香砂平胃颗粒治疗幽门螺杆菌相关性胃炎伴消化不良的近期疗效观察  

Short-term efficacy of Xiangsha Pingwei Granule in the treatment of Helicobacter pylori gastritis with dyspepsia

作　　者：朱新影[1] 赵丽伟[1] 孟霞[1] 杨亮[1] 焦黎 马欢[1] ZHU Xin-ying;ZHAO Li-wei;MENG Xia;YANG Liang;JIAO Li;MA Huan(Department of Gastroenterology,the Third Hospital of Hebei Medical University,Shijiazhuang,Hebei 050050,China)

机构地区：[1]河北医科大学第三医院消化内科,河北石家庄050050

出　　处：《中华全科医学》2021年第7期1107-1110,1178,共5页Chinese Journal of General Practice

基　　金：河北省2019年度医学科学研究课题(20190638)。

摘　　要：目的评估香砂平胃颗粒联合四联疗法治疗幽门螺杆菌(Helicobacter pylori,H.pylori)相关性胃炎伴消化不良症状的有效性及安全性。方法选取河北医科大学第三医院2017年10月—2018年12月收治的H.pylori相关性胃炎伴消化不良症状患者240例,采用随机数字表法分为对照组和观察组,每组120例。对照组采用枸橼酸铋钾220 mg+雷贝拉唑10 mg+阿莫西林1000 mg+克拉霉素500 mg,口服每天2次,疗程14 d;观察组在对照组基础上,加用香砂平胃颗粒10 g,2次/d,疗程14 d。比较2组患者H.pylori根除率,中医临床症状评分,血清胃蛋白酶原(pepsinogen,PG)Ⅰ、PGⅡ、PGⅠ/Ⅱ的比值(pepsinogen ratio,PGR)水平变化以及不良反应情况。结果2组患者H.pylori根除率差异有统计学意义(90.4%vs.93.8%,χ^(2)=0.890,P=0.345)。观察组总有效率为89.5%,明显高于对照组的79.5%,χ^(2)=4.325,P=0.038。2组患者各项中医症状积分均随时间延长而降低,观察组中医症状积分下降幅度显著大于对照组,观察组中医症状积分整体水平均明显低于对照组。2组患者血清PGⅠ、PGⅡ、PGR水平均随时间延长而降低,观察组上述指标下降幅度明显大于对照组。观察组上述指标整体水平均明显低于对照组,观察组出现不良反应20例(17.5%),明显低于对照组[32例(28.6%),χ^(2)=3.878,P=0.049]。结论香砂平胃颗粒联合四联疗法治疗H.pylori胃炎合并消化不良,具有较好的临床疗效及安全性,值得临床推广。Objective To evaluate the efficacy and safety of Xiangsha Pingwei Granule in the treatment of Helicobacter pylori(H.pylori)gastritis with dyspepsia.Methods Total 240 H.pylori gastritis patients with dyspepsia were randomly divided into control group and observation group,120 cases each.Control group received 220 mg Bismuth Potassium Citrate+Rabeprazole 10 mg+Amoxicillin 1000 mg+Clarithromycin 500 mg,oral twice a day for 14 days;observation group received Xiangsha Pingwei Granule 10 g twice a day for 14 days based on the control group.H.pylori eradication rate,TCM clinical symptom score,serum pepsinogen(PG)Ⅰ,PGⅡ,pepsinogen ratio(PGR)levels and adverse reactions were compared between the two groups.Results There was no significant difference in the eradication rate of H.pylori between the two groups(90.4%vs.93.8%,χ^(2)=0.890,P=0.345).The total effective rate of observation group was 89.5%,which was significantly higher than 79.5%of the control group(χ~2=4.325,P=0.038).The scores of TCM symptoms of the two groups decreased with time.The decrease of the above symptom scores in the observation group was significantly higher than control group.The overall level of the above symptom scores in the observation group was significantly lower than control group.The serum levels of PGⅠ,PGⅡand PGR in the two groups decreased with time.The decrease of the above indexes in the observation group was significantly greater than control group.The overall level of the above indexes in the observation group was significantly lower than that in the control group.There were 20 cases(17.5%)of adverse reactions in observation group,which was significantly lower than 32 cases(28.6%)in the control group(χ^(2)=3.878,P=0.049).Conclusion Xiangsha Pingwei Granule combined with quadruple therapy in the treatment of H.pylori gastritis complicated with dyspepsia has good clinical efficacy and safety,which is worthy of clinical promotion.

关 键 词：幽门螺杆菌 香砂平胃 胃炎 消化不良 

分 类 号：R573.3[医药卫生—消化系统]