健胃愈疡清幽汤联合四联疗法治疗Hp阳性消化性溃疡肝胃郁热证49例

Clinical effect of Jianwei Yuyang Qingyou decoction combined with quadruple therapy in treatment of Helicobacter pylori-positive peptic ulcer with liver-stomach heat accumulation:An analysis of 49 cases

目的:探讨健胃愈疡清幽汤联合四联疗法治疗幽门螺杆菌(Hp)阳性消化性溃疡肝胃郁热证的疗效及对患者血清胃肠激素水平的影响。方法:将98例Hp阳性消化性溃疡肝胃郁热证患者按随机数字表法分为治疗组和对照组,每组各49例。对照组采用标准四联疗法治疗,治疗组在对照组基础上加用健胃愈疡清幽汤治疗。比较2组临床疗效,胃十二指肠黏膜损伤评分,肝胃郁热证候评分,血清胃动素、胃泌素水平以及Hp根除率。结果:总有效率和Hp根除率治疗组分别为93.88%(46/49)、87.76%(43/49),均高于对照组的77.55%(38/49)、69.39%(34/49),差异有统计学意义(均P<0.05)。2组胃十二指肠黏膜损伤评分、肝胃郁热证候评分、血清胃动素及胃泌素水平治疗前后组内比较及治疗后组间比较,差异有统计学意义(均P<0.01)。结论:健胃愈疡清幽汤联合四联疗法治疗Hp阳性消化性溃疡肝胃郁热证疗效显著,且可有效下调患者血清胃动素、胃泌素水平。

Objective:To investigate the clinical effect of Jianwei Yuyang Qingyou decoction combined with quadruple therapy in the treatment of Helicobacter pylori(Hp)-positive peptic ulcer with liver-stomach heat accumulation and its influence on the serum levels of gastrointestinal hormones.Methods:A total of 98 patients with Hp-positive peptic ulcer with liver-stomach heat accumulation were divided into treatment group and control group using a random number table,with49 patients in each group.The patients in the control group were given standard quadruple therapy,and those in the treatment group were given Jianwei Yuyang Qingyou decoction in addition to the treatment in the control group.The two groups were compared in terms of clinical outcome,gastroduodenal mucosal injury score,syndrome score of liver-stomach heat accumulation,serum levels of motilin and gastrin,and Hp eradication rate.Results:Compared with the control group,the treatment group had significantly higher overall response rate[93.88%(46/49)vs 77.55%(38/49),P<0.05]and Hp eradication rate[87.76%(43/49)vs 69.39%(34/49),P<0.05].Both groups had significant changes in gastroduodenal mucosal injury score,syndrome score of liver-stomach heat accumulation,and serum levels of motilin and gastrin after treatment,and there were significant differences in these indices between the two groups after treatment(all P<0.01).Conclusion:Jianwei Yuyang Qingyou decoction combined with quadruple therapy has a marked clinical effect in the treatment of Hp-positive peptic ulcer with liver-stomach heat accumulation and can downregulate the serum levels of motilin and gastrin.