) were measured before treatment and for 2 weeks of treatment. HP eradication rate and symptom remission rate at 2 weeks after treatment were compared. Adverse reactions during treatment were recorded. The incidence of gastrointestinal bleeding was compared between HP-negative group( successful eradication of HP patients after treatment) and HP-positive group( Eradication of failed patients with HP) after 1 year follow-up. Results: After 2 weeks of treatment,the serum levels of IL-8,IL-10 and CRP in the combined group and single group were significantly lower than those before treatment( P < 0. 05). The levels of serum IL-8,IL-10 and CRP in the combined group were significantly lower than those in the single group( P < 0. 05). The HP eradication rate in the combined group( 91. 25%) was higher than that in the single group( 79. 38%,P < 0. 01). The incidence of adverse reactions( 16. 25%) was lower than that of the single group( 31. 88%,P < 0. 01). The clinical symptom remission rate( 90. 62%) was higher than that of single group( 73. 12%,P < 0. 01). The incidence of gastrointestinal bleeding in HP negative group( 4. 03%) was lower than that in HP positive group( 12. 77%,P < 0. 05). Conclusion: The eradication of HP by Jinghua Weikang capsules and Bifidobacterium Tetravaccine tablets combined with quadruple therapy on elderly patients taking antiplatelet drugs can improve the eradication rate of HP and theremission rate of clinical symptom,reduce inflammation and adverse reactions in elderly patients. The eradication of HP therapy can effectively reduce the risk of digestive tract hemorrhage in elderly patients taking anti-platelet drugs.
Objective: To investigate the effect of Jinghua Weikang capsules combined with Bifidobacterium quadruplet on Digestive tract Hemorrhage in elderly patients with Anti-Platelet drugs and infection of Helicobacter pylori( HP). Methods: 320 60-80-year-old patients with 100 mg aspirin daily and 14 C-urea breath test( 14 C-UBT) HP positive were divided into two groups: combination group( Jinghua Weikang capsules combined with Bifidobacterium quadruplet active bacterial tablets and quadruple therapy) and single group. Serum levels of interleukin-8( IL-8),IL-10 and C-reactive protein( CRP) were measured before treatment and for 2 weeks of treatment. HP eradication rate and symptom remission rate at 2 weeks after treatment were compared. Adverse reactions during treatment were recorded. The incidence of gastrointestinal bleeding was compared between HP-negative group( successful eradication of HP patients after treatment) and HP-positive group( Eradication of failed patients with HP) after 1 year follow-up. Results: After 2 weeks of treatment,the serum levels of IL-8,IL-10 and CRP in the combined group and single group were significantly lower than those before treatment( P < 0. 05). The levels of serum IL-8,IL-10 and CRP in the combined group were significantly lower than those in the single group( P < 0. 05). The HP eradication rate in the combined group( 91. 25%) was higher than that in the single group( 79. 38%,P < 0. 01). The incidence of adverse reactions( 16. 25%) was lower than that of the single group( 31. 88%,P < 0. 01). The clinical symptom remission rate( 90. 62%) was higher than that of single group( 73. 12%,P < 0. 01). The incidence of gastrointestinal bleeding in HP negative group( 4. 03%) was lower than that in HP positive group( 12. 77%,P < 0. 05). Conclusion: The eradication of HP by Jinghua Weikang capsules and Bifidobacterium Tetravaccine tablets combined with quadruple therapy on elderly patients taking antiplatelet drugs can improve the eradication rate of HP and theremission rate of clinical symptom,reduce inflammation and adverse reactions in elderly patients. The eradication of HP therapy can effectively reduce the risk of digestive tract hemorrhage in elderly patients taking anti-platelet drugs.
引文
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[6]张文海,梁艳平,杨建,等.幽门螺杆菌感染与老年高血压患者新发心脑血管疾病的相关性研究[J].中华医院感染学杂志,2016,26(24):5604-5606.
[7]成虹,胡伏莲,盛剑秋,等.荆花胃康胶丸联合含呋喃唑酮三联或四联疗法补救治疗幽门螺杆菌感染的多中心随机对照研究[J].中华医学杂志,2016,96(40):3206-3212.
[8]张霖.序贯疗法与三联疗法根除幽门螺杆菌的临床疗效对比[J].临床消化病杂志,2015,27(5):262-265.
