Rustamov M.N., Lazebnik L.B. Different probiotic strains as an anti-Helicobacter pylori medication in the treatment of patients with duodenal ulcer // Гастроэнтерология Санкт-Петербурга. - 2018. №2. С. 114.
Different probiotic strains as an anti-Helicobacter pylori medication in the treatment of patients with duodenal ulcer
Rustamov M.N.1, Lazebnik L.B.2
1 Belamsian State Medical University, Minsk, Belarus, 2 Moscow State Medical University of Dentistry, RussiaPurpose: To investigate the effects of probiotics (P) in patients with Helicobacter pylori (HP)-positive duodenal ulcer (DU).
Materials and methods. In this study 200 HP-positive patients with DU were randomized into 4 groups, 50 patients in each. HP was confirmed histologically in samples obtained from the antrum and corpus of stomach. Intragastric and intraduodenal pH-metry by tool Gastroscan-5M, blood analyses also were performed. The following eradication regimens were recommended.
Group I: 10-days twice daily oral administration of PPIs in standard dose, amoxicillin 1000 mg, clarithromycin 500 mg, then 20-days twice daily PPIs plus once daily oral administration of P, containing 3.025 billion alive lyophilized Lactobacillus bulgaricus DDS-14, Lactobacillus rhamnosus, Lactobacillus acidophilus DDS-1 and Bifidobacterium bifidum during 1 month; Group II: PPIs and P once daily and alkaline hydrocarbonate-chloride sodium mineral water (MW) 200 ml trice daily during 1 month; Group III: PPIs and P once daily and chloride sodium MW 200 ml trice daily during 1 month; Group IV: P and PPIs once daily during 1 month. Hierapeutic success was confirmed by a negative histological examination, performed in 4-12 weeks after therapy.
Findings. In Group I dyspeptic complaints (DC) disappeared in 74%, and decreased in 20%. Disappearance of DC was 78%, 76% and 74% in II, III and IV groups respectively. Decrease of DC was 20%, 22% and 24% in II, III and IV groups respectively. The eradication rates were 82%, 80%, 78% and 68% in I, II, III and IV groups, respectively. Healing of DU was noted in 84%, 86%, 84% and 78% of cases, in I, II, III and IV groups, respectively. Intragastric and intraduodenal pH increased in all groups, especially in II. In II, III and IV groups significantly decreased alanine transaminase, asparagines transaminase, blood bilirubin, alkaline phosphatase, cholesterol and triglycerides. Conclusions. Adding P to standard triple therapy improves compliance and efficacy of HP eradication. P may be beneficial in reducing adverse effects and increasing tolerability of HP eradication regimens. The combined use of PPIs, P and alkaline hydrocarbonate-chloride sodium MW is a highly-effective and low-cost alternative therapy in patients with HP-associated DU. This regimen may especially be helpful in patients with a history of gastrointestinal adverse effects with antibiotics, comorbid patients.
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