根治幽门螺杆菌感染需要个体化治疗

Eradication of Helicobacter pylori Infection Requires Individualized Treatment

摘要: 幽门螺杆菌(Helicobacter pylori, Hp)作为全球高发的致病菌，其感染与慢性胃炎、消化性溃疡、胃黏膜相关淋巴组织淋巴瘤以及胃癌等多种上消化道疾病密切相关，严重威胁人类健康。近年来，随着抗生素耐药率的不断攀升，传统标准化治疗方案的根除效果显著下降，临床治疗面临严峻挑战。在此背景下，个体化治疗策略逐渐成为提升幽门螺杆菌根除率、降低治疗相关不良反应及减少耐药风险的关键。本文系统综述了幽门螺杆菌感染的流行病学现状，深入剖析了其引起的临床危害与疾病负担，并重点阐述了针对不同人群(包括成人、老年人、儿童及难治性感染患者)的个体化根治疗法。文章进一步探讨了中医辅助治疗在协同增效、减少不良反应及调节整体状态方面的潜在价值。研究表明，基于患者的年龄、基础疾病状况、感染特征、耐药背景及治疗史等多维度信息，制定并实施个体化治疗方案，可显著提高患者的治疗依从性与安全性，从而优化治疗结局。个体化治疗模式代表了当前幽门螺杆菌感染根治的必然趋势与发展方向，是实现精准医疗理念在幽门螺杆菌感染治疗领域的重要实践。

Abstract: As a globally prevalent pathogen, Helicobacter pylori (H. pylori) infection is closely associated with various upper gastrointestinal diseases, including chronic gastritis, peptic ulcers, gastric mucosa-associated lymphoid tissue (MALT) lymphoma, and gastric cancer, posing a serious threat to human health. In recent years, with the continuous rise in antibiotic resistance rates, the eradication efficacy of traditional standard treatment regimens has significantly declined, presenting severe challenges to clinical practice. Against this backdrop, individualized treatment strategies have gradually become crucial for improving H. pylori eradication rates, reducing treatment-related adverse reactions, and mitigating the risk of drug resistance. This article systematically reviews the current epidemiological status of H. pylori infection, deeply analyzes its clinical hazards and disease burden, and focuses on elaborating individualized eradication therapies for specific populations, including adults, the elderly, children, and patients with refractory infections. Furthermore, the article explores the potential value of Traditional Chinese Medicine (TCM) as an adjunctive therapy in synergistically enhancing efficacy, alleviating adverse reactions, and regulating the body’s holistic state. Research indicates that formulating and implementing individualized treatment plans based on multi-dimensional information—such as patient age, underlying health conditions, infection characteristics, antibiotic resistance background, and treatment history—can significantly improve patient compliance and safety, thereby optimizing treatment outcomes. The individualized treatment model represents the inevitable trend and future direction for the eradication of H. pylori infection and serves as a significant application of the precision medicine concept in this therapeutic field.