参苓白术散辅助治疗伴幽门螺杆菌感染的慢性萎缩性胃炎的疗效及安全性分析

Clinical efficacy and safety of Shenling Baizhu powder as an adjunctive treatment for atrophic gastritis with Helicobacter pylori infection

目的分析参苓白术散辅助治疗伴幽门螺杆菌(Helicobacter pylori,H.pylori)感染的慢性萎缩性胃炎的疗效及安全性分析.方法选择从2016-01/2016-10于浙江中医药大学附属第三医院就诊60例伴H.pylori感染的慢性萎缩性胃炎患者,采用简单随机单双就诊号的方法分为试验组30例和对照组30例,对照组患者给予四联疗法根除H.pylori,试验组在此基础上联合参苓白术散治疗,两组患者治疗8 wk.观察两组患者的临床治疗效果,治疗前后主要症状积分(包括上腹饱胀、口干口苦、纳差、乏力和消化不良)的改善情况.观察两组患者治疗后H.pylori根除情况及治疗期间不良反应情况(头痛、腹泻、便秘、皮疹、恶心呕吐).结果试验组患者治疗后的总临床有效率为93.33%,对照组患者的治疗总有效率为73.33%,两组患者治疗后的总临床有效率比较,差异有统计学意义(χ~2=4.3221,P=0.0377).两组患者治疗前上腹饱胀、口干口苦、纳差、乏力和消化不良积分比较,差异均无明显统计学意义(P>0.05),治疗后上述积分均显著降低,差异有统计学意义(P<0.05),且试验组患者治疗后上腹饱胀、口干口苦、纳差、乏力和消化不良积分均显著低于对照组患者,差异有统计学意义(P<0.05).试验组患者H.pylori根除率为96.67%,对照组H.pylori根除率为80.00%,两组患者H.pylori根除率比较,差异具有统计学意义(χ~2=4.0421,P=0.0444).试验组的不良反应发生率为10.00%,对照组为23.33%,差异无统计学意义(χ~2=1.9230,P=0.1659).结论参苓白术散辅助治疗伴H.pylori感染的慢性萎缩性胃炎的疗效显著,可以明显减轻患者的临床症状,改善胃镜下黏膜血流变化,且用药安全,适合临床应用.

AIM To evaluate the clinical efficacy and safety of Shenling Baizhu powder as an adjunctive treatment for atrophic gastritis with Helicobacter pylori（H.pylon）infection.METHODS Sixty atrophic gastritis patients with H.pylori infection were selected from January 2016 to October 2016 at the Third Affiliated Hospital of Zhejiang Chinese Medicine University and randomly divided into either an experimental group（n = 30）or a control group（n = 30）.The control group was treated with quadruple therapy to eradicate H.pylori,while the experimental group was treated with quadruple therapy plus Shenling Baizhu powder.The patients in both groups were treated for 8 wk.The total effective rates of the two groups were calculated.The scores of main symptoms（including abdominal distension,dry mouth,anorexia,fatigue,and indigestion）,endoscopic mucous erosion,bile reflux,scores（including mucosa,mucous folds,and blood vessels）,H.pylori eradication rate,and complications（headache,diarrhea,constipation,rash,nausea,and vomiting）were compared between the two groups.The total effective rate was significantly higher in the experimental group than in the control group（93.33% vs 73.33%,x^2 = 4.3221,P = 0.0377）.Before treatment,there was no significant difference in abdominal distension,dry mouth,anorexia,fatigue,or indigestion scores between the two groups（P 〉 0.05）;after treatment,these scores were significantly decreased in both groups（P 〈 0.05）,and the decrease was more significant in the experimental group.The eradication rate of H.pylori was significantly higher in the experimental group than in the control group（96.67% vs 80.00%,x^2 = 4.0421,P = 0.0444）.CONCLUSION Shenling Baizhu power is effective in the treatment of atrophic gastritis with H.pylori,and it can significantly reduce the clinical symptoms and improve the clinical changes of mucosal blood flow with good safety.