五味消毒饮加味联合奥美拉唑对活动期胃溃疡黏膜愈合质量及复发的影响

Clinical Observation on Effect of Modified Wuwei Xiaodu Yin Combined with Omeprazole on the Healing Quality of Mucosa and the Recurrence in Patients with Active Gastric Ulcer

目的:观察五味消毒饮加味联合奥美拉唑对活动期胃溃疡黏膜愈合质量及复发的影响。方法:将72例幽门螺杆菌(Hp)感染的活动期胃溃疡患者随机分为2组各36例,对照组在治疗第1～2周给予根除Hp感染四联疗法治疗,第3～4周给予奥美拉唑治疗。治疗组在对照组治疗方案的基础上联合五味消毒饮加味治疗。2组均治疗4周观察疗效。观察2组Hp根除率、溃疡组织学愈合情况、Hp再感染率及溃疡复发率及不良反应率。结果:治疗组内镜下胃溃疡愈合总有效率94.44%,高于对照组77.78%,差异有统计学意义(P<0.05)。2组患者Hp清除率比较,差异无统计学意义(P>0.05)。组织学检查显示,对照组在炎性细胞浸润、炎症活动性、黏膜厚度及腺体形态方面等评分均低于对照组,差异均有统计学意义(P<0.05),治疗组优于对照组。随访6月,治疗组Hp再感染率及溃疡的复发率均低于对照组,差异均有统计学意义(P<0.05)。结论:五味消毒饮加味联合奥美拉唑对活动性胃溃疡黏膜愈合质量及复发优于单用奥美拉唑。

Objective:To observe the effect of modified Wuwei Xiaodu yin combined with omeprazole on the healing quality of mucosa and recurrence in patients with active gastric ulcer. Methods:Divided 72 cases of patients with active gastric ulcer caused by Helicobacter pylori (Hp) infection randomly into two groups,36 cases in each group. The control group was treated with quadruple therapy to eradicate Hp infection during the first and the second week of treatment,and with omeprazole during the third and the fourth week of treatment. The treatment group was additionally given modified Wuwei Xiaodu yin based on the treatment of the control group. The two groups received treatment for four weeks. Observed the clinical effect,Hp eradication rate,histological healing of ulcer,Hp reinfection rate,recurrence rate of ulcer and incidence of adverse reactions in the two groups. Results:Under endoscopy,the total effective rate was 94.44% in the treatment group,higher than that of 77.78% in the control group,the difference being significance(P < 0.05). There was no difference being found in the comparison of Hp eradication rate in the two groups(P>0.05). According to results of histological examination,scores of inflammatory cell infiltration,inflammatory activity,mucosa thickness and glandular morphology in the treatment group were lower than those in the control group,differences being significance(P<0.05). The effect in the treatment group was better than that in the control group. After six months of follow-up,Hp reinfection rate and recurrence rate of ulcer in the treatment group were lower than those in the control group,differences being significance(P<0.05). Conclusion:The therapy of the modified Wuwei Xiaodu yin combined with omeprazole is superior to simple administration of omeprazole in the healing quality of mucosa and the recurrence.