中西医结合治疗难愈性溃疡疗效观察

Combined Traditional Chinese and Western Medicine in the Treatment of Intractable Ulcer

为了寻找难愈性溃疡的有效治疗方法及药物,本组对5O8例胃及十二指肠溃疡患者随机分为内窥镜(内镜)下局部治疗配合内服穿甲胃弹冲剂组(称局组)260例和西咪替丁组(称西组)248例对比治疗。结果显示两组近期愈合率、总有效率无显著性差异;主要症状缓解率,局组第1周为70%,第2周为97%;西组分别为33%和64.5%,两组差异显著(P均<0.05)。幽门螺旋杆菌(HP)消失率,局组胃溃疡(GU)和十二指肠溃疡(DU)分别为71.2%和78.3%;西组分别为5.3%和7.2%,两组有非常显著性差异(P均<0.01)。18个月随访局组复发率GU和DU分别为13%和14.2%;西组为63%和71.3%,两组有非常显著性差异(P均<0.01)。结果表明,采用内镜下局部治疗配合内服穿甲胃弹冲剂是治疗难愈性溃疡较为理想有效的药物和方法。

The curative effects of combined traditional Chinese and Western medicine in 508 patients ofintractable peptic ulcer with gastroscopical confirmation were evaluated. The patients were dividedinto Chuanjia Weidan (穿甲胃弹) group (Group I, 260 patients) and cimetidine group (Group II, 248patients). Debridement, injection and drug covering Df ulcer surfaces were followed by oral Chinesemedicine Chuanjia Weidan (50g daily) or cimetidine (800 mg every night) for 4 weeks. In group I,95.6% of patients with gastric ulcer were cured, while in group II, 87.2% wth the same disease werecured. For the patients with duodenal ulcer in group I and group II, 88.2% and 85.2% were curedrespectively (P>0.05). 70% of the main symptoms were remitted in the first week and 97% in thesecond week in group I, whereas in group II, the remission occurred in 33% and 64.5% respectively(P<0.05). The clearance rate of Helicobacter pylori for gastric ulcer and duodenal ulcer in groupI was 71.2% and 78.3% respectively, but 5.3% and 7.2% in group II (P<0.01). Eighteen monthsafter the treatment, 13% of the patients with gastric ulcer and 14.2% with duodenal ulcer in groupI relapsed, while that of group II was 63% and 71.3% respectively (P<0.0l). The authors concludedthat debridement, injection and drug covering of ulcer surface under the endoscopy associated withoral administration of Chinese medicine Chuanjia Weidan is efficacious in treating intractable pepticulcer.