加味三仁汤对慢性胃炎首次根除幽门螺杆菌失败后的治疗  

Modified Sanren Tang as Rescue Treatment After Failed Eradication of Helicobacter Pylori in Chronic Gastritis

作　　者：洪海洲[1] 刘天易[2] 

机构地区：[1]胜利石油管理局胜利医院胜利中医分院,山东东营257000 [2]山东中医药大学附属医院,济南250010

出　　处：《中国实验方剂学杂志》2015年第23期164-167,共4页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：山东省科技发展计划项目(20130415)

摘　　要：目的:观察加味三仁汤对慢性胃炎首次根除幽门螺杆菌(Hp)失败后补救治疗的临床疗效及对血清核因子-κB(NF-κB)和热休克蛋白70(HSP70)水平的影响。方法:本组研究共135例,均为Hp首次根除治疗失败患者,随机按就诊顺序分为对照组67例和治疗组68例。对照组给予四联方案治疗,包括胶体果胶秘胶囊400 mg,2次/d,于餐后口服;雷贝拉唑钠肠溶片10 mg,2次/d,餐前口服;呋喃唑酮片100 mg,2次/d;阿莫西林胶囊1 000 mg,2次/d。治疗组在四联方案治疗的基础上给予加味三仁汤内服治疗,1剂/d,常规早晚水煎服用。两组疗程均为10 d。检测两组患者Hp根除率;比较两组中医证候(TCM)积分和临床疗程;检测两组血清核因子-κB(NF-κB)和热休克蛋白70(HSP70)水平。结果:治疗组Hp根除率为87.69%,对照组根除率为72.31%,治疗组优于对照组(P<0.05);对照组总有效率为80%,治疗组总有效率为93.85%;治疗组优于对照组(P<0.05);治疗组治疗后上腹痛、上腹胀、胃脘灼热、口苦口臭和恶心呕吐症状及总积分均明显低于对照组(P<0.01);治疗组治疗后血清NF-κB水平明显低于对照组,而血清HSP70水平明显高于对照组,比较差异有统计学意义(P<0.01)。结论:在西医四联方案治疗基础上,加味三仁汤治疗首次Hp根除失败后患者,能明显提高Hp根除率和临床疗效,改善中医临床证候,其作用可能与其降低患者血清NF-κB水平和升高HSP70水平有关。Objective： To observe the clinical efficacy of modified Sanren Tang in rescue treatment after failed eradication of helicobacter pylori（ Hp） and its effect on nuclear factor kappa B（ NF-κB） and heat shock protein70（ HSP70）. Method： One hundred and thirty-five patients with previous failed eradication of Hp were randomly divided into control group（ 67 cases） and treatment group（ 68 cases） according to visiting sequence.Control group received quadruple regimen treatment,including Colloidal bismuth pectincapsule 400 mg（ bid）,orally taken after meals. Sodium Rabeprazole Enteric-coated Tablets,10 mg（ bid）,orally taken before meals.furazolidone tablets 100 mg（ bid）,and amoxicillin capsule 1 000 mg（ bid）. Based on control group,the treatment group also received modified Sanren Tang treatment,1 dose / d and bid,in conventional decoction form in the morning and evening. The treatment course was 10 days for both groups. Hp eradication rate was detected in both groups. Scores of traditional Chinese medicine（ TCM） syndrome and clinical efficacy were compared between two groups. Serum levels of NF-κB and HSP70 were measured in both groups. Result： Hp eradication rate was87. 69% in treatment group,which was superior to 72. 31% in control group（ P 〈0. 05）. The total effective rate was 93. 85% in treatment group and 80% in control group,and there was statistical difference between two groups（ P 〈0. 05）. After treatment,scores of epigastric pain,epigastric distention,epigastric burning,fetid oris,nausea and vomiting as well as the total scores in treatment group were obviously lower than those of control group（ P 〈0. 01）. After treatment,serum level of NF-κB in treatment group was significantly lower than that in control group,while HSP70 was significantly higher than that in control group,with statistically significant difference between two groups（ P 〈0. 01）. Conclusion： Based on quadruple regimen treatment,modified Sanren Tang in treatment of failed era

关 键 词：幽门螺杆菌 三仁汤 慢性胃炎 核因子-κB 热休克蛋白70 

分 类 号：R287[医药卫生—中药学]