生胃方治疗脾虚湿热证Hp相关性消化不良临床疗效观察

Clinical Observation of Shengwei Decoction in the Treatment of Spleen Deficiency and Dampness-heat Type Dyspepsia

目的:观察生胃方联合标准三联疗法治疗脾虚湿热证幽门螺旋杆菌相关消化不良的疗效和安全性。方法:将2015年5月—2016年5月我院门诊及住院部因消化不良而就诊的脾虚湿热幽门螺旋杆菌阳性患者113例随机分为标准三联疗法组、标准三联疗法+胶体果胶秘组、标准三联疗法+生胃方组,疗程均为2周,服药2周后停药4周,通过14C呼气试验检测患者幽门螺旋杆菌根治率,观察患者入组前及入组后消化不良症候群评分,分析减分率及总有效率。结果:三组治疗后症状积分较治疗前均有明显下降,其中生胃组症状积分下降较秘剂组明显,较三联组更明显(P<0.05),差异具有统计学意义。三联组根除率63.16%,铋剂组根除率78.37%,生胃组根除率86.84%(P<0.05),差异具有统计学意义。标准三联疗法组总有效率73.68%,铋剂组总有效率86.48%,生胃组总有效率94.73%,生胃组有效率显著高于铋剂组及三联组(P<0.05),差异具有统计学意义。消化不良症状改善与幽门螺旋杆菌根治相关(P<0.05),差异具有统计学意义。结论:生胃方用于脾虚湿热证幽门螺旋杆菌相关性消化不良治疗,疗效好,安全性高,适宜临床推广运用。

Objective ： To observe the efficacy and safety of Shengwei Decoction combined standard triple therapy for treating indigestion associated with spleen deficiency and dampness-heat syndrome. Methods：The 113 cases with indigestion of H. pylori positive patients were collected form May 2015- May 2016 in Guangdong NO.2 TCM hospital outpatient and the inpatient, randomly divided into standard triple therapy group, standard triple therapy with colloidal bismuth pectin group, standard triple therapy with Shengwei Decoction, the threapy course last for 2 week, Hp was detected by 14C-urea breath test （ 14C-UBT ） 4 weeks after discontinuation of all three groups. Then score of symptom was observed before and after treatment. To compare cure rates during the three groups. Analysing the reducing rate of indigestion syndrome score and total effective rate. Results ： The indigestion syndrome symptom score of the three groups have all decreased significantly after treatment （P〈0.05）. And the Shengwei Decoction group had better effect, even more obvious than the standard triple therapy. Hp elimination rate, standard triple therapy group 63.16%, colloidal bismuth pectin group 78.37%, Shengwei Decoction 86.84%, difference was statistically significant （ P〈0.05 ）. Total effective rate, standard triple therapy group 73.68%, ccolloidal bismuth pectin group 86.48%, Shengwei Decoction 94.73%, difference is statistically significant （ P〈0.05 ）. Conclusion ： Shengwei Decoction is a drug with good efficacy, safety, less adverse effect and good compliance in the treatment of indigestion of H. pylori positive.