[9]刘文忠,谢勇,陆红,等.第五次全国幽门螺杆菌感染处理共识报告[J].中华内科杂志,2017,56(7):532-545.
[10]陶海燕,陆燕,黄晓宇.荆花胃康胶丸治疗HP阳性慢性胃炎临床观察[J].陕西中医,2017,38(2):159-160.
[11]黄灿,程晟,沈素.微生态制剂及其临床应用研究进展[J].中国医院用药评价与分析,2015,15(4):440-442.
[12]王韶华,刘刚,郑复鹏.益生菌在根除幽门螺杆菌治疗中作用的探讨[J].临床内科杂志,2015,32(10):685-687.
[13]杨文伟,潘珍红.双歧杆菌四联活菌片对肠易激综合征患者血清P物质和神经肽Y水平的影响疗效观察[J].中国药师,2015,18(5):794-796.
[14]李雪龙,付喜爱,闫天文,等.双歧杆菌四联活菌片体外生物拮抗作用的研究[J].中国微生态学杂志,2018,30(2):164-167,188.
[15]曹少红,李敏.益生菌预处理联合四联疗法对根除幽门螺杆菌的效果观察[J].安徽医药,2018,22(5):983-985.
[16]许英铭,林举辉,梁心慧,等.荆花胃康胶丸四联疗法治疗慢性胃炎及根除幽门螺杆菌的疗效观察[J].内科及危重症杂志,2016,22(1):41-42.
[2]李忠明,夏平达,周琴.幽门螺杆菌感染与冠心病患者上消化道出血的相关性研究[J].中华医院感染学杂志,2015,25(10):2188-2190.
[3]王涛,徐炳欣,吴斌.根除幽门螺杆菌对老年心血管疾病患者长期服用小剂量阿司匹林所致消化道出血的影响[J].慢性病学杂志,2018,19(4):391-393.
[4]MELTZER A C,WINTER L E,KULIE P,et al. Treating gastritis,peptic ulcer disease,and dyspepsia in the emergency department:the feasibility and patient-reported outcomes of testing and treating for helicobacter pylori infection[J]. Ann Emerg Med,2015,66(2):131-139.
[5]杨湛南,方文,黄茜.幽门螺杆菌感染对冠心病患者抗血小板治疗后上消化道出血的影响[J].贵州医科大学学报,2017,42(9):1050-1054.
[6]张文海,梁艳平,杨建,等.幽门螺杆菌感染与老年高血压患者新发心脑血管疾病的相关性研究[J].中华医院感染学杂志,2016,26(24):5604-5606.
[7]成虹,胡伏莲,盛剑秋,等.荆花胃康胶丸联合含呋喃唑酮三联或四联疗法补救治疗幽门螺杆菌感染的多中心随机对照研究[J].中华医学杂志,2016,96(40):3206-3212.
[8]张霖.序贯疗法与三联疗法根除幽门螺杆菌的临床疗效对比[J].临床消化病杂志,2015,27(5):262-265.
[9]刘文忠,谢勇,陆红,等.第五次全国幽门螺杆菌感染处理共识报告[J].中华内科杂志,2017,56(7):532-545.
[10]陶海燕,陆燕,黄晓宇.荆花胃康胶丸治疗HP阳性慢性胃炎临床观察[J].陕西中医,2017,38(2):159-160.
[11]黄灿,程晟,沈素.微生态制剂及其临床应用研究进展[J].中国医院用药评价与分析,2015,15(4):440-442.
[12]王韶华,刘刚,郑复鹏.益生菌在根除幽门螺杆菌治疗中作用的探讨[J].临床内科杂志,2015,32(10):685-687.
[13]杨文伟,潘珍红.双歧杆菌四联活菌片对肠易激综合征患者血清P物质和神经肽Y水平的影响疗效观察[J].中国药师,2015,18(5):794-796.
[14]李雪龙,付喜爱,闫天文,等.双歧杆菌四联活菌片体外生物拮抗作用的研究[J].中国微生态学杂志,2018,30(2):164-167,188.
[15]曹少红,李敏.益生菌预处理联合四联疗法对根除幽门螺杆菌的效果观察[J].安徽医药,2018,22(5):983-985.
[16]许英铭,林举辉,梁心慧,等.荆花胃康胶丸四联疗法治疗慢性胃炎及根除幽门螺杆菌的疗效观察[J].内科及危重症杂志,2016,22(1):41-42.
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