TREATMENT OF OBSTINATE PEPTIC ULCER AND CHRONIC GASTRITIS WITH A METAL RING EMBEDDED IN ZUSANLI ACUPOINT

We had treated 102 cases of obstinate peptic ulcer and chronic gastritis with ametal ring embedded in Zusanli acupoint since October 1989 to October 1992,and got satisfactorytherapeutic effects.The total effective rate is 96.08%,the cure rate of peptic ulcer is 87.32%,therecurrence rate is significantly lower than that of control group(P【0.001),and it has no side-effect.

Surgical perspectives in peptic ulcer disease and gastritis

For much of the twentieth century, surgery was frequently the solution for peptic ulcer disease. Our understanding of the pathophysiology of ulcers paralleled the development of potent pharmaceutical therapy. As the surgical world developed parietal cell vagotomy which would minimize the complications of surgery, patients failing medical therapy became rare. Emergent surgery for complicated peptic ulcers has not declined however. The development of proton pump inhibitors and the full understanding of the impact of H pylori has led to a trend towards minimalism in surgical therapy for complicated peptic ulcer disease. In addition to the changes in patient care, these developments have had an impact on the training of surgeons. This article outlines these trends and developments.

Correlation of serum albumin level on postoperative day 2 with hospital length of stay in patients undergoing emergency surgery for perforated peptic ulcer

BACKGROUND Perforated peptic ulcer(PPU)is a common emergency surgical condition and a significant cause of morbidity and mortality worldwide.While advances in surgical techniques have improved outcomes for patients with PPU,many factors still affect postoperative hospital stay and overall prognosis.One potential factor is the serum albumin(SA)level,a widely utilized marker of nutritional status that has been associated with length of stay and complications in various surgical procedures.AIM To clarify the correlation of SA level on postoperative day 2 with hospital length of stay(HLOS)in patients undergoing emergency surgery for perforated peptic ulcer(PPU).METHODS We retrospectively collected and analyzed clinical baseline data,including blood routine and SA levels,of patients who underwent emergency PPU surgery and postoperative treatment at the Lingnan Hospital,the Third Affiliated Hospital of Sun Yat-sen University between December 2012 and September 2021.Patients were grouped according to HLOS with 7 d as the cut-off value,and relevant indicators were analyzed using SPSS 26.0.RESULTS Of the 37 patients undergoing emergency surgery for PPU referred to our department,33 had gastric and 4 had duodenal ulcer perforation.The median HLOS was 10 d.There were 8 patients in the≤7-d group(median HLOS:7 d)and 29 patients in the>7-d group(median HLOS:10 d).The≤7-d group had markedly higher SA on postoperative day 2 than the>7-d group(37.7 g/L vs 32.6g/L;P<0.05).The SA level on postoperative day 2 was a protective factor for patients with HLOS>7 d(Odds ratio=0.629,P=0.015).The cut-off of SA on postoperative day 2 was 30.6g/L,with an area under the curve of 0.86 and a negative predictive value of 100%for the prediction of HLOS≤7 d.CONCLUSION The SA level on postoperative day 2 was associated with the HLOS in patients undergoing emergency surgery for PPU.The pre-and post-operative albumin levels should be monitored,and infusion of human SA should be considered in a timely manner.

Ultrastructural observation on the relation of H.pylori to the gastric epithelia in chronic gastrictis and in peptic ulcer

AIMS The relationship between Helicobacter pylori (Hp) and gastric epithelia in chronic gastritis and in petic ulcer was studied by transmission electron mi- croscopy (TEM). METHODS Seventy-five gastric antral biopsy speci- mens from the patients examined by six other methods for Hp were fixed in glutaraldehyde and treated with tanin acid before OsO_4 staining than routinely prooessed for TEM studies (at least 4 semi- thin sections oriented for ultrathin sections in each sample). RESULTS The bacilli were detected by TEM within gastric mucosa in 53 of 55 patients infected with Hp. Ultrathin sections especially stained with tanin acid re- vealed clearly glycocalyx by which the bacillus was connected with the epithelium. As the bacilli grouped as colony and breed,the adjacent mucous cells degerated and characterized by erosion of the juxtalu- minal cytoplasm,vacuolation or blebs,even desqua- mation of cell. Evidence was accumulated to show that the baoilli were located in the lumen attracted neu- trophils which intended to migrate into intercellular space of epithelia or into the lumen to exert the effect of Hp phagocytosis. CONCLUSIONS The sensitivity and specificity of Hp diagnosis by TEM is respectively 96% and 95%. Tanin acid is suitable for the preservation of glycocalyx of cell. The colonized bacilli,usually with the wide periplasmic pools,contributed to the spectrum degen- eration of epithelia,including mucous neck cells. If Hp infection persists,the degeneration and regeneration of mucous neck cells alternatively carried on and ultimate- ly the generative stem cells were damaged,as the result,the chronic atrophy gastritis could occure.

