化浊解毒汤对Hp相关性慢性萎缩性胃炎伴肠上皮化生疗效的临床研究

Clinical study of Huazhuo Jiedu decoction on Hp associated chronic atrophic gastritis with intestinal metaplasia

目的:观察分析化浊解毒汤对Hp相关性慢性萎缩性胃炎(CAG)伴肠上皮化生(IM)患者的临床疗效。方法:将河北省中医院收治的46例Hp呈阳性的CAG伴IM患者按随机数字表法分成2组,每组23例,2组均予标准四联杀菌疗法治疗2周,对照组配以胃复春片治疗,观察组予化浊解毒汤治疗,2组均连续治疗3个月。观察记录3个月后患者临床疗效、中医证候积分、病理疗效、病理组织学改变积分、Hp根除率及复发率的变化;记录其治疗6周、3个月后的Hp根除率,并随访3个月,分析其Hp复发率。结果:治疗后,2组总有效率及病理疗效相比,观察组均高于对照组(P<0.05);2组中医证候积分均较治疗前降低(P<0.05),且观察组优于对照组(P<0.05)。2组病理学组织改变积分均较治疗前降低(P<0.05),观察组优于对照组(P<0.05)。观察组Hp根除率优于对照组(P<0.05)。治疗后进行3个月的随访,与对照组相比,观察组复发率明显更低(P<0.05)。结论:化浊解毒汤治疗Hp相关的浊毒内蕴证CAG伴IM,可有效改善患者临床症状及病理组织学病变、修复胃黏膜,协助根除Hp并降低复发率,临床疗效显著。

Objective: To observe and analyze the clinical effect of Huazhuo Jiedu decoction on Helicobacter pylori(Hp) related chronic atrophic gastritis with intestinal metaplasia. Methods: Forty-six cases of Hp positive chronic atrophic gastritis with intestinal metaplasia were divided into two groups randomly. Twenty-three cases in each group, two groups were given standard quadruple sterilization therapy for 2 weeks.The control group was treated with weifuchun, and the observation group was treated with Huazhuo Jiedu decoction.Both groups were treated for 3 months. Observe and record the change of the clinical efficacy, Traditional Chinese Medicine(TCM) syndrome score, pathological efficacy, histopathological change score, Hp eradication rate and recurrence rate after 3 months. The Hp eradication rate was recorded after 6 weeks and 3 months of treatment, and the Hp recurrence rate was analyzed after 3 months of follow-up. Results: After treatment, the total effective rate and pathological curative effect in the observation group were higher than those in the control group(P<0.05), and the TCM syndrome scores in the two groups were lower than those before treatment(P<0.05).And the observation group was better than the control group(P<0.05), the scores of pathological changes in the two groups were lower than before treatment(P<0.05), the observation group was better than the control group(P<0.05). The Hp eradication rate of the observation group was better than that of the control group(P<0.05).After 3 months of follow-up, the recurrence rate of the observation group was significantly lower than that of the control group(P<0.05). Conclusion: Huazhuo Jiedu decoction can effectively improve the clinical symptoms and histopathological changes, repair the gastric mucosa, help to kill Hp and reduce the recurrence rate. The clinical effect is remarkable.