摘要
Abstract
Objective:To study the effects of Berberine against Helicobacter pylori(Hp) in vitro and its clinical effects on Hp infection to provide theoretical basis for the clinical application.Methods:Step1:The clinical strains of Hp in the gastric mucosa of 25 patients with positive results of rapid urease test were conducted separation and purification.Two cases of 12908 and 43504 Hp standard strain were the study objects.Berberine were divided into four concentration gradients of 250 ug,100 ug,50 ug and 25 ug,and the 15 ug standard Clarithromycin paper was as the positive control.The paper stripmethod was applied to perform susceptibility testing in vitro.The diameter ofaverage inhibition zone and anti-Hp effective rates were compared.Step 2:The 212 patients diagnosed as Hp infection were randomized into four groups;group A:PPI + Clarithromycin + Berberine;group B:PPI + Amoxicillin + Berberine;group C:PPI + Amoxicillin + Clarithromycin;group D:PPI + Clarithromycin + Metronidazol.The dosage of oral medication:Omeprazole of 20mg once (others with same dosage of PPI),Berberine of 0.4g once,Clarithromycin of 0.5g once,Amoxicillin of 1.0g once,Metronidazol of 0.4g once,twice a day with oral administration for successive 7 days.Four weeks after the withdrawal of anti-Hp drug,14 C expiration test was conducted.The eradication rate of Hp and occurrence rate of adverse reactions were compared between the two groups.Results:1.The Berberine inhibition zone diameter of each concentration gradient was lower than that in Clarithromycin group;the difference had statisitical significance (P ＜ 0.01).The antiHp effective rates of Berberine groups of 50ug,100ug,50ug and 25ug and the anti-Hp effective rate of Clarithromycin group of 15ug were respectively 92.59％ (25/27),85.19％ (23/27),44.44％ (12/27),44.44％ (12/27) and 88.89％ (24/27).The differences between the five groups had statistical significance (P ＜ 0.01).The comparison between every two groups indicated the differences of the anti-Hp effective rates between Clarithromycin group of 15ug and Berberine groups of 15ug,250ug and 100ug,between Berberine group of 250ug and Berberine group of 100ug had no statistical significance (P ＞ 0.05).The Hp eradication rates of group A,group B,group C and group D were respectively 70.37％ (38/54),61.22％ (30/49),68.63％ (35/51) and 65.52％ (38/58);the differences had no statistical significance (P ＞ 0.05).The occurrence rates of adverse reactions in group A,group B,group C and group D were respectively 9.12％,0.31％,2.87％ and 6.10％ (P ＜0.01).The differences of occurrence rates between every two groups had statistical significance (P ＜ 0.05).Conclusion:1.Berberine has good anti-Hp effects in vitro;2.There is no obvious difference of the eradication rates of Hp between the clinical application of PPI + Berberine + Clarithromycin or Amoxicillin and clinical application of control standard program of PPI + Clarithromycin + Metronidazole or Amoxicillin.The adverse reaction rate of group PPI + Berberine + Amoxicillin is the least.The adverse reaction rate of groups including Clarithromycin is markedly higher than that of other groups.关键词
幽门螺杆菌/盐酸小蘖碱/药敏实验Key words
Helicobacter pylori (Hp)/Berberine/susceptibility testing分类
医药卫生
