镶嵌疗法联合中药对H.pylori阳性消化性溃疡炎性相关因子及复发的影响

Effects of mosaic therapy combined with traditional Chinese medicine on inflammation-related factors and recurrence of H.pylori-positive peptic ulcer

目的观察镶嵌疗法联合中药对H.pylori阳性消化性溃疡炎性相关因子及复发的影响。方法94例H.pylori阳性消化性溃疡患者随机分为对照组和观察组,对照组采用镶嵌疗法,观察组在对照组治疗基础上加服健脾清热方。比较2组治疗前后症状评分、临床疗效及血清C-反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平,H.pylori根除率,治疗结束后6个月及12个月H.pylori再感染率、溃疡复发率。结果治疗后2组胃脘疼痛、口干口苦、身重困倦、食少纳呆及黏膜炎症积分各积分均较治疗前明显下降(P<0.05),且观察组改善更加明显(P<0.05)。观察组和对照组治疗后有效率分别为89.13%和80.85%,观察组有效率高于对照组,但差异无统计学意义(P>0.05)。治疗后2组患者血清CRP、IL-6、TNF-α水平均较治疗前显著降低,且治疗组显著低于对照组,差异均有统计学意义(P<0.05)。6个月及12个月随访时,观察组H.pylori再感染率、溃疡复发率均显著低于对照组,差异有统计学意义(P<0.05)。结论镶嵌疗法联合中药可有效改善H.pylori阳性消化性溃疡患者的临床症状,提高H.pylori根除率,改善机体炎性因子水平,降低溃疡复发率,使H.pylori再次感染率更低。

Objective To investigate the effects of mosaic therapy combined with traditional Chinese medicine on inflammation-related factors and recurrence of H.pylori-positive peptic ulcer.Methods Ninety-four patients with H.pylori-positive peptic ulcer were randomly divided into ontrol group and observation group,with 47 patients in each group.The patients in control group were treated by mosaic therapy,however,the patients in observation group,on the basis of control group,were treated by Jianpiqingre formula.The symptom scores before and after treatment,clinical efficacy and the serum levels of CRP,IL-6,TNF-α,and H.pylori eradication rate,H.pylori reinfection rate and ulcer recurrence rate at 6 months and 12 months after treatment were observed and compared between the two groups.Results After treatment,the scores of gastroparesis,dry mouth and bitterness,body weight,drowsiness,food intake,and mucosal inflammation scores were significantly decreased in both groups,as compared with those before treatment(P<0.05),moreover,the improvement degree in observation group was more significant than that in control group(P<0.05).The effective rate in observation group and control group was 89.13%and 80.85%,respectively,but there was no significant difference between the two groups(P>0.05).After treatment the serum levels of CRP,IL-6 and TNF-αwere significantly decreased in both groups,moreover,the decrease degree in observation group was more significant than that in control group(P<0.05).At 6-month and 12-month follow-up,the H.pylori reinfection rate and ulcer recurrence rate in observation group were significantly lower than those in control group(P<0.05).Conclusion The mosaic therapy combined with traditional Chinese medicine can effectively improve the clinical symptoms of patients with H.pylori-positive peptic ulcer,improve H.pylori eradication rate,improve the levels of inflammatory factors,and reduce the recurrence rate of ulcer and the re-infection rate of H.pylori.