近日，國際著名雜志《內(nèi)科學年鑒》Archives of internal medicine刊登了研究人員的最新研究成果“Helicobacter pylori Eradication in Functional Dyspepsia: HEROES Trial,。”,，研究人員研究表明，根除幽門螺桿菌可能會緩解消化不良患者的一些癥狀,，即使未發(fā)現(xiàn)其有潰瘍,。
對于那些不能通過調(diào)整飲食、鍛煉和減輕壓力之類的生活方式改變而得到改善的患者,，巴西研究人員提示胃灼熱藥物和抗生素聯(lián)用也許值得嘗試,。研究人員將404例功能性消化不良患者隨機分入兩組：一組接受奧美拉唑單藥治療，另一組接受奧美拉唑聯(lián)合阿莫西林和克拉霉素聯(lián)合治療,，為期10天,。
一年后，抗生素組中49%的患者表示其癥狀改善了至少50%,，與之相比,，對照組的這一比例為37%,。
巴西馬佐萊尼醫(yī)院路易斯埃德蒙博士和同事進行的研究報告表明,，8名患者需要抗生素治療，其中1名患者會出現(xiàn)上述比例的改善,。據(jù)研究人員表示,，關(guān)于清除幽門螺桿菌的影響，較早的研究得出的結(jié)論不明確,，影響了多達一半的世界人口,。
然而他們的研究結(jié)果僅來自于一家醫(yī)院，其它地方可能并不支持,。他們建議檢測非潰瘍性胃痛患者體內(nèi)的細菌并且予以治療,。但他們還呼吁進行更多的研究，以檢驗該措施是否劃算,。
加拿大安大略省漢密爾頓麥克馬斯大學Moyyedi博士的一篇評論指出,，現(xiàn)在有充分的證據(jù)證明清除幽門螺桿菌對小部分患者有用。
他總結(jié)道“將要面臨的挑戰(zhàn)是確定這一影響的潛在機制，以便我們可以前進一步,，更好地治療這種醫(yī)療費用昂貴的常見病,。（生物谷Bioon.com）
延伸閱讀：
Nature：幽門螺旋桿菌適應(yīng)多變條件“主轉(zhuǎn)錄組”確定
幽門螺旋桿菌可“變形”感染不同血型者
J. Med. Chem.：發(fā)現(xiàn)抗幽門螺旋桿菌活性化合物
doi:10.1001/archinternmed.2011.533
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PMID:
Helicobacter pylori Eradication in Functional Dyspepsia: HEROES Trial.
Mazzoleni LE,Heck R,Dahmer FD,et al.
Background Eradication of Helicobacter pylori in patients with functional dyspepsia continues to be a matter of debate. We studied eradication effects on symptoms and quality of life of primary care patients. Methods Helicobacter pylori –positive adult patients with functional dyspepsia meeting the Rome III International Consensus criteria were randomly assigned to receive omeprazole, amoxicillin trihydrate, and clarithromycin, or omeprazole plus placebo for 10 days. Endoscopy and H pylori tests were performed at screening and at 12 months. Outcome measures were at least 50% symptomatic improvement at 12 months using a validated disease-specific questionnaire (primary end point), patient global assessment of symptoms, and quality of life. Results We randomly assigned 404 patients (78.7% were women; mean age, 46.1 years); 201 were assigned to be treated with antibiotics (antibiotics group) and 203 to a control group. A total of 389 patients (96.3%) completed the study. The proportion of patients who achieved the primary outcome was 49.0% (94 of 192) in the antibiotics group and 36.5% (72 of 197) in the control group (P = .01; number needed to treat, 8). In the patient global assessment of symptoms, 78.1% in the antibiotics group (157 of 201) answered that they were better symptomatically, and 67.5% in the control group (137 of 203) said that they were better (P = .02). The antibiotics group had a significantly larger increase in their mean (SD) Medical Outcomes Study 36-Item Short Form Health Survey physical component summary scores than the control group did (4.15 [8.5] vs 2.2 [8.1]; P = .02). Conclusion Helicobacter pylori eradication provided significant benefits to primary care patients with functional dyspepsia.
