目的: 探讨白及萸连汤辅治幽门螺杆菌（Helicobacter pylori,Hp）阳性胃溃疡的效果及对胃肠道激素和胃黏膜形态的影响。方法: 本研究采取前瞻性的研究设计,选取2021年10月—2022年9月在我院就诊的72例脾胃湿热型Hp阳性胃溃疡患者,随机分为试验组和对照组,每组各36例,对照组予以常规四联疗法,试验组在对照组基础上联用白及萸连汤中药汤剂口服,治疗6周。通过胃肠道激素水平、胃黏膜形态、幽门螺杆菌根除率及中医症候积分评估疗效。结果: 治疗前,两组胃肠道激素水平、胃黏膜形态及中医症候积分比较,差异无统计学意义。经治疗,两组患者胃泌素（gastrin,GAS）、血管活性肠肽（vasoactive intestinal peptide,VIP）水平均低于治疗前,且试验组低于对照组;两组患者胃动素（motilin,MTI）水平均高于治疗前,且试验组高于对照组。两组患者腺体密度、黏膜厚度和炎性细胞浸润程度评分均低于治疗前,且试验组低于对照组。两组患者胃脘灼热疼痛、口干口苦等主症和脘痞腹胀、嗳气反酸、纳呆恶心,大便不畅等次症以及舌脉象的中医症候积分均低于治疗前,试验组明显低于对照组。试验组幽门螺杆菌根除率及总有效率明显高于对照组,差异有统计学意义。结论: 白及萸连汤联合四联疗法可显著提高Hp阳性胃溃疡患者的Hp根除率,改善胃黏膜形态,并通过多靶点调节胃肠道激素水平,临床疗效显著。
Abstract
Objective To investigate the effect of the decoction on treating Helicobacter pylori (Hp) positive gastric ulcer and its effect on gastrointestinal hormones and gastric mucosa morphology. Methods This prospective study selected 72 patients with Hp-positive gastric ulcers of the Piwei damp-heat syndrome type who were treated at our hospital between October 2021 and September 2022. The patients were randomly divided into an experimental group and a control group, with 36 cases in each group. The control group received conventional quadruple therapy, while the experimental group received Baiji Yulian Decoction in addition to the quadruple therapy for 6 weeks. Efficacy was evaluated based on gastrointestinal hormone levels, gastric mucosal morphology, Hp eradication rate, and TCM symptom scores. Results Before treatment, gastrointestinal hormone levels, gastric mucosal morphology and traditional chinese medicine syndrome (TCM) points were compared between the two groups. After treatment, the GAS and VIP levels in the two groups were lower than before treatment, and the difference was statistically significant, the control group, the MTL level was higher than the patients before treatment, the difference was statistically significant, and the test group was higher than the control group, the difference was statistically significant. The gland density, mucosal thickness and degree of inflammatory cell infiltration were lower than those before treatment, and the difference was statistically significant, and the difference was lower in the test group than in the control group. Two groups of patients with epigastric burning pain, dry mouth and chest, acid reflux, irritability, constipation, new abdominal distension, acid reflux, nausea, stool, and tongue pulse of TCM syndrome points are lower than before treatment, difference has statistical significance, the test group is lower than the control group, difference have statistical difference. The eradication rate and total response rate of Helicobacter pylori in the test group were significantly higher than that in the control group, and the difference was significant. Conclusion The combination of white and quadruple therapy can significantly improve the Hp eradication rate of Hp positive gastric ulcer patients, improve gastric mucosa morphology, and regulate gastrointestinal hormone levels through multiple targets, with remarkable clinical efficacy.
关键词
Hp阳性胃溃疡 /
脾胃湿热证 /
白及萸连汤 /
中西医结合
Key words
Hp positive gastric ulcer /
dampness and heat of spleen and stomach /
white and officinalis officinalis soup /
integrated Chinese and western medicine
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基金
东莞市社会发展科技项目“白及萸连汤联合三联疗法治疗HP阳性胃溃疡的临床观察”（20211800903752）
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