Can eradication rate of gastric
Helicobacter pylori be improved by
killing oral Helicobacter pylori?
Han-Yi Song, Yan Li
Han-Yi Song, Yan Li, Department of Gastroenterology,
Shengjing Hospital of China Medical University, Shenyang
110004, Liaoning Province, China
Abstract
AIM: To evaluate the influence of oral Helicobacter
pylori (H. pylori) on the success of eradication therapy
against gastric H. pylori.
METHODS: A total of 391 patients with dyspepsia were
examined for H. pylori using the saliva H. pylori antigen
test (HPS), 13C-UBT, gastroscopy, and gastric mucosal histopathological detection.
Another 40 volunteers without discomfort were subjected
to HPS and 13C-UBT, and served as the control group.
The 233 patients who were 13C-UBT+ were enrolled in
this study and divided into 4 groups. Patients who
were HPS- and 13C-UBT+ (n = 53) received triple therapy
alone. Those who were both HPS+ and 13C-UBT+ (n = 180)
were randomly divided into 3 groups: (i) the O+G+t group
which received triple therapy alone (n = 53);
(ii) the O+G+tm group which received both triple
therapy and mouthrinse treatment (n = 65);
and (iii) the O+G+tmp group which received triple
therapy, mouthrinse, and periodontal treatment (n = 62).
The HPS and 13C-UBT were continued for 4 weeks after completion
of treatment, and the eradication rate of gastric H. pylori and
the prevalence of oral H. pylori in the 4 groups were
then compared.
RESULTS: The eradication rates of gastric H. pylori
in the O-G+t group, the O+G+tm group, and the O+G+tmp
group were 93.3%, 90.0%, and 94.7% respectively; all of
these rates were higher than that of the O+G+t group
(78.4%)[O-G+t group vs. O+G+t group (P = 0.039);
O+G+tm group vs. O+G+t group (P = 0.092); O+G+tmp
group vs. O+G+t group (P = 0.012)]. The eradication of
gastric H. pylori was significantly improved using the
combination of triple therapy, mouthrinse, and periodontal
treatment. The prevalence rates of oral H. pylori in the
O-G+t group, O+G+t group, O+G+tm group and O+G+tmp group
following treatment were 0%, 76.5%, 53.3%, and 50.9%,
respectively [O-G+t group vs. O+G+t group (P<0.0001);
O+G+tm group vs. O+G+t group (P = 0.011); O+G+tmp group
vs. O+G+t group (P = 0.006); O+G+tm group vs. O-G+t group
(P <0.0001); O+G+tmp group vs. O-G+t group (P <0.0001); O+G+tm
group vs. the O+G+tmp group (P = 0.790) ].
Both mouthrinse and periodontal treatment significantly
reduced the prevalence of oral H. pylori.
CONCLUSION: Mouthrinse treatment alone or combined with
periodontal treatment can, to some extent, reduce the prevalence
of oral H. pylori and improve the eradication rate of gastric H. pylori.
Key words: Helicobacter pylori; Dental plaque; Eradication; Periodontal; Mouthrinse
详见:World J Gastroenterol 2013 October 21; 19(39):6645-6650