RESUMO
Objective:To analyze the efficacy and cost-effectiveness of probiotics in initial Helicobacter pylori ( H. pylori) eradication therapy. Methods:A total of 267 patients with positive H. pylori infection were randomly assigned to two groups, the control group ( n=133) received a 14-day bismuth agent quadruple therapy and the study group ( n=144) received conventional quadruple therapy plus probiotics from January 2020 to August 2021. Eradication status was assessed 4-12 weeks after treatment. The H.pylori eradication rate, adverse reactions, and cost-effectiveness were compared between the two groups. Results:The H.pylori eradication rate was higher in study group than that in the control group in intention-to-treat (ITT) (80.6%(108/134), 95% CI:73.8%-87.4% vs. 68.4%(91/133), 95% CI:60.4%-76.4%, P=0.022) and per-protocol (83.1%(108/130), 95% CI:76.5%-89.6% vs. 72.2%(91/126), 95% CI:64.3%-80.2%, P=0.037). The incidence of adverse effects in the study group was lower than that in the control group (8.2%(11/134) vs. 18.8%(25/133), χ 2=6.415, P=0.011). Cost-effectiveness analysis showed that compared with the control group, the incremental cost-effectiveness ratio (ICER) of the study group was 1 010.49 yuan. The single factor sensitivity analysis showed that the H.pylori eradication rate of the study group had a greater impact on the results, followed by that of the control group and the cost of bifidobacterium quadruplex viable tablets. The probability sensitivity analysis showed that when the willingness to pay value (WTP) was 2 500 yuan, the probability that the probiotics combined with the bismuth agent quadruple therapy group was more cost-effective than the simple bismuth agent quadruple therapy group was 91.2%. Conclusion:As initial Helicobacter pylori treatment, probiotics combined with the bismuth agent quadruple scheme has a higher eradication rate and a lower incidence of adverse events than the bismuth agent quadruple scheme.
RESUMO
Objective To explore the clinical character istics of bile reflux gastritis. Methods We observed 1328 patients with bile reflux gastritis(excluding gastritis of the remnant stomach),and selected 425 superficial gastritis as control group.All the patients took helicobacter pylori(Hp) rapid urease examination. 664 cases in observed group and all in patients of control group were examined for bile disease by UB. Results In 1328 patients,there were 797 male and 531 female,and the ratio of male and female was 1.5/1.The detecting rate of bile reflux gastritis was decreased along with aging. Among all the patients,there were 651 simple superficial gastritis(49%),86 gastric ulcer(6.5%),412 duodenal ulcer (31%),122 combined ulcer(9.2%) and 57 other disease(4.7%).In observed group,1030 HP(77.56%) were regative; 298 Hp(22.44%) were positive,and in control group,282 Hp(66.35%) were regative,147 Hp(33.65%) were positive.The amount of gallbladder disease resection was 221(33.3%),which was more than that of control group(16.9%). Conclusion The detecting rate of bile reflux gastritis was decreased along with aging.Bile reflux gastritis is more often combined with ulcer disease or gallbladder disease. The Hp infection rate of bile reflux gastritis is significant lower than that of non-bile reflux gastritis.