H pylori infection and other risk factors associated with peptic ulcers in Turkish patients: A retrospective study

AIM: To identify and evaluate the relative impact of H pylori infection and other risk factors on the occurrence of gastric ulcer (GU), duodenal ulcer (DU) and gastritis in Turkish patients. METHODS: A total of 4471 patients (48.3% female) out of 4863 attended the Samatya hospital in Istanbul (June 1999 - October 2003) were included. The records of H pylori status (CLO-test), endoscopic f indings of GU, DU and gastritis, personal habits (smoking, alcohol intake) and medication [non-steroidal anti-inflammatory drugs (NSAIDs), aspirin intake] were analyzed using multi-way frequency analysis. RESULTS: We have found that GU in the presence of H pylori had significant association with aspirin (P = 0.0001), alcohol (P = 0.0090) and NSAIDs (P = 0.0372). DU on the other hand had significant association with aspirin/ smoking/NSAIDs (P = 0.0259), aspirin/alcohol (P = 0.0002) and aspirin/smoking (P = 0.0233), also in the presence of H pylori. In the absence of H pylori GU had significant association with alcohol/NSAIDs (P = 0.0431), and NSAIDs (P = 0.0436). While DU in the absence of H pylori had significant association with smoking/alcohol/ NSAIDs (P = 0.0013), aspirin/NSAIDs (P = 0.0334), aspirin/alcohol (P = 0.0360). CONCLUSION: In the presence of H pylori, aspirin, alcohol and NSAIDs intake act as an independent risk factors that had an augmenting impact on the occurrence of GU and only together on the occurrence of DU in Turkish patients.

Dominant cagA/vacA genotypes and coinfection frequency of H. pylori in peptic ulcer or chronic gastritis patients in Zhejiang Province and correlations among different genotypes, coinfection and severity of the diseases

