临床误诊误治2023，Vol.36Issue(9)：112-117,6.DOI:10.3969/j.issn.1002-3429.2023.09.023
自拟15味健脾护膜汤加抗Hp四联方案治疗慢性消化性溃疡脾胃虚寒型效果及相关机制
Effect and Related Mechanism of Self-prepared Shiwuwei Jianpi Humo De-coction Plus Anti-HP Quadruple Regimen in the Treatment of Chronic Pep-tic Ulcer of Spleen and Stomach Deficiency Cold Type
摘要
Abstract
Objective To investigate the effect and related mechanism of self-prepared Shiwuwei Jianpi Humo Decoc-tion plus anti-Helicobacter pylori(Hp)quadruple regimen in treating chronic peptic ulcer(PU)of spleen-stomach deficiency cold type.Methods Eighty patients with chronic PU treated from March 2019 to October 2022 were selected and divided into two groups according to different treatment methods:combination group and Western medicine group with 40 cases in each group.The combination group was treated with Shiwuwei Jianpi Humo decoction plus anti-HP quadruple regimen,and the Western medicine group was treated with anti-HP quadruple regimen.Clinical efficacy,Hp eradication,recurrence,tradition-al Chinese medicine(TCM)syndrome score,ulcer healing quality,gastric acid secretion[maximum gastric acid secretion(MAO),basic gastric acid secretion(BAO),peak gastric acid secretion(PAO),gastric fluid pH values],gastrointestinal function[pepsinogen Ⅰ(PGⅠ),pepsinogen Ⅱ(PGⅡ),gastrin(GAS),motilin(MTL)]and adverse reactions of the two groups were compared.Results At 4 weeks after drug withdrawal following treatment,the total effective rate(39/40,97.50%)and eradication rate of Hp(35/40,87.50%)in combination group were higher than those in Western medicine group(32/40,80.00%;24/40,60.00%).The recurrence rate of the combination group(2/40,5.00%)was lower than that of the Western medicine group(8/40,20.00%)at 3-month follow-up after treatment(P＜0.05,P＜0.01).At 2 and 4 weeks after treatment,the scores of stomach pain,bloating,pain,excessive fasting pain,dizziness,fatigue and lazy speech,as well as BAO,MAO,PAO,PG Ⅰ,PG Ⅱ,GAS,and MTL,in both groups were lower than those before treat-ment,and lower in the combination group than in the Western medicine group.The Ph value of gastric fluid in the two groups was higher than that before treatment,and higher in combination group than in the Western medicine group(P＜0.01).The excellent and good rate of ulcer healing in the combination group after treatment was higher than that in the Western medicine group(P＜0.01).During treatment,there was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion The self-prepared Shiwuwei Jianpi Humo decoction plus anti-HP quadruple regimen has ob-vious effect and good safety in the treatment of chronic PU of spleen-stomach deficiency cold type,which can improve clinical symptoms of patients,inhibit gastric acid secretion,increase Hp eradication rate,promote ulcer repair and reduce recurrence rate,which may be related to the regulation of GAS and MTL expression.关键词
消化性溃疡/15味健脾护膜汤/抗Hp四联方案/溃疡愈合质量/Hp根除率/复发率/中医证候积分/胃肠道功能Key words
Peptic ulcer/Shiwuwei Jianpi Humo decoction/Anti-helicobacter pylori quadruple regimen/Ulcer heal-ing quality/Hp eradication rate/Recurrence rate/TCM syndrome score/Gastrointestinal function分类
医药卫生引用本文复制引用
王凌红,项梅,詹士宝,郭慧敏..自拟15味健脾护膜汤加抗Hp四联方案治疗慢性消化性溃疡脾胃虚寒型效果及相关机制[J].临床误诊误治,2023,36(9):112-117,6.基金项目
安徽省中央引导地方科技发展专项项目(2018080802D0080) （2018080802D0080）
