Development of complementary and alternative medicine against antibiotic-resistant Helicobacter pylori infection

幽门螺杆菌（Helicobacter pylori，H.pylori）是胃十二指肠疾病的重要致病菌，可引起慢性胃炎、消化性溃疡、胃腺癌和粘膜相关淋巴组织淋巴瘤（mucosa-associated lymphoid tissue lymphoma，MALToma）等多种疾病。尽管使用抗生素根除幽门螺杆菌通常可以改善胃十二指肠疾病，但对抗生素的耐药性正在出现。在这项研究中，精油和草药的抗菌作用进行了评估，在体外和体内。本研究中使用的13种精油在0.1%（vol/vol）的浓度下完全抑制体外幽门螺杆菌的生长。香茅（香茅）和柠檬马鞭草（柠檬马鞭草）在pH 4.0和5.0下在0.01%时对幽门螺杆菌具有杀菌作用。耐柠檬草没有发展，即使经过10个连续的通道，而耐克拉霉素在相同的条件下开发。在体内研究中，与未处理的小鼠相比，用柠檬草处理的小鼠胃中幽门螺杆菌的密度显著降低。另外，还对18种中草药进行了体内、体外抗菌试验。黄芪、茵陈、红花在1 mg/ml以上的剂量下对幽门螺杆菌的生长有抑制作用。此外，用这些草药治疗的小鼠胃中幽门螺杆菌的密度显著降低。这些结果表明，精油和草药对幽门螺杆菌具有杀菌作用，而不会产生获得性耐药性，这表明精油和草药可能具有作为治疗幽门螺杆菌耐药性感染的补充和替代药物的潜力。

Helicobacter pylori (H.pylori) is now recognized as an important causal agent in gastroduodenal diseases, such as chronic gastritis, peptic ulceration, gastric adenocarcinoma and mucosa-associated lymphoid tissue lymphoma (MALToma). Although the eradication of H.pylori using antibiotics often improves gastroduodenal diseases, resistance to the antibiotics is emerging. In this study, the antimicrobial effects of essential oils and herbal medicines were evaluated in vitro and in vivo. Thirteen essential oils used in this study completely inhibited the growth of H.pylori in vitro at a concentration of 0.1% (vol/vol). Cymbopogon citratus (lemongrass) and Lippia citriodora (lemon verbena) were bactericidal against H.pylori at 0.01% at pH 4.0 and 5.0. Resistance to lemongrass did not develop even after 10 sequential passages, whereas resistance to clarithromycin developed under the same conditions. In in vivo studies, the density of H.pylori in the stomach of mice treated with lemongrass was significantly reduced compared with untreated mice. On the other hand, the antibacterial effects of 18 herbal medicines were also evaluated in vitro and in vivo. Rhei Rhizoma, Artemisiae Capillari Flos and Caryophylli Flos inhibited the growth of H.pylori at a dose of 1mg/ml or more in vitro. Furthermore, the density of H.pylori in the stomach of mice treated with these herbal medicines was significantly reduced. These results demonstrate that the essential oils and herbal medicines are bactericidal against H.pylori without the development of acquired resistance, suggesting that essential oils and herbal medicines may have potential as complementary and alternative medicines for treatment of antibiotic-resistant H.pylori infection.