Background Almost half of the world’s population suffer from the Helicobacter pylori (H. pylori) infection, but only some individuals develop gastric diseases with clinical symptoms. One reason for the phenomenon may be the different pathogenicity of infected H. pylori strains. The presence of cytotoxin-associated gene A (cagA) and expression of vacuolating cytotoxin activity encoded by vacuolating cytotoxin gene A (vacA) are considered the two major virulent markers of H. pylori. The aim of this study was to detect dominant cagA/vacA genotypes and coinfection frequency of H. pylori in patients with peptic ulceration (PU) or chronic gastritis (CG), and to determine correlations among different cagA/vacA genotypes, coinfection and severity of the diseases. Methods For each of 139 patients in Zhejiang Province who had been diagnosed as PU or CG based on clinical symptoms and gastroscopy, two gastric biopsy specimens (one from antrum and the other from corpus) for H. pylori isolation were taken by two different disinfected biopsy forceps. One hundred and fifty-six H. pylori strains were isolated from both the antrum and corpus biopsy specimens of 78 patients (36 PU and 42 CG). PCRs were performed to detect cagA genes, and signal (s) and middle (m) regions of vacA genes in the H. pylori isolates. The amplified fragments of dominant vacA gene s and m subtypes from representative H. pylori isolates were sequenced after TA cloning. Dominant cagA/vacA genotypes of the H. pylori isolates, coinfection frequency and correlations among the different genotypes, coinfection and severity of the diseases were determined.Results Of the H. pylori strains isolated from the antrum specimens, 96.2% were cagA gene positive, as were 97.4% of the H. pylori strains isolated from the corpus specimens. Only one s region subtype (s1a) and four m region subtypes m1, m2, m1b and m1b-m2 of vacA gene were found. The proportions of vacA gene subtypes s1a/m1, s1a/m2, s1a/m1b and s1a/m1b-m2 in the 83 strains isolated from the antrum specimens were 7.2%, 61.5%, 30.1% and 1.2%, respectively, while those in the other 84 strains isolated from the corpus specimens were 9.5%, 58.3%, 28.6% and 3.6%, respectively. s1a/m2 (58.3% vs 30.1%, χ~2=13.47, P<0.01) and then s1a/m1b (28.6% vs 9.5 %, χ~2=9.88, P<0.01) were the dominant vacA gene subtypes in the (H. pylori) isolates. The dominant H. pylori genotype was (cagA+s1a/m2 (59.0%) from antrum specimens and 57.1% from corpus specimens), and followed by cagA+s1a/m1b (28.9% from antrum specimens and 27.4% from corpus specimens). Sixteen of 78 patients (20.5%) were infected with two or three H. pylori strains with different genotypes. However, no statistically significant differences among cagA occurrence, the different vacA subtypes and PU or CG could be found (each P>0.05). Similarities of the nucleotide sequences from vacA gene s region PCR products of six isolates and from vacA gene m region PCR products of four isolates were 93.2% to 98.3% and 93.8% to 97.6%, respectively, compared to the reported corresponding sequences.Conclusions The dominant genotypes of H. pylori in PU or CG patients in Zhejiang area may be cagA+ s1a/m2 and cagA+ s1a/m1b. Numerous coinfections with different H. pylori strains in PU or CG patients indicate diversity of the infected H. pylori origins. s and m regions of vacA gene from different H. pylori isolates show high nucleotide sequence similarities. cagA gene positive rate, different vacA gene subtypes and coinfection with different H. pylori strains are not closely associated with severity of the diseases.

Histopathological profile of gastritis in adult patients seen at a referral hospital in Kenya

AIM： To conduct a detailed histological study of gastritis in adult patients attending an endoscopy clinic at a Kenyan teaching and referral hospital.METHODS： Biopsy specimens from consecutive patients were examined and graded according to the Updated Sydney System for H pylori infection, chronic inflammation, neutrophil activity, glandular atrophy and intestinal metaplasia. Also documented were gastric tissue eosinophil counts and presence of lymphoid follicles.RESULTS： The rate of the graded variables, in the antrum and corpus respectively, were as follows： H pylori infection （91%, 86%）, chronic inflammation （98%, 93%）, neutrophil activity （91%, 86%）, glandular atrophy （57%, 15%） and intestinal metaplasia （11%, 2%）. Lymphoid follicles were noted in 11% of cases. Duodenal and gastric ulcers were documented in 32% and 2% respectively. The mean eosinophil count was 5.9 ±0.74 eosinophils/ HPF and 9.58 ± 0.93 eosinophils/HPF in the corpus and antrum respectively. Significant association was found between the degree of H pylori colonisation with chronic inflammation, neutrophil activity and antral glandular atrophy. Biopsies from the antrum and corpus showed significant histopathological discordance for all the graded variables. H pylori negative cases were associated with recent antibiotic use.CONCLUSION： The study the chief cause of gastritis reaffirms that H pylori is in this environment. The majority of patients show a moderate to high degree of inflammation but a low degree of glandular atrophy and intestinal metaplasia. The study shows that interrelationships between the histological variables in this African population are similar to those found in other populations worldwide including non-African populations.

