Effect of probiotics combined with bismuth-containing quadruple therapy on pediatric helicobacter pylori-associated gastritis

Gan Pengfei; Yang Hong; Peng Shuxian

doi:10.3969/j.issn.1672-8157.2025.03.024

Abstract：Objective To investigate the influence of probiotics combined with bismuth-containing quadruple therapy on intes-tinal microecology,immunity and pepsin in children with helicobacter pylori(Hp)infection-related gastritis.Methods A total of 104 children with Hp infection-related gastritis admitted to Zigong First People's Hospital from May 2021 to May 2023 were selected as the research subjects,and divided into the control group(n=52)and experimental group(n=52)by Doll's random grouping meth-od.The patients in the control group were treated with omeprazole+amoxicillin+colloidal bismuth pectin capsule+metronidazole,while those in the experimental group were given probiotics based on the regimen in the control group.Symptom relief degree and Hp eradication rate after treatment and Hp recurrence rate at 6 months after treatment were observed in the two groups.The gastro-in-testinal colony logarithm,immune function,pepsinogen I(PGI),pepsinogen II(PGII)and serum progastrin-releasing peptide(Pro-GRP)before and after treatment were compared between the two groups,and the adverse reactions during treatment were recorded in both groups.Pairwise comparison was performed by t test,and enumeration data were analyzed by chi-square test and rank sum test.Results The symptom relief degrees in the experimental group were greater than those in the control(abdominal pain and disten-sion:(0.91±1.23)points vs(1.32±0.56)points,acid reflux burning:(0.63±0.79)points vs(1.13±0.89)points,appetite loss:(0.76±0.51)points vs(1.03±0.56)points)(t=2.187,3.029,2.570,all P<0.05).The Hp eradication rate was higher in the experimental group than in the control(94.23%(49/52)vs 78.85%(41/52))(χ2=5.283,P=0.022),while the recurrence rate was lower in the experimental group than in the control(6.12%(3/49)vs 26.82%(11/41))(χ2=7.286,P=0.007).The colony logarithm values of Bifidobacterium and Lactobacillus and B/E value in the experimental group after treatment were higher than those in the control((9.92±1.25)lgCFU·g-1 vs(6.61±1.22)lgCFU·g-1,(9.25±1.21)lgCFU·g-1 vs(7.21±1.23)lgCFU·g-1,(1.20±1.81)lgCFU·g-1 vs(0.80±1.69)lgCFU·g-1)(t=13.665,8.525,1.164,all P<0.05).The levels of CD3+,CD4+,CD8+and CD4+/CD8+in the experimental group were higher than those in the control((69.70±3.68)%vs(62.31±3.60)%,(58.75±2.56)%vs(48.22±2.51)%,(40.52±1.56)%vs(38.24±1.58)%,(1.45±0.51)vs(1.24±0.53))(t=10.351,20.769,7.404,2.058,all P<0.05).The levels of PGI,PGII and serum ProGRP in the experimental group were lower than those in the control((136.22±7.24)μg·L-1 vs(145.10±7.26)μg·L-1,(8.20±1.06)μg·L-1 vs(11.76±1.09)μg·L-1,(131.79±12.15)ng·L-1 vs(138.52±10.26)ng·L-1)(t=6.245,45.815,3.051,all P<0.05).There were no statistical differences in inci-dence of adverse reactions between the two groups(Z=0.013,1.385,0.612,0.707,all P>0.05).Conclusion Probiotics combined with omeprazole has prominent efficacy,good safety and low risk of recurrence for the treatment of Hp infection-related gastritis in children.It has positive significance for improving intestinal microecology,enhancing intestinal immunity and alleviating body's in-flammatory response.