微米大黄炭联合三联疗法治疗幽门螺杆菌阳性活动期胃溃疡的临床观察

Clinical efficacy of micron rhubarb charcoal combined with anti-Hp therapy against Hp-associated active gastric ulcer

目的:研究微米大黄炭联合三联疗法治疗幽门螺杆菌(Hp)阳性活动期胃溃疡的临床疗效、溃疡愈合质量及对肿瘤坏死因子-α(TNF-α)、白介素-8(IL-8)的影响。方法:将72例Hp阳性活动期胃溃疡患者随机分为观察组和对照组各36例。对照组予以三联疗法根除Hp治疗2周后,给予埃索美拉唑治疗6周;观察组在对照组基础上加用微米大黄炭口服。2组总疗程均为8周。观察治疗前后2组患者的临床症状积分、Hp根除情况、内镜及组织学再生黏膜成熟度以及血清TNF-α、IL-8的变化。结果:在改善患者临床症状方面,两组临床症状积分无明显差异(P>0.05);在内镜下再生黏膜成熟度、组织学再生黏膜成熟度、Hp根除率方面,观察组均明显优于对照组(P<0.05);在血清TNF-α、IL-8水平方面,观察组明显低于对照组(P<0.05)。结论:微米大黄炭联合三联疗法治疗Hp阳性活动期胃溃疡可提高Hp清除率,提高再生胃黏膜成熟度,提高溃疡愈合质量,其作用机制可能与降低炎症因子TNF-α、IL-8水平相关。

OBJECTIVE To study the clinical efficacy,the quality of ulcer healing,the effects of tumor necrosis factor alpha(TNF-α) and interleukin-8(IL-8) in the treatment of Hp positive gastric ulcer by micron rhubarb charcoal combined with triple therapy. METHODS Totally 72 cases of Hp positive gastric ulcer were randomly divided into treatment group and control group,36 cases in each group. Patients in the control group were treated with triple therapy. After Hp treatment for 2 weeks,esomeprazole was given for 6 weeks. Patients in the treatment group were treated with micron rhubarb charcoal orally based on the therapy of the control group.The total course of treatment in the two groups was both 8 weeks. The clinical symptom scores,Hp eradication,endoscopic and histological regeneration,mucosal maturation,and changes of serum TNF-α,and IL-8 levels were observed before and after treatment. RESULTS In improving the clinical symptoms of the patients,no significant difference was observed between the two groups of clinical symptom(P > 0. 05). Regenerative mucosa maturity and histological maturity of regenerated mucosa,the eradication rate of Hp in endoscopic treatment group were significantly better than the control group(P < 0. 05). The serum TNF-α and IL-8 levels of the treatment group were significantly lower than the control group(P < 0. 05). Ulcer recurrence in the treatment group was significantly lower than the control group(P < 0. 05). CONCLUSION Micron rhubarb charcoal combined with triple therapy in the treatment of Hp positive gastric ulcer can improve the clearance rate of Hp,improve the regeneration of gastric mucosal maturity,improve the quality of ulcer healing,and the mechanism may be related with the decrease of inflammatory factor TNF-α and IL-8 levels.