Objective To explore the microenvironment treatment strategy for patients with positive atrophic gastritis infected by Helicobacter pylori (Hp), and to verify the synergistic effect of Qinghua Chuyou decoction combined with bismuth quadruple therapy on their immune function, serum inflammatory factors and clinical efficacy. Methods 112 patients with HP-positive atrophic gastritis who were treated in Handan Hospital of Traditional Chinese Medicine from July 2021 to July 2023 were randomly divided into control group (bismuth quadruple therapy) and observation group (bismuth quadruple plus Qinghua Chuyou decoction), with 56 cases in each group. After the treatment, the eradication rate and recurrence rate of Hp, TCM symptom score, gastroscope mucosa score, inflammatory factors [IL-8(Interleukin-8), IL-1β (Interleukin-1β), IL-6 (Interleukin-6), TNF-α (Tumor Necrosis Factor-α)], and immune function index (CD4+、CD8+、CD4+/CD8+), gastric function indicators [serum I (Pepsinogen I, PGI), pepsinogen II (PGII), PGR ratio, gastrin-17(G-17)], clinical efficacy and self-rating anxiety scale (SAS). Results After treatment, compared with the control group, the observation group can significantly improve the eradication rate of Hp and the total clinical effective rate, the recurrence rate and the incidence of adverse reactions have no significant increase (P>0.05). The observation group improved the symptoms of Chinese medicine such as burning pain in the stomach, swelling pain in both ribs, upset and irritable, belching, acid regurgitation and poor stool. (Cohen's d: 0.509-0.611), gastroscopic mucosal manifestations and anxiety and depression (SAS/SDS score). In addition, the observation group showed stronger immunomodulation and anti-inflammatory effects, the CD4+ T cell ratio and CD4+/CD8+ ratio increased significantly, and the levels of proinflammatory factors (IL-8, IL-1β, IL-6, TNF-α) decreased significantly, especially the inhibitory effects of IL-1β and TNF-α (Cohen's d>1.0). The gastric function indexes (PGI, PGR, PGII, G-17) also were significantly improved compared with the control group. Conclusion Qinghua Chuyou Decoction can synergistically enhance the immune regulation and anti-inflammatory effect of bismuth quadruple therapy in treating Hp-positive atrophic gastritis of spleen and stomach damp-heat type, and ultimately promote the repair of gastric mucosa and the rehabilitation of patients, which is an effective strategy for treating Hp-positive atrophic gastritis in cooperation with traditional Chinese and western medicine.
Key words
qinghua chuyou decoction /
microenvironment /
bismuth quadruple therapy /
helicobacter pylori /
positive atrophic gastritis
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