透過您的圖書館登入
IP:44.197.114.92
  • 學位論文

莓果萃取物對幽門螺旋桿菌的抑制和根除率之影響

The Adjuvant Effects of Berry Extract on Triple Therapy for Helicobacter pylori Eradication

指導教授 : 黃士懿

摘要


幽門螺旋桿菌是造成胃炎、胃潰瘍、十二指腸潰瘍,胃部淋巴癌或是胃癌的重要危險因子之一,研究調查指出,開發中國家的感染率為70-90%,而已開發國家的感染率為25-50%。目前臨床對於感染幽門螺旋桿菌之病患大多施以三合一療法。服用抗生素會破壞腸道正常菌叢因此對患者產生生理上的副作用如噁心、嘔吐、腹痛、腹瀉等,且研究發現有部分幽門螺旋桿菌菌株對抗生素具有抗藥性,進而影響幽門螺旋桿菌殺菌的成效,故亟需發展非抗生素的替代療法協助治療幽門螺旋桿菌之感染。文獻報告指出蔓越莓可以抑制幽門螺旋桿菌對胃黏膜之吸附而具有輔助治療的效果,然而缺乏相關文獻探討其他莓果對幽門螺旋桿菌之影響。因此,本研究目的為人體實驗探討莓果萃取物(藍莓萃取物、葡萄籽萃取物) 對幽門螺旋桿菌的抑制和根除率之影響。 本研究為人體實驗,意圖治療分析法發現莓果萃取物組和安慰劑組沒有統計上的差異 (ITT: 82.81% vs. 73.33%, p=.201)。就完成計畫書療程分析法而言,則發現莓果萃取物組有增加幽門螺旋桿菌根除率的趨勢 (PP: 94.64% vs. 84.62%, p=.085)。軟便的副作用則是在服用莓果萃取物後有增加的趨勢。服用莓果萃取物前後的IL-6,TNF-α 和多酚成份沒有改變。

並列摘要


Helicobacter pylori (H. pylori) was found in 70-90% of the population in developing countries and in 25-50% of developed countries. H. pylori is the major risk factors of gastritis, gastric ulcers, duodenal ulcers, mucosa associated lymphoid tissue lymphoma (MALToma) and gastric cancer. One-week of triple therapy is currently regarded as the gold standard for H. pylori eradication. However, the eradication rate continues to be disappointing. Large dosages of antibiotic treatment during eradication of H. pylori may induce a change in the bowel flora and lead gastrointestinal side-effects. Poor patient compliance and bacterial resistance are the main factors contributing to treatment failure. Some literatures reported that cranberry may inhibit H. pylori adhesion to the human gastric mucus and may reduce H. pylori infection in adults. However, the therapeutic possibility of other berries on H. pylori was rarely discussed. Thus, the aims of this study were to explore the impact of blueberry and grape seed extract on triple therapy for H. pylori eradication. In our study, we found that although there is no significant difference between berry extract group and placebo group (ITT: 82.81% vs. 73.33%, p=.201), however in the per-protocol analysis, the triple-plus-berry group had a significant trend of higher eradication rate (PP: 94.64% vs. 84.62%, p=.085). This result indicated that we need more study samples for the further evaluation. The loose stool passage may increase in berry extract group after taking berry extracts, this may related to inulin content of the berry extracts. The serum IL-6, TNF-α and polyphenol level are similar in both group.

參考文獻


Basu A, Du M, Leyva MJ, Sanchez K, Betts NM, Wu M, Aston CE, and Lyons TJ. (2010) Blueberries decrease cardiovascular risk factors in obese men and women with metabolic syndrome. J Nutr 140(9):1582-1587.
Bobe G, Albert PS, Sansbury LB, Lanza E, Schatzkin A, Colburn NH, and Cross AJ. (2010) Interleukin-6 as a potential indicator for prevention of high-risk adenoma recurrence by dietary flavonols in the polyp prevention trial. Cancer Prev Res (Phila) 3(6):764-775.
Bravo L. (1998). Polyphenols: chemistry, dietary sources, metabolism, and nutritional significance. Nutr Rev 56(11):317-333.
Burger O, Weiss E, Sharon N, Tabak M, Neeman I, and Ofek I. (2002) Inhibition of Helicobacter pylori adhesion to human gastric mucus by a high-molecular-weight constituent of cranberry juice. Crit Rev Food Sci Nutr 42(3 Suppl):279-284.
Chacon MR, Ceperuelo-Mallafre V, Maymo-Masip E, Mateo-Sanz JM, Arola L, Guitierrez C, Fernandez-Real JM, Ardevol A, Simon I, and Vendrell J. (2009) Grape-seed procyanidins modulate inflammation on human differentiated adipocytes in vitro. Cytokine 47(2):137-142.

延伸閱讀