益气健脾方联合中医特色单元护理对儿童幽门螺旋杆菌相关性胃炎的疗效观察

Effect of Qi Supplement and Spleen Reinforcement Decoction Combined with Traditional Chinese Medicine Nursing Unit on Children with Helicobacter Pylori Associated Gastritis

目的研究益气健脾方联合中医特色单元护理对儿童幽门螺旋杆菌相关性胃炎的疗效作用。方法选取广东省第二中医院与黄浦区永和街社区卫生服务中心儿科门诊治疗的幽门螺旋杆菌相关性胃炎患儿76例,按随机数字表法将患者分为治疗组和对照组,每组各38例。对照组予奥美拉唑、阿莫西林颗粒与甲硝唑治疗,治疗组在对照组的基础上给予益气健脾方联合中医特色单元护理治疗,2组均连续治疗14 d。观察2组患者的临床症状与体征改善情况,采用中医证候评分进行疗效评价。检测2组患儿血清白介素(IL)-6、C反应蛋白(CRP)的水平。13C呼气试验检测2组患儿治疗前与治疗后2个月的感染水平,并随访2组患儿治疗后2个月的症状复发率情况。结果观察组患儿总有效率为94.74%,对照组患儿总有效率为71.05%,2组总有效率比较,差异有统计学意义(P<0.05)。观察组患儿胃区疼痛、腹胀不适、恶心呕吐症状评分均低于对照组,差异有统计学意义(P<0.05)。观察组患者治疗后血清IL-6浓度水平明显低于对照组,差异有统计学意义(P<0.05)。观察组患者治疗后血清CRP浓度水平明显低于对照组,差异有统计学意义(P<0.05)。随访3个月,观察组患儿Hp转阴率明显高于对照组(89.47%vs65.79%),差异有统计学意义(P<0.05)。此外,观察组患儿复发率明显低于对照组(5.26%vs 23.68%),差异有统计学意义(P<0.05)。结论益气健脾方联合中医特色单元护理能够显著改善Hp相关性胃炎患儿的临床症状,缩短病程,其作用可能与减少IL-6与CRP的分泌有关。

To study the therapeutic effect of Qi Supplement and Spleen Reinforcement Decoction combined with traditional Chinese medicine（ TCM） nursing unit on children with helicobacter pylori（ HP） associated gastritis. Methods： 76 pediatric outpatients with Helicobacter Pylori associated gastritis were included from the Second Hospital of Guangdong Province and the Community Health Service Center in Yonghe Street of Huangpu District. The patients were averagely divided into the treatment group（ n = 38） and the control group（ n = 38）according to random number table method. The control group was given with omeprazole,amoxicillin and metronidazole. And the treatment group was administered Qi Supplement and Spleen Reinforcement Decoction combined with traditional Chinese medicine nursing unit on the basis of the control group. Both of groups were treated for 14 consecutive days. The improvement of clinical symptoms and signs in the two groups were observed,and TCM syndrome scores system was used to evaluate the efficacy. In addition,interleukin（ IL）-6 and C-reactive protein（ CRP） levels in serum were measured. The 13 C breath test was also used to test infection status before and after the treatment（ 2 months later） and the patients were followed up for their recurrence rate in 2 months. Results： The total effective rate was 94. 74% in the treatment group and 71. 05% in the control group with significant difference（ P〈0. 05）. The scores of gastric pain,abdominal distension,nausea and vomiting in the treatment group were lower than those in the control group with significant difference（ P〈0. 05）. The serum IL-6 and CRP level in the treatment group were significantly lower than that in the control group with significant difference（ P〈0. 05）. After 3 months of follow-up,the negative conversion rate of HP in the treatment group was significantly higher than that in the control group（ 89. 47% vs 65. 79%,P〈0. 05）. In addition,the recurrence rate in the treatment group was significantly lower than that in the control group（ 5. 26% vs 23. 68% P〈0. 05）. Conclusion： The combination of Qi Supplement and Spleen Reinforcement Decoction and TCM nursing unit can significantly improve the clinical symptoms and shorten the duration of the disease in children with HP-associated gastritis,possibly related to the decrease of IL-6 and CRP secretion.