健脾疏肝活血解毒法联合四联疗法治疗幽门螺杆菌阳性慢性萎缩性胃炎

摘要

目的 观察中西医结合治疗幽门螺杆菌阳性慢性萎缩性胃炎的临床疗效及安全性.方法 患者80例,据随机数字表分为治疗组和对照组,每组各40例.治疗组予四联疗法及自拟中药方(黄芪、党参等)治疗10d后,继续服用该方治疗3个月;对照组服用四联及胃复春片(红参、香茶菜等)10d后,继续服用胃复春3个月.3个月疗程结束后,观察幽门螺杆菌根除情况,临床症状缓解情况,镜下胃黏膜、病理组织改善情况及药物不良反应等.结果 治疗组幽门螺杆菌根除率较对照组显著提高,差异具有统计学意义(P＜0.05);2组患者治疗后症状总积分较治疗前明显降低,且治疗组改善显著优于对照组;胃镜疗效:治疗组的总有效率为92.5％,明显高于对照组的75.0％(P＜0.05);2组胃黏膜病理总积分较治疗前均降低,且治疗组较对照组降低更加明显(P＜0.05);治疗后治疗组未出现任何不良反应,对照组5例患者仅出现恶心、头晕等轻度不适,未服药后可自行缓解.结论 健脾疏肝、活血解毒法联合四联疗法可以提高疗效、改善临床症状、有效逆转胃黏膜萎缩,且安全性好,无毒副作用.%Objective To observe clinical effect and safety of chronic Atrophic Gastritis (CAG) with Helicobacter pylori (HP) positive treated by "Jianpi Shugan Huoxue Jiedu method" combined with "quadruple chemotherapy". Methods A total of 80 cases patients with CAG and HP were randomly divided into the treatment group and the control group. The treatment group in which 40 cases were treated by the prescription (Astragalus membranaceu, Codonopsis pilosula etc) combined with "quadruple chemotherapy" with a course of 10 days, then continue to take the prescription for 3 months. The control group in which 40 cases were treated by "Weifuchun Pill" (red ginseng, Isodon amethystoides etc) combined with "quadruple chemotherapy" with a course of 10 days, then continue to take "Weifuchun Pill" for 3 months. Three months after the treatment, the eradication of HP, the clinical symptoms, gastric mucosa, pathological changes of gastric mucosa adverse reactions were observed. Results The eradication rate of HP in treatment group were significantly higher than those in the control group, the difference was statistically significant (P＜0.05); After treatment, symptoms of total points were compared with those before treatment have decreased significantly, and the treatment group improved significantly better than the control group; Effect under the Endoscopic: The total efficiency of the treatment group (92.5％) was significantly higher than that of control group (75.0％), P＜0.05. The total scores of gastric mucosa pathology were markedly decreased in both groups, and the treatment group was significantly lower than the control group (P＜0.05); After treatment, there was no adverse reaction in the treatment group; Five patients in the control group only appeared mild nausea, and dizziness, it can alleviate without taking any medicine. Conclusion "Jianpi Shugan Huoxue Jiedu method" combined with "quadruple chemotherapy" can improve the efficacy of HP eradication, the clinical symptoms and reverse gastric atrophy effectively. It is reliable, safe and has good clinical application prospects.