养胃颗粒联合四联疗法治疗Hp阳性慢性萎缩性胃炎的临床研究

Clinical study of Yangwei Granules combined with quadruple therapy in the treatment of chronic atrophic gastritis with positive Hp

目的探讨养胃颗粒联合四联疗法治疗幽门螺杆菌(Hp)阳性慢性萎缩性胃炎(CAG)的临床效果。方法选取2015年1月～2017年1月辽宁省抚顺市中医院收治的Hp阳性CAG患者81例,根据随机数字表法将患者分为对照组(40例)和研究组(41例)。对照组给予四联疗法治疗,研究组给予养胃颗粒联合四联疗法治疗。比较两组患者治疗90 d后临床疗效、Hp根除情况,比较两组治疗前、治疗90 d后胃动素(MLT)、内皮素(ET)、胃泌素(GAS)、胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、PGⅠ/PGⅡ水平,记录两组治疗期间不良反应发生情况。结果研究组治疗90 d后总有效率显著高于对照组患者(P <0.05)。研究组的Hp根除率明显高于对照组(P <0.05)。两组患者治疗90 d后MLT、ET较治疗前降低,且研究组低于对照组(P <0.05);GAS较治疗前升高,且研究组高于对照组(P <0.05)。两组治疗前与治疗90 d后PGⅡ比较差异无统计学意义(P> 0.05);两组患者治疗90 d后PGⅠ、PGⅠ/PGⅡ较治疗前显著升高,且研究组高于对照组(P <0.05)。两组治疗期间不良反应发生率比较差异无统计学意义(P> 0.05)。结论养胃颗粒联合四联疗法治疗Hp阳性CAG效果确切,可有效改善患者胃蛋白酶原、胃肠激素水平,且不增加不良反应发生率,具有较高的临床应用价值。

Objective To investigate the clinical efficacy of Yangwei Granules combined with quadruple therapy in the treatment of chronic atrophic gastritis (CAG) with positive Helicobacter pylori (Hp). Methods Eighty-one cases of Hp-positive CAG admitted to Fushun Hospital of Traditional Chinese Medicine from January 2015 to January 2017 were selected, they were randomly divided into control group (40 cases) and study group (41 cases) according to the number table method. The control group was treated with quadruple therapy and the study group was treated with Yangwei Granules combined with quadruple therapy.The clinical efficacy and Hp eradication of the two groups was compared at 90 d after treatment. The levels of motilin (MLT), endothelin (ET), gastrin (GAS), pepsinogen Ⅰ(PGI), pepsinogen Ⅱ(PGⅡ), PGⅠ/PGⅡ were recorded before and 90 d after treatment, the adverse reactions during the treatment were recorded. Results 90 days after treatment, the total effective rate in the study group was significantly higher than the control group (P < 0.05). The eradication rate of Hp in the study group was significantly higher than that in the control group (P < 0.05). After 90 days of treatment, MLT and ET in the two groups were lower than those before treatment, and the GAS in the study group was higher than that in the control group (P < 0.05), which in the study group was higher than that in the control group (P < 0.05). There were no significant differences in PGⅡ between the two groups before and 90 days after treatment (P > 0.05);PGⅠ, PGⅠ/PGⅡ in the two groups increased significantly after 90 days of treatment, and the study group was higher than the control group (P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups during treatment (P > 0.05). Conclusion Yangwei Granules combined with quadruple therapy is effective in the treatment of Hp-positive CAG. It can effectively improve the level of pepsinogen and gastrointestinal hormones without increasing the incidence of adverse reactions. It has high clinical value.