清胃降逆方治疗幽门螺杆菌相关性胃炎临床观察

Clinical Observation of Qingwei Jiangni Recipe in Treating Helicobacter-pylori-associated Gastritis

【目的】观察自拟清胃降逆方治疗幽门螺杆菌(Hp)相关性胃炎湿热蕴胃兼胃阴不足型的临床疗效。【方法】将84例Hp阳性的胃炎患者随机分为2组,治疗组42例以自拟清胃降逆方(主要由黄连、吴茱萸、栀子、蒲公英、太子参等组成)为基本方随症加减,对照组42例口服胶体次枸橼酸铋、阿莫西林、克拉霉素,疗程结束后进行统计分析,并对部分病例进行远期疗效随访。【结果】治疗组和对照组总有效率分别为95.2%、76.2%,治疗组疗效优于对照组(P<0.05)。治疗组和对照组的Hp根除率分别为64.3%、71.4%,2组比较差异无显著性意义(P>0.05)。在消除胃脘灼热隐痛、反酸、嗳气等主要症状方面治疗组疗效优于对照组(P<0.05)。远期疗效方面,治疗组中胃脘灼热隐痛复发3例,服用清胃降逆方3～5剂后消失;对照组中胃脘灼热隐痛复发6例,其中5例改服清胃降逆方后缓解,表明清胃降逆方依从性及远期疗效更好。【结论】清胃降逆方治疗Hp相关性胃炎湿热蕴胃兼胃阴不足型疗效确切,使用安全。

Objective To observe the therapeutic effect of Qingwei Jiangni Recipe（QJR） in treating gastritis associated with helicobacter pylori（Hp） which is differentiated as damp-heat accumulating stomach complicated with deficiency of stomach yin.Methods Eighty-four qualified gastritis patients were equally randomized into two groups.The treatment group was given herbal medicine based on QJR,and the control group was given orally with colloidal bismuth subcitrate,amoxicillin,and clarithromycin.After treatment,the therapeutic effect was evaluated,and a follow-up was carried out in some of the patients for the observation of long-term therapeutic effect.Results The total effective rate was 95.2% in the treatment group and 76.2% in the control group,the difference being significant（P0.05）.Hp eradication rate was 64.3% in the treatment group and 71.4% in the control group,the difference being insignificant（P0.05）.Treatment group had better effect on relieving upper abdominal scorching hot and vague pain,acid regurgitation,and belching than the control group（P0.05）.As for the long-term therapeutic effect,upper abdominal scorching hot and vague pain recurred in 3 patients of the treatment group,and then disappeared after oral use of 3～5 doses of QJR;upper abdominal scorching hot and vague pain recurred in 6 patients of the control group,and then relieved after oral use of 5 doses of QJR.Conclusion QJR is effective and safe for the treatment of Hp-associated gastritis with damp-heat accumulating stomach complicated with deficiency of stomach yin.