Effect of Banxia Xiexin decoction on Helicobacter pylori-related peptic ulcers and its possible mechanism via the TGF-β/Smad signaling pathway

OBJECTIVE: To investigate the effect of Banxia Xiexin decoction(BXD) on Helicobacter pylori(Hp)-related peptic ulcers(PUs) and the possible mecha-nism underlying BXD actions via the transforming growth factor-β/small mothers against decapentaplegic(TGF-β/Smad) signaling pathway.METHODS: PU patients with cold-heat complex syndrome were randomly assigned to groups that received Chinese or Western medicines with 20 patients in each group. Serum was collected after 7 d of treatment. The healthy group included 20 individuals. Gastric mucosal epithelial cell line GES-1 was cultured in vitro and randomly divided into the following seven groups: control, model, healthy,Western Medicine, prior treatment, low dosage,and high dosage. After 72 h of treatment with the corresponding serum, the m RNA and protein expression levels of TGF-β1, Smad3, and Smad7 were measured by reverse transcription quantitative polymerase chain reaction and western blotting, respectively.RESULTS: The m RNA expression levels of TGF-β1 and Smad3 in GES-1 cells were increased after Hp introduction, and these increased levels were reduced by the BXD-containing serum. The protein levels of p-Smad3, but not TGF-β1 or Smad3, were significantly increased in Hp-treated GES-1 cells,and treatment with the BXD-containing serum markedly decreased the protein levels. Smad7 expression was significantly enhanced following treatment with the BXD-containing serum at transcriptional and protein levels in a dose-dependent manner.CONCLUSION: BXD regulates the TGF-β/Smad signaling pathway by inhibiting the expression of TGF-β1 and Smad3, and increasing the expression of Smad7.

奥美拉唑联合凝血酶治疗慢性胃炎合并消化性溃疡出血的价值

目的 探讨奥美拉唑联合凝血酶治疗慢性胃炎合并消化性溃疡出血的应用价值。方法 选择2022年10月至2023年10月在我院治疗的慢性胃炎合并消化性溃疡出血患者80例,根据随机数字表法分为两组,对照组中使用奥美拉唑治疗,试验组使用奥美拉唑联合凝血酶治疗,持续治疗5 d。比较两组胃蛋白酶原Ⅰ、胃蛋白酶原Ⅱ、血红蛋白、超氧化物酶、出血量、止血时间、胃肠功能评分、不良反应发生情况。结果 治疗后,试验组胃蛋白酶原Ⅰ、胃蛋白酶原Ⅱ低于对照组,血红蛋白、超氧化物酶水平高于对照组,出血量低于对照组,止血时间短于对照组,胃肠功能评分低于对照组,不良反应发生率低于对照组(P <0.05)。结论 在慢性胃炎合并消化性溃疡出血患者中应用奥美拉唑联合凝血酶治疗可降低不良反应发生率,缩短止血时间,改善胃肠道功能,提高血红蛋白。

艾普拉唑联合凝血酶治疗胃炎合并消化性溃疡出血的疗效及安全性探讨

目的探究艾普拉唑联合凝血酶治疗胃炎合并消化性溃疡出血患者的疗效及安全性。方法50例胃炎合并消化性溃疡出血患者,以随机数字表法分为对照组和研究组,每组25例。对照组患者采取凝血酶治疗,研究组患者在对照组基础上给予注射用艾普拉唑钠治疗。对比两组疗效、生活质量、炎症因子水平和不良反应发生情况。结果研究组临床治疗总有效率为92.00%,明显高于对照组的68.00%(P<0.05)。治疗后,两组生理功能、心理状况、物质生活、社会关系评分均高于治疗前,且研究组生理功能评分(80.46±4.62)分、心理状况评分(82.81±3.89)分、物质生活评分(82.11±3.49)分、社会关系评分(81.63±4.85)分均高于对照组的(75.37±3.65)、(75.18±2.83)、(72.18±3.82)、(73.52±3.17)分(P<0.05)。治疗后,两组C反应蛋白、白细胞介素-6、白细胞介素-1水平均低于治疗前,且研究组C反应蛋白(3.35±0.79)mg/L、白细胞介素-6(40.63±5.24)ng/L、白细胞介素-1(16.43±5.16)ng/L均低于对照组的(5.59±0.57)mg/L、(62.37±3.53)ng/L、(25.18±5.14)ng/L(P<0.05)。两组不良反应发生率无统计学差异(P>0.05)。结论对胃炎合并消化性溃疡出血患者应用艾普拉唑联合凝血酶治疗,可显著提升临床效果,改善患者血清炎症因子指标和生活质量,降低不良反应发生率,安全性较高,值得在临床推广应用。

