标准三联加大黄、黄连及黄芩根除幽门螺杆菌疗效的比较

Clinical effects of standard triple therapy in combination with different single traditional Chinese medicine on Hp infection

[目的]观察标准三联疗法联合不同单味中药治疗幽门螺杆菌(Hp)的临床疗效。[方法]将门诊经14 C呼气试验检测Hp阳性患者255例,随机分为5组:标准三联组(A组):奥美拉唑+阿莫西林+克拉霉素;标准三联分别加黄连、黄芩及大黄免煎冲剂(B、C、D组);标准三联加胶体铋(E组)。剂量为奥美拉唑20mg/次,克拉霉素0.5g/次,阿莫西林1.0g/次,黄连免煎冲剂5g/次,黄芩免煎冲剂7.5g/次,大黄免煎冲剂3g/次,胶体果胶铋150mg/次,均每日2次,口服,连续服用10d。抗Hp治疗停药4周后复查14 C呼气试验。比较各组Hp根除率。[结果]各组Hp根除率分别为E组86.11%,D组85.29%,B组75%,C组51.43%,A组51.52%。D、B、E组分别与A、C组比较差异有统计学意义(P<0.05)。D、B、E组比较差异无统计学意义。A、C组间差异无统计学意义。在临床症状改善率方面,D、B、E组分别与A、C组比较差异有统计学意义(P<0.01)。D、B、E组比较差异无统计学意义。A、C组比较有统计学差异(P<0.05)。[结论]中药大黄、黄连加标准三联对Hp的根除率高于标准三联,前者根除率与铋剂加标准三联相近。中药加标准三联的临床症状改善率明显高于标准三联。

[Objective]To explore the clinical effects of standard triple therapy in combination with different single traditional Chinese medicine on Hp infection.[Methods]Two hundred and fifty-five patients with Hp infection were randomly divided into 5groups：standard triple therapy group：omeprazole（OME）,amoxicillin（AML）combined with clarithromycin（CLA）,free-boiled herbs coptis root,scutellaria root or rhubarb root combined with standard triple therapy,colloidal bismuth pectin in combination with standard triple therapy.Dose：OME 20 mg per time,CLA 0.5g per time,amoxicillin1.0g per time,free-boiled herbs coptis root 5g per time,free-boiled herbs scutellaria root 7.5g per time,free-boiled herb rhubarb roots 3g per time,colloidal bismuth pectin 150 mg per time,all twice a day for 10 days.After the treatment of 4weeks,we reexaminate the ^14 C urea breath test,and compare the Hp eradicate rate among different groups.[Results]Hp eradicate rates of groups were shown respectively as follows：the rate of colloidal bismuth pectin combined with standard triple therapy（E）group is 86.11%,the rate of rhubarb root combined standard triple therapy（D）group is 85.29%,the rate of coptis root combined standard triple therapy（B）is group75%,the rate of scutellaria root combined with standard triple therapy（C）group is 51.43%,and the rate of standard triple therapy（A）group is 51.52%.There was significant difference between the groups treated with B,D,E and A,C（P〈0.05）.There was no significant difference among the groups treated with B、D and E.No significant difference between the groups treated with A and C was observed.On the clinical symptoms improvement rate,there was significant difference between the groups treated with B,D,E and A,C（P〈0.01）.There was no significant difference among the groups treated with B,D and E.Significantdifference between the groups treated with A and C（P〈0.05）was observed.[Conclusion]Rhubarb root or coptis root,combined with standard triple therapy,is better than standard triple therapy on the curative effect of anti-Hp.The former is similar with colloidal bismuth pectin combined with standard triple therapy.Standard triple therapy combined with traditional Chinese medicine is superior to standard triple therapy on the improvement rate of clinical symptoms.