四联疗法联合黄芪建中汤加减对老年幽门螺杆菌相关性胃溃疡患者胃黏膜愈合及炎症反应的影响

Effects of quadruple therapy combined with modified Huangqi Jianzhong decoction on gastric mucosal healing and inflammatory response in elderly patients with Helicobacter pylori related gastric ulcer

目的探究四联疗法联合黄芪建中汤加减对老年幽门螺杆菌(Hp)相关性胃溃疡患者胃黏膜愈合及炎症反应的影响。方法选取2019年5月至2020年5月永寿县人民医院收治的88例老年Hp相关性胃溃疡患者作为研究对象,根据治疗方法的不同将其分为对照组与研究组,各44例。对照组给予四联疗法治疗,研究组在对照组的基础上给予黄芪建中汤加减治疗。比较两组的临床疗效、Hp根除率、实验室指标、不良反应发生情况及复发情况。结果研究组的治疗总有效率为95.45%,显著高于对照组的79.55%,差异具有统计学意义(P<0.05);研究组的Hp根除率为97.73%,显著高于对照组的81.82%,差异具有统计学意义(P<0.05)。治疗前,两组的白细胞介素-1β(IL-1β)、C反应蛋白(CRP)、胃泌素(GAS)、生长抑素(SS)水平比较,差异无统计学意义(P>0.05);治疗后,两组的IL-1β、CRP、GAS水平均低于治疗前,SS水平高于治疗前,差异具有统计学意义(P<0.05);治疗后,研究组的IL-1β、CRP、GAS水平均低于对照组,SS水平高于对照组,差异具有统计学意义(P<0.05)。两组的不良反应总发生率比较,差异无统计学意义(P>0.05);研究组的复发率为2.27%,明显低于对照组的15.91%,差异具有统计学意义(P<0.05)。结论四联疗法联合黄芪建中汤加减治疗老年Hp相关性胃溃疡患者的效果显著,可有效根除Hp,降低疾病复发率,改善炎症因子水平,促进机体恢复,且不会增加不良反应,安全性高,值得临床推广与应用。

Objective To explore the effects of quadruple therapy combined with modified Huangqi Jianzhong decoction on gastric mucosal healing and inflammatory response in elderly patients with Helicobacter pylori(Hp)related gastric ulcer.Methods A total of 88 elderly patients with Hp related gastric ulcer admitted in the People's Hospital of Yongshou County from May 2019 to May 2020 were selected as the research objects.According to different treatment methods,the patients were divided into control group and study group,with 44 cases in each group.The control group was treated with quadruple therapy,and the study group was treated with modified Huangqi Jianzhong decoction on the basis of the control group.The clinical efficacy,eradication rate of Hp,laboratory indexes,occurrence of adverse reactions and recurrence were compared between the two groups.Results The total effective rate of treatment in the study group was 95.45%,which was significantly higher than 79.55%in the control group,and the difference was statistically significant(P<0.05);the eradication rate of Hp in the study group was 97.73%,which was significantly higher than 81.82%in the control group,and the difference was statistically significant(P<0.05).Before treatment,there were no significant differences in the levels of interleukin-1β(IL-1β),C-reactive protein(CRP),gastrin(GAS)and somatostatin(SS)between the two groups(P>0.05);after treatment,the levels of IL-1β,CRP and GAS in the two groups were lower than those before treatment,the level of SS was higher than that before treatment,and the differences were statistically significant(P<0.05);after treatment,the levels of IL-1β,CRP and GAS in the study group were lower than those in the control group,the level of SS was higher than that in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05);the recurrence rate in the study group was 2.27%,which was significantly lower than 15.91%in the control group,and the difference was statistically significant(P<0.05).Conclusion Quadruple therapy combined with modified Huangqi Jianzhong decoction in the treatment of elderly patients with Hp related gastric ulcer has a significant effect,it can effectively eradicate Hp,reduce the recurrence rate of disease,improve the levels of inflammatory factors,promote body recovery,without increasing adverse reactions,and has high safety,which is worthy of clinical promotion and application.