升清益胃汤及穴位敷贴治疗老年消化性溃疡临床观察

Discussion on the Therapeutic Effect and Optimal Time of Shengqing Yiwei Decoction and Acupoint Application in the Treatment of Senile Peptic Ulcer

目的探讨升清益胃汤及穴位敷贴联合四联疗法治疗胃阴不足型Hp阳性老年人消化性溃疡的临床疗效及最优治疗时间。方法选取2017年4月—2019年2月收治的50例胃阴不足型Hp阳性老年人消化性溃疡患者,随机分为对照组和观察组,各25例。对照组行常规四联疗法,观察组在对照组基础上服用升降益胃汤配合穴位敷贴,比较2组总疗效、临床症状总积分及复发率、Hp转阳率,并初步探讨升清益胃汤及穴位敷贴改善症状的最优治疗时间。结果观察组总有效率(84.0%)明显高于对照组(44.0%)(P<0.05);观察组治疗后临床症状总积分低于对照组(P<0.05);观察组治疗后4周和治疗后6周症状总积分比较差异无统计学意义(P>0.05),提示最优治疗时间是4周;观察组复发率、Hp转阳率均明显低于对照组(均P<0.05)。结论升清益胃汤配合穴位敷贴治疗胃阴不足型Hp阳性老年人消化性溃疡能有效缓解患者症状,提高临床疗效,降低复发率。

Objective To explore the clinical effect and optimal treatment time of Shengqing Yiwei decoction and acupoint application combined with quadruple therapy in the treatment of peptic ulcer of HP positive elderly patients with deficiency of stomach yin.Methods50 cases of PU patients with HP positive from April 2017 to February 2019 were randomly divided into control group and observation group,with 25 cases in each group.The control group received routine quadruple therapy,and the observation group also took Shengjiang Yiwei decoction combined with acupoint application.The total curative effect,total score of clinical symptoms,recurrence rate and HP conversion rate were compared between the two groups,and the optimal treatment time was analyzed.Results The total effective rate of the observation group(84.0%)was significantly higher than that of the control group(44.0%)(P<0.05).After treatment,the total score of clinical symptoms in the observation group was lower than that in the control group(P<0.05).By comparing the clinical symptom scores of different time points before and after treatment,the optimal treatment time was 4 weeks.After 6 months’following-up,the recurrence rate and HP positive conversion rate in the observation group were significantly lower than those in the control group(P<0.05).Conclusion Shengqing Yiwei decoction combined with acupoint application can effectively improve the clinical efficacy in the treatment of PU in the elderly with HP positive stomach yin deficiency.