益胃汤加减联合四联疗法治疗Hp阳性慢性胃炎患儿的效果

Effects of Yiwei decoction combined with Bismuth quadruple therapy in treatment of children with Hp positive chronic gastritis

目的:观察益胃汤加减联合四联疗法治疗幽门螺杆菌(Hp)阳性慢性胃炎患儿的效果。方法:选取2019年3月至2021年3月该院收治的84例Hp阳性慢性胃炎患儿进行前瞻性研究,按随机数字表法将其分为观察组与对照组各42例。对照组采用四联疗法治疗,观察组在对照组基础上联合益胃汤加减治疗,比较两组临床疗效、治疗前后中医证候积分、T细胞亚群指标水平,Hp清除率、复发率和不良反应发生率。结果:观察组治疗总有效率为95.24%(40/42),高于对照组的78.57%(33/42),差异有统计学意义(P<0.05);治疗后,两组胃脘隐痛、嗳气反酸、食少纳呆、恶心呕吐、神疲乏力等中医证候积分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组CD4^(+)、CD4^(+)/CD8^(+)水平均高于治疗前,且观察组高于对照组,两组CD8^(+)水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组复发率比较,差异无统计学意义(P>0.05);观察组Hp清除率高于对照组,差异有统计学意义(P<0.05);治疗期间,两组均未见明显不良反应。结论:益胃汤加减联合四联疗法治疗Hp阳性慢性胃炎患儿可提高治疗总有效率和Hp清除率,改善T细胞亚群指标水平,降低中医证候积分,其效果优于单纯四联疗法治疗。

Objective:To observe effects of Yiwei decoction combined with Bismuth quadruple therapy in treatment of children with Helicobacter pylori(Hp)positive chronic gastritis.Methods:A prospective study was conducted on 84 children with Hp-positive chronic gastritis admitted to the hospital from March 2019 to March 2021.They were divided into observation group and control group according to the random number table method,42 cases in each.The control group was treated with Bismuth quadruple therapy,while the observation group was treated with Yiwei decoction on the basis of that of the control group.The clinical efficacy,the TCM syndrome score,the T cell subset index levels,the Hp clearance rate,the recurrence rate,and the incidence of adverse reactions were compared between the two groups before and after the treatment.Results:The total effective rate of treatment in the observation group was 95.24%(40/42),which was higher than 80.95%(34/42)in the control group,and the difference was statistically significant(P<0.05).After the treatment,the scores of epigastric pain,belching and acid regurgitation,poor appetite,nausea and vomiting,and mental fatigue in the two groups were lower than those before the treatment,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of CD4^(+)and CD4^(+)/CD8^(+)in the two groups were higher than those before the treatment,and those in the observation group were higher than those in the control group;the levels of CD8^(+)in the two groups were lower than those before the treatment,and that in the observation group was lower than that in the control group;and the differences were statistically significant(P<0.05).There was no significant difference in the recurrence rate between the two groups(P>0.05).The Hp clearance rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).During the treatment,there were no obvious adverse reactions in the two groups.Conclusions:Yiwei Decoction combined with Bismuth quadruple therapy in the treatment of the children with Hp positive chronic gastritis can improve the total effective rate and the Hp clearance rate,improve the levels of T cell subset indexes,and reduce the TCM syndrome scores.Its effect Moreover,it is superior to single Bismuth quadruple therapy.