岩藻多糖联合铋剂四联疗法对幽门螺杆菌相关性胃炎的临床疗效
| 作 者：韦飞, 邵建国, 陈琳, 张玉姣, 李秀清, 方海云, 倪俊, 杨志欣, 张晓杰, 刘超越 |
| 单 位：南通大学第三人民医院 |
| 基金项目：海藻活性物质国家重点实验室开放基金项目 |
| 摘 要： |
| 背景：全球幽门螺杆菌（Hp）感染率高达43.1%，抗菌药物耐药和四联疗法导致的胃肠道不适是目前Hp根除面临的严峻挑战。目的：探讨岩藻多糖联合铋剂四联疗法对Hp相关性胃炎的疗效。方法：纳入2022年1月—2025年1月4家中心收治的Hp感染患者110例，随机分为4组，A组接受铋剂四联疗法（奥美拉唑20 mg bid+甲硝唑400 mg bid+阿莫西林1 g bid+枸橼酸铋钾300 mg bid），B、C和D组分别接受高（3 g/d）、中（2 g/d）、低剂量（1 g/d）岩藻多糖+铋剂四联疗法，疗程均为2周。治疗结束4周后采用14C/13C-尿素呼气试验评估Hp根除情况，治疗前后以胃肠道症状评定量表（GSRS）评估患者的胃肠道症状，基于活检病理评估慢性炎症严重程度，治疗过程中记录不良反应发生情况。结果：A、B、C和D组的Hp根除率、GSRS评分、慢性炎症严重程度、不良反应总体差异有统计学意义（P均<0.05）。与A组相比，B组Hp根除率显著升高（P<0.05），GSRS评分显著降低（P<0.05），慢性炎症明显改善，不良反应发生率显著降低（P<0.05）。C、D组上述指标与A组无明显差异。结论：高剂量岩藻多糖（3 g/d）联合铋剂四联疗法能显著提高Hp根除率，改善胃炎相关临床和组织学表现，并降低不良反应发生率，可作为根除Hp的辅助手段。 |
| 关键词：岩藻多糖；幽门螺杆菌；胃炎；治疗 |
Clinical Efficacy of Fucoidan Combined With Bismuth-containing Quadruple Therapy for Helicobacter pylori-associated Gastritis
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| Abstract: |
| Background: The global prevalence of Helicobacter pylori (Hp) is as high as 43.1%. Antibiotic resistance and gastrointestinal discomfort induced by quadruple therapy are significant challenges for Hp eradication. Aims: To investigate the efficacy of fucoidan combined with bismuth-containing quadruple therapy in the treatment of Hp-associated gastritis. Methods: A total of 110 Hp-infected patients from 4 centers from January 2022 to January 2025 were enrolled and randomly allocated into 4 groups. Patients in group A received bismuth-containing quadruple therapy (omeprazole 20 mg bid + metronidazole 400 mg bid + amoxicillin 1 g bid + bismuth potassium citrate 300 mg bid). Patients in group B, C, and D received the same quadruple therapy combined with high- (3 g/d), medium- (2 g/d), and low-dose (1 g/d) fucoidan, respectively. The course of treatment was 2 weeks. Hp eradication was assessed by 14C/13C-urea breath test 4 weeks after treatment. The gastrointestinal symptom rating scale (GSRS) score and severity of chronic inflammation based on biopsy pathology were evaluated before and after treatment, and the adverse reactions during the treatment period were recorded. Results: There were statistically significant differences in Hp eradication rate, GSRS score, severity of chronic inflammation, and adverse reactions among group A, B, C, and D (all P<0.05). Compared with group A, group B showed a significantly higher Hp eradication rate (P<0.05), lower GSRS score (P<0.05), alleviation of chronic inflammation, and a significant reduced incidence of adverse reactions (P<0.05). No significant differences in the above-mentioned indices were found between group C, D and group A. Conclusions: High-dose fucoidan (3 g/d) combined with bismuth-containing quadruple therapy significantly improves the Hp eradication rate, ameliorates clinical manifestations and histological changes of gastritis, and reduces the incidence of adverse reactions, suggesting its potential as an adjunctive approach for Hp eradication. |
| Keywords: Fucoidan; Helicobacter pylori; Gastritis; Therapy |
| 投稿时间：2025-03-13 |
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