Clinical redemption treatment effects with Astragalus membranaceus and Curcuma zedoaria mixtures combined with W.medicine on gastrointestinal illness infected by H.pylori were observed,and investigated for their clinical application value.A total of 182 cases of upper gastrointestinal patients who failed in eradication therapy of H.pylori were randomly divided into single W.medicine group (quadruple therapy for 14 days) and combined with Chinese-W.medicine group (quadruple therapy for 14 days,plus mixtures of A.membranaceus and C.zedoaria for 10 days).Patients with peptic ulcer after the above medication were administrated with esomeprazole for another 14 days.The relieving of ulcer and erosion,relief of symptom,and adverse reactions on medicine were recorded by doctor's follow-up visit.Post-therapy H.pylori positive rate was assessed by 14C-UBT or 13C-UBT in 4 weeks.The results showed that H.pylori eradication rates by intention-to-treat (ITT) and per-protocol (PP) analysis were 86.8％ and 89.8％ in combination of Chinese-W.medicine group respectively,in the meantime 73.6％ and 78.8％ in single W.medicine group,and PP analysis on differences of these two groups were statistically significant (P ＜ 0.05).The curative rates of ulcer and erosion were 90.0％ and 80.6％ in the combined Chinese-W.medicine group respectively,while 64.3％ and 48.5％ in the single W.medicine group.The symptom relieving rate was 97.7％ in the combination group and higher than single administration of W.medicine group 85.7％ (P ＜ 0.05).The occurring rates of adverse reactions were 10.2％ and 15.3％ respectively in the combination group and the single group,and had no significantly statistic differences (P ＞ 0.05).Therefore,the redemption therapy combined with A.membranaceus and C.zedoaria mixture combined with W.medicine could gain higher H.pylori eradication rates and effectively cure peptic ulcer and erosion,relief clinical symptom and have low occurrence of side reactions rates.%观察中药芪莪合剂联合西药补救治疗幽门螺杆菌(Helicobacter pylori)感染上消化道疾病的临床疗效,探讨其临床应用价值.对182例常规抗H.pylori治疗清除失败的上消化道疾病患者,随机分为单用西药组(14 d四联疗法)和中西药联合组(14 d四联疗法+中药芪莪合剂10剂),疗程结束后消化性溃疡患者继服埃索美拉唑14 d,并胃镜观察溃疡及糜烂愈合情况,随访症状缓解及不良反应情况;治疗结束后4周复查14C-UBT或13C-UBT,观察H.pylori清除率.结果显示,H.pylori清除率按意向性治疗(ITT)和试验方案(PP)分析在中西药联合组分别为86.8％和89.8％,单用西药组分别为73.6％和78.8％,PP分析两组差异有统计学意义(P＜0.05);中西药联合组溃疡和糜烂治愈率分别为90.0％和80.6％,单用西药组分别为64.3％和48.5％(P＜0.05);中西药联合组的症状缓解率为97.7％,高于单用西药组(85.7％,P＜0.05);两组不良反应发生率无统计学差异(10.2％ vs 15.3％,P＞0.05).结果表明,采用中药芪莪合剂联合西药补救治疗能获得较高的H.pylori清除率,并能有效治愈溃疡和糜烂,缓解临床症状,且副反应发生率低.
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