复方嗜酸乳杆菌联合四联疗法治疗幽门螺杆菌感染的临床效果

目的:分析复方嗜酸乳杆菌联合四联疗法治疗幽门螺杆菌(Hp)感染的临床效果。方法:选取2021年5月—2022年5月海淀区北太平庄社区卫生服务中心收治的98例Hp合并慢性胃炎或消化性溃疡患者作为研究对象,以随机数字表法分为对照组与观察组,各49例。对照组行四联疗法,观察组在对照组基础上联用复方嗜酸乳杆菌治疗。比较两组临床疗效。结果:观察组治疗1周、2周后及停药后1个月Hp根除率均高于对照组,6个月内复发率低于对照组,差异有统计学意义(P<0.05)。治疗后,观察组C反应蛋白、肿瘤坏死因子-α、白细胞介素-6水平及上腹部烧灼感、餐后腹胀、腹部疼痛、腹泻评分低于对照组,差异有统计学意义(P<0.05)。治疗后及停药后1个月,观察组肠道菌群失调总发生率低于对照组,差异有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论:复方嗜酸乳杆菌联合四联疗法治疗Hp感染的临床效果理想,能够提高Hp根除率,减少复发,减轻炎性反应,促进症状改善,恢复肠道菌群平衡,且安全性较高。

EPIYA基序与幽门螺杆菌感染相关胃病关系的研究进展

幽门螺杆菌(Hp)是一种人类主要致病菌,人体在感染Hp后会引发慢性胃炎、消化性溃疡、胃癌等一系列胃肠道疾病。近年来,随着这些疾病的发病率升高,它们的病因及发病机制日益在世界范围内受到许多学者的关注。而Hp的毒力基因之一即细胞毒素相关基因A(CagA)的致病机制也因此受到重视,谷氨酸-脯氨酸-异亮氨酸-酪氨酸-丙氨酸组成的重复序列(EPIYA基序)与Hp感染相关胃病也成为目前研究的热点。该文就EPIYA基序与Hp感染相关胃病的关系作一简要综述。

兰索拉唑治疗慢性胃炎和消化性溃疡的效果及对患者血清胃肠激素与氧化应激指标水平的影响

目的探讨慢性胃炎和消化性溃疡患者应用兰索拉唑治疗的疗效和对血清胃肠激素及氧化应激指标的影响。方法选取70例2020年1月至2023年6月余干县中医院收治的慢性胃炎和消化性溃疡患者,按信封随机法分成试验组(35例)、对照组(35例)。对照组施行法莫替丁治疗,试验组在此基础上施行兰索拉唑治疗,对比两组疗效、血清胃肠激素、氧化应激指标、表皮生长因子(EGF)、干扰素-γ(IFN-γ)和转化生长因子-α(TGF-α)指标和不良反应等。结果试验组有效合计率97.14%高于对照组82.86%(P<0.05)。治疗6周后,两组胃泌素-17(GAS-17)与胃蛋白酶原I(PG I)指标升高,胃动素(MTL)指标降低,且试验组GAS-17与PG指标高于对照组,MTL指标低于对照组(P<0.05)。治疗6周后,两组超氧化物歧化酶指标、EGF、TGF-α指标升高,一氧化氮、丙二醛指标、IFN-γ指标下降,且试验组超氧化物歧化酶指标、EGF、TGF-α指标高于对照组,一氧化氮、丙二醛指标、IFN-γ指标低于对照组(P<0.05)。两组肠胃不适、皮肤瘙痒和转氨酶升高等不良反应合计率对比差异无统计学意义(P>0.05)。结论在慢性胃炎和消化性溃疡疾病的治疗中,兰索拉唑的疗效显著,有助于改善人体胃肠激素,调节EGF与TGF-α水平,促进氧化应激状态缓解,且不良反应较少。

