芪连清胃方辅助治疗幽门螺杆菌阳性胃溃疡的疗效观察  

Clinical Effect of Qilian Qingwei Decoction on Helicobacter pyloripositive Gastric Ulcer Based on the Theory of“Treating with Carbuncle”

作　　者：王芳[1] 秦燕鸿[1] 王婧 WANG Fang;QIN Yan-hong;WANG Jing(Cangzhou Hospital of Integrated Traditional Chinese Medicine-Western Medicine,Cangzhou Hebei 061000)

机构地区：[1]河北省沧州中西医结合医院,河北沧州061000

出　　处：《世界中西医结合杂志》2022年第9期1854-1858,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：河北省中医药管理局2020年度科研计划课题(2020462)。

摘　　要：目的观察芪连清胃方治疗幽门螺杆菌(Helicobacter pylori,Hp)阳性胃溃疡的临床疗效。方法选取2019年10月—2020年9月期间河北省沧州中西医结合医院消化内科收治的Hp阳性胃溃疡患者92例,按照随机数字表法分为治疗组和对照组,每组各46例。对照组予以西医四联疗法雷贝拉唑肠溶片+枸橼酸铋钾胶囊+阿莫西林胶囊+克拉霉素分散片治疗,治疗组在对照组治疗基础上予以中药芪连清胃方口服。治疗8周后,观察比较两组患者治疗前后中医证候评分(胃脘胀痛、恶心呕吐、嗳气反酸、嘈杂、纳差)、胃镜下胃黏膜评分(炎性细胞浸润程度、黏膜厚度、腺体密度、黏膜形态)和黏膜转化生长因子β(Transforming growth factor-β,TGF-β)、Smad 3表达情况,比较两组患者血清白细胞介素(Interleukin,IL)-2、IL-12和干扰素-γ(Interferon-γ,IFN-γ)水平,比较两组患者总有效率和Hp转阴率。结果治疗后两组患者各项中医证候评分均低于治疗前,差异有统计学意义(P<0.05);且治疗组各项中医证候评分低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者各项胃黏膜评分均低于治疗前,差异有统计学意义(P<0.05);且治疗组各项胃黏膜评分低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者胃黏膜TGF-β、Smad 3阳性表达均低于治疗前,差异有统计学意义(P<0.05)且治疗组胃黏膜TGF-β、Smad 3阳性表达情况均低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清IL-2、IL-12、IFN-γ水平均低于治疗前,差异有统计学意义(P<0.05);且治疗组血清IL-2、IL-12、IFN-γ水平低于对照组,差异有统计学意义(P<0.05)。治疗后治疗组总有效率97.83(45/46)明显高于对照组89.13(41/46),差异有统计学意义(P<0.05)。治疗后治疗组Hp转阴率91.11%(41/46)明显高于对照组76.09%(35/46),差异有统计学意义(P<0.05)。结论芪连清胃方可有效缓解中医证候,促进胃黏膜�Objective To observe the clinical effect of Qilian Qingwei Decoction on Helicobacter pylori(Hp)positive gastric ulcer based on the theory of“treating with carbuncle”.Methods Ninty-two patients with Hp-positive gastric ulcers in Cangzhou Hospital of Integrated Traditional Chinese Medicine-Western Medicine in Hebei province from October 2019 to September 2020 were included and randomly divided into a treatment group and a control group by the number random table method,with 46 cases in each group.The control group was treated with western medicine quadruple therapy,and the treatment group was additionally given Qilian Qingwei Decoction based on the control group.The course of treatment lasted for 8 weeks.The traditional Chinese medicine(TCM)syndrome scores(stomachache,nausea and vomiting,belching acid regurgitation,gastric discomfort,and poor appetite)and the gastric mucosa scores under gastroscope(degree of inflammatory cell infiltration,mucosal thickness,gland density,and mucosal morphology)of the two groups before and after treatment were compared.The expressions of mucosal transforming growth factor-β(TGF-β)and Smad 3,the levels of interleukin(IL)-2,IL-12,and interferon-γ(IFN-γ),the total effective rates,and the Hp clearance rate of the two groups were compared.Results After treatment,the TCM syndrome scores of the two groups were lower than those before treatment(P<0.05),and the TCM syndrome scores in the treatment group were lower than those in the control group(P<0.05).After treatment,the scores of gastric mucosa in the two groups were lower than those before treatment(P<0.05),and the scores of gastric mucosa in the treatment group were lower than those in the control group(P<0.05).The positive expressions of TGF-βand Smad 3 in gastric mucosa were lower than those before treatment(P<0.05),and the treatment group was lower than the control group(P<0.05).After treatment,the levels of serum IL-2,IL-12,and IFN-γwere lower than those before treatment(P<0.05),and the treatment group was lower than the co

关 键 词：胃溃疡 幽门螺杆菌 芪连清胃方 

分 类 号：R573.1[医药卫生—消化系统]