半夏泻心汤合三联疗法对Hp相关性慢性胃炎患者的疗效及血清CagA、VacA的影响

Clinical effect of Banxia Xiexin decoction combined with triple therapy in patients with Helicobacter pylori-related chronic gastritis and its effect on serum cytotoxin-associated protein A and vacuolating cytotoxin A

目的:观察半夏泻心汤联合三联疗法对幽门螺杆菌(Hp)相关性胃炎脾胃湿热证患者的疗效及血清细胞毒素相关蛋白A(Cag A)和空泡毒素A(Vac A)抗体水平的影响。方法:将105例Hp相关性慢性胃炎脾胃湿热证患者随机分为治疗组、对照1组和对照2组,每组各35例。治疗组予半夏泻心汤合三联疗法治疗,对照1组单用半夏泻心汤治疗,对照2组单用三联疗法治疗。治疗6周后比较各组的综合疗效、治疗前后中医症状(上腹胀满、反酸、口苦、胃脘痛、大便黏腻)积分、Hp根除率及血清Cag A、Vac A含量。结果:总有效率治疗组为94.29%(33/35),优于对照1组的88.57%(31/35)与对照2组的85.71%(30/35),差异均有统计学意义(均P<0.05);治疗组中医症状改善、Hp清除率、血清Cag A和Vac A水平均优于对照1、2组,差异均有统计学意义(均P<0.05)。结论:半夏泻心汤联合三联疗法治疗Hp相关性慢性胃炎脾胃湿热证患者,可有效改善患者症状,其机制与通过降低Cag A和Vac A含量,从而减轻Hp致病力有关。

Objective:To investigate the clinical effect of Banxia Xiexin decoction combined with triple therapy in patients with Helicobacter pylori(Hp)-related chronic gastritis with spleen-stomach damp-heat syndrome and its effect on the serum levels of cytotoxin-associated protein A(CagA)and vacuolating cytotoxin A(VacA)antibodies.Methods:A total of 105 patients with Hp-related chronic gastritis with spleen-stomach damp-heat syndrome were randomly divided into treatment group,control group 1,and control group 2,with 35 patients in each group.The patients in the treatment group were given Banxia Xiexin decoction combined with triple therapy,those in the control group 1 were given Banxia Xiexin decoction alone,and those in the control group 2 were given triple therapy alone.After 6 weeks of treatment,the two groups were compared in terms of overall response,scores of traditional Chinese medicine(TCM)symptoms(abdominal distension,acid reflux,bitter taste,epigastric pain,and sticky stool),Hp eradication rate,and serum levels of CagA and VacA.Results:The treatment group had a significantly higher overall response rate than the control group 1 and the control group 2[94.29%(33/35)vs 88.57%(31/35)and 85.71%(30/35),both P<0.05].Compared with the control group 1 and the control group 2,the treatment group had significantly better improvements TCM symptoms,Hp eradication rate,and serum levels of CagA and VacA(all P<0.05).Conclusion:In the treatment of Hp-related chronic gastritis,Banxia Xiexin decoction combined with triple therapy can effectively improve the symptoms of patients with spleen-stomach damp-heat syndrome,possibly by reducing the levels of CagA and VacA to reduce the pathogenicity of Hp.