清化饮联合四联疗法治疗Hp相关十二指肠溃疡的疗效及机制研究  

Study on curative effect and mechanism of Qinghua Drink combined with quadruple therapy for Helicobacter pylori associated duodenal ulcers

作　　者：黄铭涵[1] 许若缨 郑榕 王鑫[1] 林秀明[1] 王文荣[1] 杨春波[1] 林平[1] HUANG Ming-han;XU Ruo-ying;ZHENG Rong;WANG Xin;LIN Xiu-ming;WANG Weng-rong;YANG Chun-bo;LIN Ping(The Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Fuzhou 350003,China)

机构地区：[1]福建中医药大学附属第二人民医院,福州350003

出　　处：《中华中医药杂志》2020年第9期4735-4739,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：福建省自然科学基金项目(No.2017J01305);福建省中医药科研项目(No.2017FJZYJC206);福建省创新课题(No.2018-CX-47);福建中医药大学基金项目(No.X2016001-临床);福建中医药大学脾胃优势特色学科开放课题(No.X2019014-学科)。

摘　　要：目的:探讨清化饮联合四联疗法治疗Hp相关十二指肠溃疡的临床疗效及机制。方法:将120例Hp相关十二指肠溃疡患者随机分为治疗组和对照组,每组60例,两组均给予标准四联疗法及足程抑酸治疗,治疗组在对照组基础上加予清化饮口服治疗,比较两组临床疗效、电子胃镜及Hp根除率情况,检测治疗前后血清NLRP3、Caspase-1、IL-1β、IL-18水平。结果:剔除脱落及退出病例,治疗组在中医证候疗效、临床症状积分、电子胃镜的比较上均优于对照组(P<0.05,P<0.01);治疗组Hp根除率为93.0%,显著高于对照组的78.2%(P<0.05);与治疗前比较,治疗后两组血清细胞焦亡相关因子NLRP3、Caspase-1、IL-1β、IL-18水平均显著降低(P<0.01),且治疗组血清NLRP3、Caspase-1、IL-1β、IL-18水平低于对照组(P<0.05,P<0.01)。结论:清化饮联合四联疗法治疗脾胃湿热型Hp相关十二指肠溃疡疗效确切,能有效改善临床症状,提高Hp根除率,其机制可能与下调NLRP3、Caspase-1、IL-1β、IL-18等细胞焦亡相关因子表达,进而抑制Hp感染及炎症反应有关。Objective:To observe the clinical efficacy and mechanism of Qinghua Drink combined with quadruple therapy treating Helicobacter pylori(Hp)associated duodenal ulcers.Methods:A total of 120 patients of Hp associated duodenal ulcers were divided into two groups randomly,the control group and the therapy group with 60 patients in each group.Two groups both were treated by the standard quadruple therapy and enough treatment of acid suppression therapy.In addition,the therapy group also used Qinghua Drink to treat on the basis of that.The clinical efficacy,gastroscope and Hp eradication rate of two groups were compared,and the serum levels of NLRP3,Caspase-1,IL-1β and IL-18 before and after treatment were detected.Results:After eliminating the falling and withdrawal cases,the effects on the TCM syndromes efficacy,integration of main clinical symptoms,gastroscopy in the therapy group were better than those in the control group(P<0.05,P<0.01).The difference in the Hp eradication rate between the control group(78.2%)and the therapy group(93.0%)was significant(P<0.05).The levels of pyroptosis related factors NLRP3,Caspase-1,IL-1β,L-18 in two groups reduced significantly compared with that before treatment(P<0.01),and the levels of which in the therapy group was lower than that in the control group(P<0.05,P<0.01).Conclusion:Qinghua Drink combined with quadruple therapy has definite curative effect in treating Hp associated duodenal ulcers,which can improve the Hp eradication rate and the mechanism may be related to downgrading the pyroptosis factor NLRP3,Caspase-1,IL-1β and IL-18 expression in order to restrain Hp and inflammation.

关 键 词：清化饮 四联疗法 Hp相关十二指肠溃疡 临床疗效 细胞焦亡 

分 类 号：R573.1[医药卫生—消化系统]