辨证论治配合西药治疗幽门螺杆菌相关性慢性胃炎临床研究

Syndrome differentiation treatment combined western medicine for helicobacter pylori related chronic gastritis

目的:观察中药辨证论治联合西药三联疗法治疗幽门螺杆菌相关性慢性胃炎的疗效。方法:将符合纳入标准的180例患者按中医辨证分成脾胃虚弱型、脾胃湿热型、肝郁气滞型,每组再随机分为两个亚组,即中药加三联组和铋剂四联组,每个亚组30例。其中中药加三联组予奥美拉唑20mg、阿莫西林1000mg和克拉霉素500mg,2次/d,疗程10d,同时予中药服用10d,铋剂四联组在三联基础上加枸橼酸铋钾220mg,疗程10d;治疗结束后至少28d,予行13碳尿素呼气试验,从幽门螺杆菌根除率、临床受益反应和不良反应三方面评价各组的治疗结果。结果:中药加三联组幽门螺杆菌根除率为76.7%,铋剂四联组为80%,比较差异无统计学意义(P>0.05);治疗后三联加中药组症状评分明显优于铋剂四联组(P<0.05);三联加中药组有1例发生不良反应,铋剂四联组有9例发生不良反应(P<0.05)。结论:中药辨证论治联合三联疗法治疗幽门螺杆菌相关性慢性胃炎疗效确切,较铋剂四联组更能改善临床受益反应,减少不良反应。

Objective：To observe the therapeutic effect of Chinese material medica combined triple therapy treatment for HP related chronic gastritis.Methods：180cases with HP related chronic gastritis were divided into weakness of spleen and stomach syndrome,dampness-heat of spleen and stomach syndrome,liver depression and qi stagnation syndrome,and each group were subdivided into triple therapy with Chinese material medica and bismuthcontaining quadruple therapy.The group of triple therapy with Chinese material medica received omeprazole 20mg、amoxicillin 1000 mg and clarithmmycin 500 mg,twice a day,for 10 days,and Chinese material medica for 10 days,and another group add Colloidal Bismuth Subcitrate 220 mg base on triple therapy.At least 28 days after treatment,all patients underwent 13 Curea breath test.The therapeutic effect was evaluated by the helicobacter pylori eradication rate and clinical benefit response and adverse reactions.Results：The helicobacter pylori eradication rate in group of triple therapy with Chinese material medica were 76.7%and the group of bismuth-containing quadruple therapy 80%with no statistical significance（P〉0.05）.Symptom scores of group of triple therapy with Chinese material medica were better than group of bismuth-containing quadruple therapy after treatment（P〈0.05）,and less adverse reactions（1∶9,P 〈0.05）.Conclusion：Chinese material medica combined triple therapy was useful in treating HP related chronic gastritis.And bring more clinical benefit response and less adverse reactions than bismuth-containing quadruple therapy.