半夏泻心汤加减治疗Hp相关消化性溃疡的临床分析  

Clinical Analysis of Banxia Xiexin Tang Add and Subtract in Treatment of Hp-associated Peptic Ulcer

作　　者：彭国强[1] 商建飞[1] 杜杰[1] 李伟[1] 张汉阳[2] 

机构地区：[1]白城医学高等专科学校,吉林白城137000 [2]吉林大学第二医院,长春130041

出　　处：《中国实验方剂学杂志》2016年第5期197-201,共5页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：吉林省自然科学基金重点项目(20010303-2)

摘　　要：目的:探讨半夏泻心汤加减治疗幽门螺杆菌(Hp)相关消化性溃疡寒热错杂证的疗效以及对血清血清骨桥蛋白(OPN)和β-链蛋白(β-catenin)水平的影响。方法:将本院消化内科收治Hp相关消化性溃疡110例参照数字表法随机分为治疗组和对照组各55例;两组均参照《消化性溃疡病诊断与治疗规范》,给予非药物治疗;对照组采取子泵抑制剂(PPI)三联疗法,包括奥美托唑肠溶片20 mg,2次/d;克扣霉素片500 mg,2次/d;阿莫西林胶囊0.5 g,2次/d,以上均采取口服治疗2周;2周后再口服泮托拉唑钠肠溶片40 mg,1次/d,继续治疗2周。治疗组在对照组治疗的基础上采取半夏泻心汤加减,1剂/d,常规水煎煮2次内服,两组共治疗4周。比较两组治疗前后寒热错杂证主要症状和胃十二指肠黏膜损伤评分;分析两组治疗后Hp消除率和临床疗效;检测两组血清OPN和β-catenin水平。结果:治疗组治疗后寒热错杂证主要症状积分均明显低于对照组(P<0.01);治疗组临床总有效率为96.36%,对照组为80%,治疗组优于对照组(P<0.05);治疗组治疗后Hp根除率为90.91%,对照组根除率为74.45%;治疗组优于对照组(P<0.05);治疗组治疗后胃和十二指肠黏膜损伤评分均明显低于对照组(P<0.01);治疗后治疗组OPN和β-catenin水平均明显高于对照组,比较差异均有统计学意义(P<0.01)。结论:在常规非药物治疗和三联疗法基础上,采取半夏泻心汤加减治疗Hp相关消化性溃疡可明显改善患者临床主要症状和胃、十二指肠黏膜损伤,提高临床疗效和Hp的根除率,其上述作用可能与抑制血清OPN和β-catenin水平有关。Objective： To investigate the clinical efficacy of Banxia Xiexin Tang in treatment of helicobacter pylori（Hp）-associated peptic ulcer with syndrome of intermingled heat and cold and observe its effect on serum levels of osteopontin （OPN） and β-catenin. Method： One hundred and ten patients with Hp-associated peptic ulcers at internal digestive wards of our hospital were randomly divided into treatment group and control group （55 cases in each group） referring to random number table. Patients in both groups were given with non-drug therapy with reference to ＂Diagnosis and Treatment Guidelines for Peptic Ulcer Disease＂. Patients in control group received therapy of proton pump inhibitors （PPI）,including omeprazole enteric-coated tablets （20 mg, bid）, clarithromycin tablets （500 mg, bid） and amoxicillin capsules （0.5 g, bid）. The above drugs were orally taken for 2 weeks. After 2 weeks, Pantoprazole sodium enteric-coated tablets （40 mg, qd） were orally taken for 2 weeks. Patients in treatment group were also treated with Banxia Xiexin Tang （1 dose/d, boiled twice conventionally） for 4 weeks in total based on the treatment in control group. The main symptoms and scores of gastroduodenal mucosa injury were compared before and after treatment in both groups. Hp elimination rates and the clinical curative effects were analyzed for both groups. Serum levels of OPN and β-catenin were detected. Result： Scores of clinical symptom for syndrome of intermingled heat and cold in treatment group were significantly lower than those of control group after treatment （P〈0.01）. The total effective rate was 96.36% in treatment group, superior to 80% in control group, with statistical differences （P〈0.05）. After treatment,Hp elimination rate in treatment group was 90.91%, superior to 74.45% in control group, with statistical differences （P〈0.05）. Scores of gastroduodenal mucosa injury in treatment group were significantly lower than those in control group after treatment

关 键 词：半夏泻心汤 幽门螺杆菌 寒热错杂证 骨桥蛋白 Β-链蛋白 

分 类 号：R287[医药卫生—中药学]