Effect of Combined Probiotics on the Intestinal Ecosystem during Triple Therapy for Eradication of Helicobacter Pylori

Abstract

Background: China has a high incidence of Helicobacter pylori (Hp)-positive peptic ulcers and triple therapy is widely used to eradicate Hp. However, the antibiotics and proton pump inhibitors used in the standard triple therapy can potentially disrupt the equilibrium of the intestinal flora, resulting in adverse reactions such as loss of appetite, abdominal pain, and diarrhea. Aim: To explore the effect of combined probiotics on the intestinal ecosystem during triple therapy. Methods: A total of 120 patients with a diagnosis of duodenal ulcer and confirmed Hp infection, admitted to the Third Hospital of Hebei Medical University between January 2018 and January 2019, were selected for a prospective randomized clinical study. They were divided into two groups. A joint group (n = 60) and a control group (n = 60) using a simple randomized method. The control group was treated with standard triple therapy, specifically a proton pump inhibitor + clarithromycin + amoxicillin, while the joint group received triple therapy plus Bacillus subtilis and Enterococcus faecium enteric-soluble capsules. Ulcer healing rate, clinical efficacy, Hp eradication rate, changes in the primary intestinal flora, and incidence of adverse reactions were compared between the two groups. Results: After treatment, there was no significant difference in the overall healing effect, clinical efficacy, and Hp-negative conversion rate between the two groups (p > 0.05). During treatment, the incidence of adverse reactions in the combined treatment group was 5.00% lower than 20.00% in the control group, and the difference was statistically significant (p < 0.05). After treatment, the numbers of Enterococcus and Enterobacter in the joint group were lower than those of the control group (p < 0.05), while the numbers of Lactobacillus, Bifidobacterium, Bacteroidetes, Clostridium, and total bacteria in the joint group were higher than those of the control group (p < 0.05). Conclusions: Combined probiotics used as an adjuvant to standard triple therapy have no beneficial or disadvantageous effects on ulcer healing and Hp eradication. But they can reduce adverse reactions for the duration of the treatment process and maintain the equilibrium of the intestinal flora.