优质护理服务对慢性胃炎合并消化性溃疡患者睡眠质量的影响观察

目的:探讨优质护理服务对慢性胃炎合并消化性溃疡患者的护理效果及对睡眠质量的影响。方法:选取2021年11月至2022年12月福建省泉州市第一医院消化内科收治的慢性胃炎合并消化性溃疡患者84例作为研究对象,按照随机抽样法分为对照组和观察组,每组42例。对照组在治疗期间行常规护理,观察组则行优质护理。比较分析2组患者疾病症状缓解情况、睡眠质量、生命质量、护理满意度。结果:护理后,观察组腹痛、腹胀、早饱、反酸症状缓解率均高于对照组(均P<0.05)。护理前,2组阿森斯失眠量表(AIS)评分、觉醒次数、入睡时间比较,差异无统计学意义(均P>0.05);护理后,观察组AIS、觉醒次数、入睡时间指标均低于对照组(均P<0.05)。护理前,2组患者生命质量评分比较,差异无统计学意义(P>0.05);护理后,观察组生命质量评分高于对照组(P<0.05)。观察组护理满意度为97.62%,显著高于对照组的83.33%(P<0.05)。结论:优质护理服务对慢性胃炎合并消化性溃疡患者的护理效果良好,可促进消化系统症状改善,并有利于睡眠质量的提升,还能提升患者的生命质量、护理满意度,值得临床推广应用。

三联疗法联合双歧杆菌四联活菌片对幽门螺杆菌感染消化性溃疡的疗效观察

目的 分析幽门螺杆菌感染消化性溃疡患者采用双歧杆菌四联活菌片联合三联疗法治疗的效果。方法 选择泉州市洛江区妇幼保健院收治的80例幽门螺杆菌感染消化性溃疡患者为研究群体,研究时间为2020年7月—2021年11月。通过随机摸红蓝球方式将所有患者划分成常规组以及试验组,其中摸红球为常规组(40例),摸蓝球为试验组(40例),予以常规组患者三联疗法干预,予以试验组患者双歧杆菌四联活菌片联合三联疗法干预。对比2组患者治疗总有效率、症状缓解率、溃疡愈合率以及幽门螺杆菌根除率、用药前后血清生长抑素以及胃动素水平、不良反应发生率。结果 试验组与常规组患者治疗总有效率分别是95.00%、77.50%(P<0.05)。试验组与常规组患者症状缓解率依次是92.50%、72.50%,幽门螺杆菌根除率依次是87.50%、62.50%,差异均有统计学意义(P<0.05)。用药后试验组患者血清生长抑素水平低于常规组,胃动素水平高于常规组(P<0.05),并且同组组内患者用药后血清生长抑素水平均低于用药前,胃动素水平相较于用药前高(P<0.05)。在不良反应方面,发生率试验组患者为20.00%,而常规组是22.50%,差异无统计学意义(P>0.05)。结论 幽门螺杆菌感染消化性溃疡患者采用双歧杆菌四联活菌片联合三联疗法治疗,能够缓解临床症状,消除幽门螺杆菌,改善血清生长抑素以及胃动素水平,提升治疗效果,并且用药后不良反应少,可发挥良好的干预作用。

西药联合旋覆代赭汤加味治疗肝胃不和型消化性溃疡的疗效分析

目的:分析西药联合旋覆代赭汤加味治疗肝胃不和型消化性溃疡的效果。方法:选取2020年2月—2021年2月凤冈县中医医院肝胃不和型消化性溃疡患者50例为研究对象,随机均分为对照组和观察组,各25例。对照组进行常规西药治疗,观察组在对照组基础上联合旋覆代赭汤加味治疗。对比两组治疗效果、临床症状改善时间、营养指标及生活质量。结果:观察组患者治疗总有效率高于对照组,差异有统计学意义(P=0.001);观察组患者腹痛、恶心、呕吐及食欲不振改善时间均短于对照组,差异有统计学意义(P=0.001);干预后,观察组患者白蛋白、血红蛋白、血清蛋白水平均高于对照组,差异有统计学意义(P=0.001);干预后,观察组患者生理功能、生理职能、躯体疼痛、总体健康、生命活力、社会功能、情感职能及精神健康评分高于对照组,差异有统计学意义(P<0.05)。结论:西药联合旋覆代赭汤加味治疗肝胃不和型消化性溃疡,可提高治疗效果,缩短临床症状改善时间,改善营养指标,提高生活质量。

