三黄泻心汤中西医结合根除幽门螺杆菌感染的体内外实验研究

Experimental Study in Vivo and in Vitro for Eradication of HP Infection by San huang Xiexin Decoction with Integrated Traditional Chinese and Western Medicine

目的评价三黄泻心汤与莫西沙星对55株幽门螺杆菌体外联合抗菌效应和临床根除率。方法采用二倍稀释法、棋盘格法和Vitek-32型全自动细菌鉴定仪测定三黄泻心汤与莫西沙星单用或联用对55株幽门螺杆菌的最低抑菌浓度(MIC),计算其联合药敏指数(FIC),绘制药物质量浓度-累积抑菌率曲线;对比观察中西医结合与埃索美拉唑三联方根除幽门螺杆菌感染的疗效。结果试验组与对照组中西药联用对幽门螺杆菌的MIC值均较单用显著降低;试验组FIC不大于0.50,有协同作用,对照组FIC为0.50～0.75,有相加作用;两组药物质量浓度-累积抑菌率曲线向低浓度方向移动联用均较单用明显;观察组和对照组的溃疡愈合率分别为90.91%和78.18%,幽门螺杆菌根除率分别为89.09%和81.82%,两组比较,P<0.01或P<0.05。结论三黄泻心汤中西医结合根除幽门螺杆菌感染的疗效确切,可作为二线治疗方案。

Objective To investigate the antibacterial effects in vitro and the c linical eradication rate of Sanhuang Xiexin Decoction combined with moxifloxacin against 55 strains of Helicobacter pylori（HP）.Methods The method of doubling di lution test,checkboard test and Vited-32 type full automated bacterial detectio n device were used.The MIC of Sanhuang Xiexin Decoction and moxifloxacin with in tegrated traditional Chinese and Western medicine（TCWM） against 55 strains of HP were detected and the joint of drug sensitive index（FIC） was calculated.The ac cumulative bacteriostatic rate curve was drawn according to MIC values.To observ e the curative effect of integrated TCWM versus esomeprazole triple therapy on e radication of HP infection.Results The MIC against HP with integrated TCWM in th e trial and control groups was significantly reduced compared with single use.Th e FIC index in the trial group was less than 0.50,showing the synergism action,w hile the FIC index in the control group was 0.50-0.75,showing the additive acti on.The accumulative bacteriostatic rate curve in the trial and control groups sh owed left deviation to low concentration region compared with the single use.The healing rates of peptic ulcer and HP eradication rates in the observation and c ontrol groups were 90.91%and 78.18%,89.09%and 81.82%,P〈0.01,P〈0.05,respe ctively.Conclusion Sanhuang Xiexin Decoction with integrated TCWM has good effec t on eradication of HP infection,which can be the choice of second-line treatme nt.