清利化浊方联合铋剂四联治疗幽门螺杆菌相关慢性非萎缩性胃炎脾胃湿热证40例临床观察

Clinical Observation of Qing Li Huazhuo Fang( 清利化浊方) Combined with Bismuth-quadruple in the Treatment of 40 Cases of Chronic Non-atrophic Gastritis with Helicobacter Pylori with Damp Heat in the Spleen and the Stomach Syndrome

目的观察清利化浊方联合铋剂四联治疗幽门螺杆菌(Hp)相关慢性非萎缩性胃炎脾胃湿热证的临床疗效及安全性。方法将80例Hp相关慢性非萎缩性胃炎患者随机分为治疗组和对照组各40例,对照组口服铋剂四联治疗(雷贝拉唑肠溶胶囊,每次20 mg;阿莫西林克拉维酸钾分散片,每次914 mg;甲硝唑,每次200 mg;胶体果胶铋胶囊,每次200 mg,均每日2次),治疗组在对照组的基础上加用清利化浊方,每日1剂。两组均治疗14天。治疗前后观察两组患者胃镜下胃黏膜改变及病理变化、中医主要症状(包括胃脘痛、上腹胀满、口苦、反酸、大便黏滞)积分及Hp根除率,判定临床疗效并观察不良反应。结果治疗组临床疗效总有效率为90.0%,明显高于对照组的77.5%(P<0.05)。治疗组治疗后中医各主要症状积分均明显下降,且均明显低于对照组(P<0.05或P<0.01)。治疗组Hp根除率92.5%明显高于对照组的77.5%(P<0.05)。两组均无严重不良反应。结论清利化浊方联合铋剂四联治疗Hp相关慢性非萎缩性胃炎脾胃湿热证患者疗效确切,能明显改善临床症状,提高Hp根除率,安全性较好。

Objective To observe the clinical efficacy and safety of QingLi Huazhuo Fang combined with bismuth-quadruple in the treatment of chronic non-atrophic gastritis with helicobacter pylori （Hp） with damp heat in the spleen and the stomach syndrome. Methods Eighty cases of chronic non-atrophic gastritis with Hp were randomly divided into a treatment group and a control group, with 40 cases in each group. Both groups were given bismuth-quadruple therapy （20mg of rabeprazole enteric capsules, 914mg of amoxicillin clavulanate potassium dispersible tablets, 200 mg of metronidazole, and 200 mg of colloidal bismuth pectin capsules, twice a day） , and the treatment group also used QingLi Huazhuo Fang, one dose daily. Both groups were treated for 14 days. Before and after treatment, changes of gastric mucosa and pathological change under gastroscope, scores of Chinese medical symptoms （including epigastric pain, epigastric distention, bitter taste, acid regurgitation and viscous faeces）, eradicated rate of Hp, and adverse reactions were observed in two groups, and the clinical efficacy was evaluated. Results The total effective rate in the treatment group was 90. 0%, which was significantly higher than 77.5% in the control group （ P 〈 0. 05 ）. After treatment, the scores of Chinese medical symptoms in the treatment group decreased significantly and were significantly lower than those in the control group （P 〈 0.05 or P 〈 0. 01 ）. Eradica- ted rate of Hp in the treatment group was 92. 5%, which was obviously higher than 77.5% in the control group （P 〈 0. 05）. No serious adverse reactions were found in both groups. Conclusion There is definite curative effect of QingLi Huazhuo Fang combined with bismuth-quadruple in treating chronic non-atrophic gastritis with Hp with damp heat in the spleen and the stomach syndrome. It can significantly improve clinical symptoms and eradicated rate of Hp with good safety.