益气活血清热化湿方对消化性溃疡患者幽门螺杆菌根除率的影响  

Effect of Yiqi Huoxue Qingre Huashi Recipe on the Eradication Rate of Hp in Peptic Ulcer Patients

作　　者：戴高中[1] 范先靖[1] 田秋实[1] 朱世楷[1] 赵克学[1] 沈旦蕾[1] 

机构地区：[1]无锡市中医医院脾胃病科,江苏214071

出　　处：《中国中西医结合杂志》2015年第12期1437-1441,共5页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：江苏省科技厅社会发展科技计划指导性项目(No.BS2006506)

摘　　要：目的观察益气活血清热化湿方对幽门螺杆菌(Hp)阳性的消化性溃疡患者溃疡愈合及Hp根除率的影响,探讨在根除过程中Hp可能出现的球形变异。方法采用随机数字表法将80例Hp阳性的消化性溃疡患者分为对照组及治疗组,每组40例。两组均给予西药标准三联疗法,疗程2周,在此基础上对照组继服奥美拉唑镁肠溶片20 mg,每日1次,服用4周。治疗组同时联合中药益气活血清热化湿方治疗,每日2次,总疗程均为6周。停药2周后复查胃镜观察并记录溃疡的愈合情况,统计治疗后内镜下溃疡愈合的有效率;行14C呼气试验(urea breathe test,UBT);胃体、胃窦各取1块组织行快速尿素酶试验(rapid urease test,RUT);胃镜抽取胃液,胃窦部位钳取活组织标本行Hp尿素酶基因PCR扩增试验(urea A-PCR)。记录并评估上述3种不同检测方法的Hp阳性情况,确定最终的根除率。使用电子显微镜观察治疗后的胃黏膜组织,以发现未被根除的Hp,对其形态进行观察。结果治疗组内镜疗效总有效率为97.5%(39/40),明显优于对照组的80.0%(32/40),差异有统计学意义(P<0.05)。治疗组Hp根除率为75.0%(30/40),亦明显优于对照组52.5%(21/40),差异有统计学意义(P<0.05)。治疗后不同检测法得出的Hp阳性总个数分别为^(14)C UBT(12个)、RUT(8个)、urea A-PCR(27个),^(14)C UBT及RUTHp阳性检出率均低于urea A-PCR法(P<0.05)。电子显微镜下可观察到杆状及球状的Hp。结论益气活血清热除湿方联合标准三联法较西药标准三联疗法能更为有效地促进溃疡的愈合,提高Hp的根除率。Objective To observe the effect of Yiqi Huoxue Qingre Huashi Recipe（ YHQHR,a recipe capable of supplementing qi,activating blood,clearing heat,and dissipating dampness） on ulcer healing and Helicobacter pylori（Hp）eradication rate in Hp positive peptic ulcer patients,and to explore coccoid Hp occurrence in the eradication. Methods Totally 80 Hp positive peptic ulcer patients were assigned to the treatment group and the control groups by random digit table,40 in each group. All patients received standard triple therapy of Western medicine for 2 successive weeks. Those in the control group additionally took omeprazole enteric coated tablet,20 mg each time,once per day for 4 successive weeks. Those in the treatment group additionally took YHQHR,twice per day for 6 successive weeks. The ulcer healing was observed and recorded by gastroscope after discontinued medication of 14 days. The effective rate of ulcer healing under endoscope was statistically calculated. Rapid urease test（ RUT） was performed in one small piece of tissue from corpora ventriculi and sinuses ventriculi using （14） C breathe test（ UBT）. Gastric juice was collected from the stomach. Hp urease gene amplification test（ urea A-PCR） was performed in living tissue from gastric antrum. Results obtained from the above three test methods were re-corded and assessed to decide the final eradiation rate. Gastric mucosa tissue was observed under electron microscope,attempting to find non-eradicated Hp,which was further observed. Results The total curative effect under gastroscope was 97. 5%（ 39 /40 cases） in the treatment group,obviously higher than that in the control group（ 80. 0%,32 /40 cases）（P〈0. 05）. The eradication rate of Hp was 75. 0%（ 30 /40 cases）,obviously better than that of the control group（ 52. 5%,21 /40 cases）（P〈0. 05）. The total positive Hp numbers after treatment was ^14C UBT（ 12）,RUT（ 8）,and urea A-PCR（ 27）,respectively. TheH p positive rate detected by ^14C UBT and RUT was lowe

关 键 词：益气活血 清热化湿 幽门螺杆菌 消化性溃疡 尿素酶基因扩增试验 

分 类 号：R285.6[医药卫生—中药学]