化湿健脾方辅助治疗功能性消化不良的效果及对Hp清除率和复发情况的影响

Therapeutic effect of Huashi Jianpi Decoction as an adjuvant therapy for functional dyspepsia and its influence on Hp clearance rate and recurrence

目的探讨功能性消化不良(FD)患者通过化湿健脾方治疗的效果及对幽门螺杆菌(Hp)清除率及复发情况的影响。方法选取78例2022年9月至2023年6月浙江省中医院收治的FD患者,按信封随机法分成试验组(39例,Hp阳性22例)、对照组(39例,Hp阳性23例)。对照组施行单一莫沙必利治疗,试验组施行化湿健脾方辅助莫沙必利治疗,对比两组疗效、中医症状积分、胃肠激素、Hp清除状况和复发率。结果治疗后,试验组总有效率为94.87%,高于对照组的79.49%,差异有统计学意义(P<0.05)。治疗4周后,两组各项中医症状积分、胃动素(MTL)指标均下降,胃泌素-17(GAS-17)与胃蛋白酶原Ⅰ(PGⅠ)指标升高,差异有统计学意义(P<0.05);且试验组各项中医症状积分、MTL指标低于对照组,GAS-17与PGⅠ指标高于对照组,差异有统计学意义(P<0.05)。治疗前经13C呼气试验与胃镜镜检诊断试验组Hp阳性22例、对照组Hp阳性23例,治疗后试验组Hp阳性10例、对照组Hp阳性18例,试验组Hp清除率为54.55%,高于对照组的21.74%,差异有统计学意义(χ^(2)=5.148,P=0.023)。治疗3个月后,试验组复发2例、对照组复发8例,试验组复发率为5.13%,低于对照组的20.51%,差异有统计学意义(χ^(2)=4.129,P=0.042)。结论在FD的治疗中,化湿健脾方辅助莫沙必利治疗有助于改善人体胃肠激素,提高Hp清除率,缓解疲乏无力、嗳气呃逆等症状,有效预防疾病的复发。

Objective To explore the therapeutic effect of Huashi Jianpi Decoction on patients with functional dyspepsia(FD)and its influence on the clearance rate and recurrence of Helicobacter pylori(Hp).Methods A total of 78 FD patients admitted to the Zhejiang Provincial Hospital of Chinese Medicine from September 2022 to June 2023 were selected and randomly divided into an experimental group(39 cases,Hp positive 22 cases)and a control group(39 cases,Hp positive 23 cases)using envelope randomization.The control group was treated with a single Mosapride,while the experimental group was treated with the combination of Huashi Jianpi Decoction and Mosapride.The therapeutic effects,traditional Chinese medicine symptom scores,gastrointestinal hormones,Hp clearance status,and recurrence rate of the two groups were compared.Results After treatment,the total effective rate of the experimental group was 94.87%higher than that of the control group,which was 79.49%,and the difference was statistically significant(P<0.05).After 4 weeks of treatment,the traditional Chinese medicine symptom scores and motilin(MTL)indicators in both groups decreased,while gastrin-17(GAS-17)and pepsinogenⅠ(PGⅠ)indicators increased,with statistically significant difference(P<0.05).And the TCM symptom scores and MTL indicators of the experimental group were lower than those of the control group,while the GAS-17 and PGⅠindicators were higher than those of the control group,with statistically significant difference(P<0.05).Before treatment,a 13C breath test and gastroscopy were performed to diagnose 22 cases of Hp positivity in the experimental group and 23 cases in the control group.After treatment,10 cases in the experimental group and 18 cases in the control group were Hp positivity.The Hp clearance rate in the experimental group was 54.55%,which was higher than that in the control group’s 21.74%,and the difference was statistically significant(χ^(2)=5.148,P=0.023).After 3 months of treatment,there were 2 relapses in the experimental group and 8 relapses in the control group.The recurrence rate in the experimental group was 5.13%lower than that in the control group,which was 20.51%,and the difference was statistically significant(χ^(2)=4.129,P=0.042).Conclusion In the treatment of FD disease,Huashi Jianpi Decoction combined with Mosapride helps improve gastrointestinal hormones,increase Hp clearance rate,relieve fatigue,belching and hiccups,and effectively prevent the recurrence of the disease.