中西药序贯疗法治疗幽门螺杆菌阳性慢性荨麻疹临床研究

Clinical Effect of Sequential Therapy with Chinese and Western Medicines in Treatment of Helicobacter pylori-positive Chronic Urticaria

目的观察中西药序贯疗法治疗幽门螺杆菌(Heliobacter pylofi,Hp)阳性慢性荨麻疹的临床疗效,并初步探讨其作用机制。方法将符合诊断标准的61例Hp阳性慢性荨麻疹患者随机分为3组:西药组20例,予西替利嗪口服;联合组20例,在西药组基础上加服2周抗Hp四联药物;序贯组21例,在西药组基础上加服2周抗Hp四联药物后以序贯中药口服,3组疗程均为8周。观察3组临床疗效、症状积分、治疗前后白细胞介素-4(interleukin-4,IL-4)、干扰素-γ(interferon-γ,IFN-γ)水平的变化及Hp转阴率。结果 3组临床疗效比较,差异具有统计学意义(P<0.05),序贯组疗效优于西药组和联合组;3组治疗后IL-4水平较治疗前降低(P<0.05),IFN-γ水平较治疗前升高(P<0.05)。序贯组治疗后症状总积分降低值显著大于联合组和西药组(P<0.05)。3组治疗后Hp转阴率比较,差异有统计学意义(P<0.05),以序贯组Hp转阴率为最高。结论抗组胺药联合抗Hp四联药物后序贯中药治疗伴有Hp感染的慢性荨麻疹疗效显著。

Objective To investigate the clinical effect of sequential therapy with Chinese and Western medicines in the treatment of Helicobacter pylori-positive chronic urticaria and related mechanisms. Methods A total of 61 patients with Helicobacter pylori-positive chronic urticaria who met the diagnostic criteria were randomly divided into three groups. The 20 patients in the Western medicine group were given oral cetirizine, the 20 patients in the combination group were given four anti-Helicobacter pylori drugs for 2 weeks in addition to the treatment for the Western medicine group, and the 21 patients in the sequential group were given four anti-Helicobacter pylori drugs for 2 weeks in addition to the treatment for the Western medicine group, followed by oral traditional Chinese medicine. The course of treatment was 8 weeks for all groups. The clinical outcome, symptom score, changes in the levels of interleukin-4 （IL-4） and interferon-γ （IFN-γ） after treatment, and Helicobacter pylori clearance rate were observed in all the three groups. Results There was a significant difference in clinical outcome between the three groups （P〈0.05）, and the sequential group had a significantly better clinical outcome than the Western medicine group and the combination group. After treatment, all the groups had a significant reduction in IL-4 level （P〈0.05） and a significant increase in IFN-γ level （P〈0.05）. The sequential group had a significantly greater decrease in the total symptom score than the Western medicine group and the combination group （P〈0.05）. There was a significant difference in the Helicobacter pylori clearance rate between the three groups （P〈0.05）, and the sequential group had the highest Helicobacter pylori clearance rate. Conclusion Sequential therapy with antihistamine combined with four anti-Helicobacter pylori drugs followed by traditional Chinese medicine has a significant clinical effect in the treatment of chronic urticaria with Helicobacter pylori infection.