6. 综述：益生菌在幽门螺旋杆菌感染治疗的临床应用

J Microbiol Immunol Infect. 2014 Oct;47(5):429-37. doi: 10.1016/j.jmii.2013.03.010. Epub 2013 Jun 10.

Clinical application of probiotics in the treatment of Helicobacter pylori infection--a brief review.

Patel A1, Shah N2, Prajapati JB2.

越来越多文献报道益生菌在幽门螺旋杆菌感染治疗中的作用，可作为抗生素的替代或补充，可能可以减少抗生素的用量从而减轻其副作用。尽管抗生素为基础的根除幽门螺杆菌治疗方案90%是有效的，但十分昂贵并且会产生耐药性，可能伴随很多副作用。体外实验中益生菌对幽门螺杆菌有抑制作用。动物实验表明益生菌能有效治疗幽门螺杆菌相关的胃内炎症。近十二个人类研究支持益生菌联合抗生素治疗的疗效，十六个研究单独使用益生菌用于幽门螺杆菌感染作为抗生素的替代治疗。大多数研究表明使用益生菌后幽门螺杆菌相关胃炎好转且胃内幽门螺杆菌负荷量减少。然而，尚未有研究表明仅靠益生菌可以根除幽门螺杆菌。联合益生菌可以减少幽门螺杆菌根除治疗过程中的副作用，对患者有益。长期服用含益生菌株制品可对人的幽门螺杆菌感染有益，尤其可以减少由严重胃内炎症导致症状的风险。

译者点评：益生菌对幽门螺杆菌相关胃炎的益处体现在两方面：一是可以减轻炎症程度缓解症状，二是可提高根除治疗的成功率并降低不良反应发生率。

Abstract

The role of probiotics in the treatment of gastrointestinal infections is increasingly being documented as an alternative or complement to antibiotics, with the potential to decrease the use of antibiotics or reduce their side effects. Although antibiotics-based Helicobacter pylori eradication treatment is 90% effective, it is expensive and causes antibiotic resistance associated with other adverse effects. Probiotics have an in vitro inhibitory effect on H. pylori. Animal studies demonstrated that probiotic treatment is effective in reducing H.pylori-associated gastric inflammation. About 12 human studies investigated the efficacy of combinations of antibiotics and probiotics, whereas 16 studies used probiotic alone as an alternative to antibiotics for the treatment of H. pylori infection. Most of the studies showed an improvement of H. pylori gastritis and decrease in H. pylori colonization after administration of probiotics. However, no study could demonstrate complete eradication of H. pylori infection by probiotic treatment. Probiotic combinations can reduce adverse effects induced by H. pylori eradication treatment and, thus, have beneficial effects in H. pylori-infected individuals. Long-term intakes of products containing probiotic strains may have a favorable effect on H. pylori infection in humans, particularly by reducing the risk of developing disorders associated with high degrees of gastric inflammation.