Clinical effectiveness of compound probiotics combined with standard quadruple regimen on Helicobacter pylori infection

Objective To evaluate the clinical effective of Lactobacillus rhamnosus, Bifidobacterium lactis and Lactobacillus acidophilus compound probiotics combined with standard quadruple regimen in the treatment of Helicobacter pylori and related adverse reactions. Methods A total of 148 patients who were diagnosed with H. pylori infection in Department of Gastroenterology, the Affiliated Hospital of Xuzhou Medical University from November 2020 to May 2021 were included. They were randomly divided into two groups: a study group (n=70) and a control group (n=65). Both groups received standard quadruple regimen, with a treatment course of 14 days. In addition, the study group was administered with compound probiotics, with a treatment course of 30 days. Then, the ¹³C or ¹⁴C-urea breath test was performed at least one month after drug withdrawal. Negative result indicated successful eradication of H. pylori. Both groups were compared for the eradication rate of H. pylori, the incidence and severity of adverse reactions, symptom relief and improvement of Bristol stool types. Results According to both intention-to-treat (ITT) and per protocol (PP) analysis, the study group presented remarkably increases in the eradication rate of H. pylori (P<0.05) and decreases in the incidences of adverse reactions and of diarrhea than the control group (P<0.05). The severity of abdominal distension and diarrhea was less in the study group than that in the control group (P<0.05). There were no statistical differences in the incidence and severity of other adverse reactions and symptom relief among the groups (P>0.05). For patients with Bristol stool type >4 or <3 before anti-H. pylori eradication treatment, improvement in Bristol stool types after treatment was significantly better in the study group than that in the control group (P<0.05). Conclusions probiotics combined with standard quadruple regimen can significantly increase the eradication rate of H. pylori infection, reduce the incidence of anti-H. pylori-related adverse reactions and reduce the incidence of diarrhea, and reduce the severity of abdominal distention and diarrhea in adverse reactions. Patients with Bristol stool type >4 or <3 show improvement in Bristol stool type after anti-H. pylori eradication therapy.