柴胡疏肝散合沉香降气散联合四联疗法治疗幽门螺杆菌感染 肝胃不和型慢性胃炎的临床观察

Effect of Chaihu Shugan Powder and Chenxiang Jiangqi Powder combined with quadruple therapy on Helicobacter pylori infection-caused chronic gastritis of liver-stomach disharmony

目的观察柴胡疏肝散合沉香降气散治疗幽门螺杆菌(Hp)感染肝胃不和型慢性胃炎的临床疗效。方法将94例Hp感染肝胃不和型慢性胃炎患者按照随机数字表法分为2组,对照组47例予常规四联疗法(雷贝拉唑钠肠溶片+克拉霉素胶囊+阿莫西林胶囊+枸橼酸铋钾胶囊)治疗,治疗组47例在对照组基础上加用柴胡疏肝散合沉香降气散治疗。2组均治疗2周后统计疗效,比较2组治疗前后中医症状评分(包括胃脘痞满、胃脘痛、烧灼感、反酸嗳气、疲倦乏力及恶心呕吐)、红细胞免疫功能[包括红细胞C3b受体花环率(RBC-C3bRR)、免疫复合物花环率(RBC-ICR)]、炎症指标[包括C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)]水平变化情况,比较2组Hp根除率及药物不良反应发生率。结果治疗组总有效率97.87%(46/47),Hp根除率97.87%(46/47),不良反应总发生率4.26%(2/47),对照组分别为82.98%(39/47)、80.85%(38/47)、21.28%(10/47),治疗组总有效率及Hp根除率均高于对照组(P<0.05),不良反应总发生率低于对照组(P<0.05)。与本组治疗前比较,2组治疗后中医症状胃脘痞满、胃脘痛、烧灼感、反酸嗳气、疲倦乏力、恶心呕吐评分及总分均降低(P<0.05),且治疗组治疗后中医症状各项评分及总分均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后RBC-C3bRR水平均升高(P<0.05),RBC-ICR水平均降低(P<0.05),且治疗组治疗后RBC-C3bRR水平高于对照组(P<0.05),RBC-ICR水平低于对照组(P<0.05)。与本组治疗前比较,2组治疗后CRP及TNF-α水平均降低(P<0.05),且治疗组治疗后CRP及TNF-α水平均低于对照组(P<0.05)。结论柴胡疏肝散合沉香降气散联合四联疗法治疗Hp感染肝胃不和型慢性胃炎临床疗效确切,可明显改善患者中医症状,提高Hp根除率,减少药物不良反应,其作用机制可能与抑制炎性反应,改善机体红细胞免疫功能有关。

Objective To investigate the effect of Chaihu Shugan Powder and Chenxiang Jiangqi Powder combined with quadruple therapy on Helicobacter pylori(Hp)infection-caused chronic gastritis(CG)of liver-stomach disharmony.Methods Totally 94 patients with Hp infection-caused CG(liver-stomach disharmony)were randomly divided into the control group and the treatment group,with 47 cases in each group.The control group was given quadruple therapy(rabeprazole sodium enteric-coated tablets+clarithromycin capsules+amoxycillin capsules+bismuth potassium citrate capsules),and the treatment group was given Chaihu Shugan Powder and Chenxiang Jiangqi Powder on the basis of the control group.A 2-week course of treatment was conducted in groups.The key observation was traditional Chinese medicine(TCM)symptom scores(epigastric fullness,epigastric pain,burning sensation,acid regurgitation,belching,fatigue,nausea and vomiting),red blood cell(RBC)immune function(RBC C3b receptor rosette rate[RBC-C3bRR]and immune complex rosette rate[RBC-ICR]),inflammatory factors(C-reactive protein[CRP]and tumor necrosis factor alpha[TNF-α]),and the Hp eradication rates and incidence of adverse reactions in the two tissues were compared.Results The overall effective rate and Hp eradication rates in the treatment group were decidedly higher than those in the control group(97.87%[46/47]vs 82.98%[39/47];97.87%[46/47]vs 80.85%[38/47];P<0.05,respectively).The incidence of adverse reactions in the treatment group was significantly lower than that in the control group(4.26%[2/47]vs 21.28%[10/47];P<0.05,respectively).Compared with before treatment,the TCM symptoms scores were decreased in groups after treatment(P<0.05),which were lower in the treatment group than the control group(P<0.05);the levels of RBC-C3bRR in groups were increased(P<0.05),the improvement in the treatment group was prevalent(P<0.05);and the levels of RBC-ICR were decreased(P<0.05),the reducation in the observation group was common(P<0.05);the levels of CRP and TNF-αin groups were decreased(P<0.05),and which were lower in the treatment group than the control group(P<0.05).Conclusion For HP infection-caused CG(liver-stomach disharmony),Chaihu Shugan Powder and Chenxiang Jiangqi Powder combined with quadruple therapy is capable of improving the HP eradication rate,it can significantly improve the TCM symptom and reduce adverse drug reactions by inhibiting inflammatory response and improving RBC immune function.