中西医结合治疗脾胃虚寒型Hp阳性消化性溃疡35例临床观察

Clinical Observation on 35 Cases of Hp Positive Peptic Ulcer of Spleen-stomach Deficiency-cold Type Treated with Combination of Traditional Chinese and Western Medicine

目的:观察中西医结合治疗脾胃虚寒型Hp阳性消化性溃疡的临床疗效。方法:将70例幽门螺旋杆菌阳性消化性溃疡脾胃虚寒证患者随机分为观察组、对照组,每组35例。对照组采用基础的含铋四联用药方案:雷贝拉唑、枸橼酸铋钾、阿莫西林、克拉霉素;观察组在对照组含铋四联疗法的基础上口服加减阳和汤。对照组及观察组的总疗程均为6周,其中阿莫西林、克拉霉素、枸橼酸铋钾的用药疗程为2周。比较两组治疗后的胃镜疗效、幽门螺旋杆菌根除率、中医证候积分、总疗效,并通过血常规、肝功能、二便常规评价其安全性并记录不良反应。结果:观察组的胃镜疗效、中医证候积分均明显好于对照组(P<0.05)。两组Hp根除率较高,疗效相同(P>0.05)。安全性评价方面,两组血常规、二便常规、肝肾功能均未发生明显变化,两组治疗均安全。两组患者均有可耐受的不良反应,但观察组的不良反应发生率明显低于对照组(P<0.05)。总疗效方面,观察组为94.29%,高于对照组91.42%(P<0.05)。结论:中西医结合治疗脾胃虚寒型Hp阳性消化性溃疡疗效肯定,能促进溃疡愈合,改善中医证候,改善患者症状,安全性好,不良反应少,具有一定的临床价值。

Objective To observe the clinical effect of integrated traditional Chinese and Western medicine on 35 cases of Hp positive peptic ulcer of Spleen-stomach deficiency-cold type.Methods 70 patients with Helicobacter Pylori positive peptic ulcer syndrome were randomly divided into observation group and control group with 35 cases in each group.The Control Group was treated with the basic bismuth-containing quadruple regimen:Rabeprazole,Bismuth Potassium citrate,Amoxicillin,Clarithromycin.Observation Group in the Control Group on the basis of treatment with Modified Langhe Decoction.In the Control Group and the Observation Group,the total course of treatment was 6 weeks,including Bismuth Potassium Citrate,Amoxicillin and Clarithromycin for 2 weeks.The curative effect of gastroscopy,eradication rate of Helicobacter pylori,integral of TCM Syndrome,total curative effect were compared between the two groups and record adverse reactions.Results The curative effect of gastroscopy and TCM symptom scores in the observation group were significantly better than those in the control group(P<0.05).The eradication rate of HP was higher and the curative effect was the same between the two groups(P>0.05).In terms of safety evaluation,blood routine,stool routine and liver and kidney function did not change significantly in the two groups.Both groups had tolerable adverse reactions,but the incidence of adverse reactions in the observation group was significantly lower than that in the control group.The total effective rate of the observation group was 94.29%higher than that of the control group was 91.42%(P<0.05).Conclusion Hp positive peptic ulcer of Spleen-stomach deficiency-cold type treated with combination of traditional Chinese and Western medicine has positive effect,can promote ulcer healing,improve TCM symptoms,improve patients symptoms,less adverse reactions,has certain clinical value.