给予磺基磷脂、姜黄素和Lactobacillus-containing食物补充剂后持续clarithromycin-resistant幽门螺杆菌感染的组织学消失：一例报告
Histological disappearance of persistent clarithromycin-resistant Helicobacter pylori infection following administration of a sulforaphane-, curcumin- and Lactobacillus-containing food supplement: a case report.
- 期刊Wiener medizinische Wochenschrift (1946)（Wien Med Wochenschr）
- 发表时间2026-11-03
- 作者Fischler N
- DOI10.1007/s10354-026-01199-8
- PMID42975778
摘要机译
[背景]增加耐药性已成为治疗幽门螺杆菌感染的主要挑战。萝卜硫素是一种来自西兰花芽的生物活性异硫氰酸酯，在实验和临床研究中显示出抗幽门螺杆菌的活性。姜黄素和益生菌也被研究作为辅助疗法。
【病例介绍】一位七十多岁的女性接受上消化道内镜筛查，组织学发现慢性活动性幽门螺杆菌相关性胃炎累及胃窦和胃体，分子检测证实幽门螺杆菌感染，并在23S rRNA基因中检测到克拉霉素耐药突变A2143G。
在使用由Pylera®组成的铋四联疗法治疗后（法国的实验室尤维克斯制药公司：次柠檬酸铋钾140毫克、甲硝唑125毫克和盐酸四环素125毫克每粒胶囊；
3粒胶囊，每日4次）加潘托拉唑（40毫克，每日2次，持续10天，随后潘托拉唑40毫克，每日1次，持续4周），1年后重复内镜检查显示持续活动性胃炎和耐药突变持续存在。患者随后接受了含有西兰花衍生萝卜硫素、姜黄素和嗜酸乳杆菌的营养制剂。
该制剂每天饭前两次以两粒胶囊的形式给药，持续21天。大约3个月后的随访内镜检查显示炎症活动消失，胃窦和体活检中没有可检测到的幽门螺杆菌。[结论]本病例记录了持久性clarithromycin-resistantH的组织学消失。
施用舒张素、姜黄素和probiotic-containing保健品后幽门螺杆菌感染。虽然不能从单一观察中确定因果关系，但研究结果支持对treatment-refractory感染患者进行此类干预的进一步调查。
展开英文摘要原文
【BACKGROUND】Increasing antimicrobial resistance has become a major challenge in the treatment of Helicobacter pylori infection. Sulforaphane, a bioactive isothiocyanate derived from broccoli sprouts, has demonstrated anti-H. pylori activity in experimental and clinical studies. Curcumin and probiotic bacteria have also been investigated as adjunctive therapies.
【CASE PRESENTATION】A woman in her seventies underwent upper gastrointestinal endoscopy screening. Histology revealed chronic active Helicobacter pylori-associated gastritis involving the antrum and corpus. Molecular testing confirmed H. pylori infection and detected the clarithromycin resistance mutation A2143G in the 23S rRNA gene. Following treatment with bismuth quadruple therapy consisting of Pylera® (Laboratoires Juvise Pharmaceuticals, France: bismuth subcitrate potassium 140 mg, metronidazole 125 mg and tetracycline hydrochloride 125 mg per capsule; three capsules four times daily) plus pantoprazole (40 mg twice daily for 10 days, followed by pantoprazole 40 mg once daily for 4 weeks), repeat endoscopy 1 year later demonstrated persistent active gastritis and persistence of the resistance mutation. The patient subsequently received a nutraceutical preparation containing broccoli-derived sulforaphane, curcumin, and Lactobacillus acidophilus. The preparation was administered as two capsules twice daily before meals for 21 days. Follow-up endoscopy approximately 3 months later demonstrated resolution of inflammatory activity and the absence of detectable H. pylori organisms in antral and corpus biopsies.
【CONCLUSION】This case documents the histological disappearance of persistent clarithromycin-resistant H. pylori infection following administration of a sulforaphane-, curcumin- and probiotic-containing nutraceutical. Although causality cannot be established from a single observation, the findings support further investigation of such interventions in patients with treatment-refractory infection.
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