Current and future perspectives for Helicobacter pylori treatment and management: From antibiotics to probiotics.
Current and future perspectives for Helicobacter pylori treatment and management: From antibiotics to probiotics.
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DOI：
10.3389/fcimb.2022.1042070
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发表时间：
2022
影响因子：
5.7
通讯作者：
中科院分区：
文献类型：
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幽门螺杆菌（H. pylori）是一种革兰氏阴性厌氧细菌，定植于人类胃中，是慢性胃炎和消化性溃疡等胃病的主要原因，也是胃癌发展最明确和可控的危险因素。目前，H.幽门螺杆菌根除从三联改为四联，疗程延长，抗生素种类和剂量调整，疗效改善有限，但副作用逐渐增加，反复治疗失败的患者越来越多。近年来，益生菌已成为支持肠道健康和免疫力的最重要工具之一。大量体外研究、动物研究和临床观察表明，益生菌在辅助抗H.是常规治疗的有价值的补充。然而，许多不同类型的益生菌被用作抗H.幽门螺杆菌，在各种组合，不同的剂量和时间，和临床研究的质量各不相同，使其难以标准化的结果。本文就H.幽门螺杆菌感染和审查国际共识指南。我们还总结了现有的科学证据，使用硅乳杆菌罗伊（L。reuteri）作为H. pylori治疗的研究进展，并从循证医学的角度探讨其临床研究与应用。
Helicobacter pylori (H. pylori) is a Gram-negative anaerobic bacterium that colonizes the human stomach and is the leading cause of gastric diseases such as chronic gastritis and peptic ulcers, as well as the most definite and controllable risk factor for the development of gastric cancer. Currently, the regimen for H. pylori eradication has changed from triple to quadruple, the course of treatment has been extended, and the type and dose of antibiotics have been adjusted, with limited improvement in efficacy but gradually increasing side effects and repeated treatment failures in an increasing number of patients. In recent years, probiotics have become one of the most important tools for supporting intestinal health and immunity. Numerous in vitro studies, animal studies, and clinical observations have demonstrated that probiotics have the advantage of reducing side effects and increasing eradication rates in adjuvant anti-H. pylori therapy and are a valuable supplement to conventional therapy. However, many different types of probiotics are used as adjuncts against H. pylori, in various combinations, with different doses and timing, and the quality of clinical studies varies, making it difficult to standardize the results. In this paper, we focus on the risk, status, prevention, control, and treatment of H. pylori infection and review international consensus guidelines. We also summarize the available scientific evidence on using Limosilactobacillus reuteri (L. reuteri) as a critical probiotic for H. pylori treatment and discuss its clinical research and application from an evidence-based perspective.