艾普拉唑肠溶片应用于消化性溃疡患者的临床效果观察

分析艾普拉唑肠溶片应用于消化性溃疡患者的临床效果。选取日照港口医院2022年1月—2023年1月收治的200例消化性溃疡患者作为研究对象,将其平均分为甲组和乙组,每组各100例。甲组实施常规治疗,乙组在常规治疗基础上辅以艾普拉唑肠溶片治疗,比较两组患者的治疗效果。结果显示,乙组患者的血清炎性因子水平下降,治疗效果更佳(P<0.05)。研究发现,艾普拉唑肠溶片治疗消化性溃疡的效果更佳,可以显著降低患者血清炎性因子水平,缓解患者临床症状,值得推广。

抑制幽门螺旋菌中药的初步筛选

本研究对２２６例有上消化道症状患者进行的胃镜和病理学检查，诊断为慢性胃炎和消化性溃疡。同时取胃窦粘膜做幽门螺旋菌（ＨＰ）培养，其中１３６例ＨＰ阳性（６０．１８％）。经用２００种不同性味、不同作用的单味中药做对ＨＰ的抑菌试验，结果发现其中３８种中药对ＨＰ有不同程度的抑菌作用，为慢性胃炎和消化性溃疡的临床辩证论治和清除ＨＰ提供参考。

尿囊素铝颗粒治疗胃炎及消化性溃疡的疗效及安全性

目的:观察尿囊素铝颗粒对消化性溃疡和急慢性胃炎的疗效及安全性。方法:采用多中心、随机单盲、平行对照方法进行临床观察。共选取132例患者,其中胃溃疡32例,十二指肠球部溃疡32例,胃炎68例,按病种随机均分为治疗组和对照组各66例。治疗组给予尿囊素铝颗粒每次0.2g,tid;对照组给予替普瑞酮,每次50mg,tid。2组均辅助使用雷尼替丁用于抑酸,2组疗程均为4周。结果:治疗组和对照组用药4周后消化性溃疡患者的疼痛缓解率分别为100％和96.55％,胃炎患者疼痛缓解率分别为79.31％和78.46％,组问比较差异无显著性;返酸、烧心、恶心、腹胀、嗳气等缓解率组间比较差异无显著性。胃镜下消化性溃疡的愈合率治疗组为87.49％,对照组为48.28％;胃炎愈合率治疗组为85.29％,对照组为55.17％,治疗组均显著高于对照组(P<0.05)。治疗组胃黏膜组织中前列腺素水平用药后明显升高,差值为(1 794.23±3474.53)ng·g-1,显著高于对照组[-(925.61±7 099.59)ng·g-1]。结论:尿囊素铝颗粒治疗消化性溃疡和急、慢性胃炎安全有效。

不同胃疾病患者血清胃蛋白酶原亚群的变化

目的探讨不同胃疾病患者胃黏膜病理改变过程中,血清胃蛋白酶原(PG)Ⅰ和Ⅱ的变化规律。方法选择已行常规胃镜检查和病理活检确诊的245例患者。其中非萎缩性胃炎53例,慢性萎缩性胃炎20例,胃溃疡36例,十二指肠溃疡31例,进展期胃癌69例,早期胃癌13例,胃癌术后23例,并设正常对照组36例,用酶联免疫吸附实验(ELISA)测定其血清PGⅠ及PGⅡ,并计算PGⅠ/PGⅡ的比值(PGR)。结果与正常对照组比较,早期胃癌和进展期胃癌患者血清PGⅠ和PGⅠ/Ⅱ比值均显著降低(P<0.005),胃溃疡患者血清PGⅠ升高(P<0.05),十二指肠溃疡患者血清PGⅠ和PGⅡ升高,PGI/PGⅡ比值升高(P<0.05);进展期胃癌血清PGⅠ、早期与进展期胃癌PGR均显著低于萎缩性胃炎组(P<0.001)。胃癌组中以PGⅠ≤70μg/L和PGR≤6作为阳性指标,同时符合这两项的确诊率为62.1%,特异性为94.2%。结论血清PGⅠ、PGⅡ含量的变化及PGR值与胃黏膜病变有关,血清PGⅠ和PGⅠ/PGⅡ比值的降低,是胃癌发生的危险因素,可以作为人群筛查和辅助诊断胃癌的一项血清学指标。