Quadruple therapy with pantoprazole based effect of combined protective agent of gastric mucosa of Hp positive duodenal ulcers of intestinal microflora

Abstract

Objective To investigate the use of protective agent of gastric mucosa of helicobacter pylori quadraple therapy with pantoprazole based plus(Hp) positive duodenal ulcer intestinal microflora influence. Methods One hundred and twenty cases patients with Hp positive duodenal ulcer who were treated in Fuzhou University Hospital from September 2015 to September 2016 were selected and randomly divided into triplet group, quadruplet group, quadruplet + protective agent group.Triplet group were treated with pantoprazole 40 mg, oral amoxicillin 1 000 mg and oral clarithromycin 500 mg, 2 times one day, for 14 d treatment.Quadruplet group were given triple group therapy plus bismuth potassium citrate 220 mg, 2 times one day, oral treatment, for 14 d treatment.Quadruplet+ protective agent group was given quadruple group therapy plus oral rebamipide 200 mg, 3 times one day.The effect of Hp eradication and the distribution of intestinal microflora after treatment were compared. Results The eradication rate of Hp in triple group was 65.00%(26/40), in quadruplet was 82.50%(33/40), in quadruplet+ protective agent group was 87.50%(35/40), Hp eradication rate in quadruplet+ protective agent group was higher than the triple group and quadruplet group(P<0.05). Overall symptom improvement rate in quadruplet + protective agent group(95.00%) was better than quadruple group(80.00%) and triplet Group(75.00%), the difference was significant(P<0.05). After the eradication of gastric antrum, gastric body was higher than the number of Lactobacillus((1.7424±0.162) vs.(1.6796±0.223), t=4.023, P<0.05). Ggastric acid bacillus, clostridium, and number of enterobacteriaceae were higher than the before eradication((1.742±0.162) lg cfu/mg vs.(1.505±0.250) lg cfu/mg, (2.106±0.083) lg cfu/mg vs.(2.010±0.131) lg cfu/mg, (2.030±0.119) lg cfu/mg vs.(1.609±0.399) lg cfu/mg), the differences were significant(t=3.225, 3.174, 3.571, P<0.05). The number of clostridium quasiballs lower than before eradication((1.654±0.177) lg cfu/mg vs.(1.808±0.300) lg cfu/mg), the difference was significant (t=2.896, P<0.05). The body of the stomach Lactobacillus number was higher than before eradication((1.680±0.223) lg cfu/mg vs.(1.524±0.294) lg cfu/mg), the difference was significant(t=2.974, P<0.05). Clostridium quasiballs quantity was lower than before eradication((1.694±0.216) lg cfu/mg vs.(1.8526±0.1193) lg cfu/mg), the difference was significant(t=1.332, P<0.05). The number of fecal lactobacillus was higher than that before treatment((40.406±3.242) lg cfu/mg vs.(38.2034 + 3.036) lg cfu/mg), the difference was significant (t=3.115, P<0.05). Conclusion Pantoprazole based quadruple therapy plus the eradication rate of gastric mucosal protective agent can improve the use of Hp positive duodenal ulcer Hp, improve the overall symptoms, and it is more conducive to the balance of intestinal micro flora after Hp eradication. Key words: Pantoprazole; Duodenal ulcer; Microbial community; Helicobacter pylori