清幽健胃汤联合铋剂四联疗法治疗脾虚湿热型Hp相关性胃炎临床研究  

Clinical Study on the Treatment of Spleen Deficiency and Damp-heat Type Hp-Related Gastritis with Qingyou Jianwei Decoction(清幽健胃汤)Combined with Bismuth Quadruple Therapy

作　　者：高翠丽 赵慧慧 刘有霞 郭冬奇 李雪莹[1] 郑丽红[2] GAO Cuili;ZHAO Huihui;LIU Youxia;GUO Dongqi;LI Xueying;ZHENG Lihong(Heilongjiang University of Chinese Medicine,Harbin 150001,Heilongjiang,China;The Fourth Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150040,Heilongjiang,China)

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150001 [2]黑龙江中医药大学附属第四医院,黑龙江哈尔滨150040

出　　处：《辽宁中医药大学学报》2025年第2期196-200,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：黑龙江省自然科学基金项目(H2017061);黑龙江中医药管理局科研课题(HZYCΧ2022081);黑龙江省卫生健康委科研课题(20222121021005);黑龙江中医药大学研究生创新科研项目(2022jyscx051)。

摘　　要：目的 观察清幽健胃汤联合铋剂四联疗法治疗脾虚湿热型幽门螺杆菌(Hp)相关性胃炎的临床疗效及安全性,为临床治疗Hp相关性胃炎提供科学方法。方法 选取2022年1月—2022年12月就诊于黑龙江中医药大学附属第四医院的脾虚湿热型Hp相关性胃炎患者80例作为研究对象,按随机数字表法分为对照组(40例)和试验组(40例),对照组给予铋剂四联疗法,选用雷贝拉唑、阿莫西林、克拉霉素、胶体果胶铋,口服;试验组在对照组治疗基础上选用清幽健胃汤联合治疗,每日1剂,口服。两组患者治疗周期均为2周。比较两组患者治疗前后的临床疗效、中医症状积分、Hp根除率、Hp复发率以及药物不良反应发生率。结果 治疗后,试验组的总有效率为92.31%(36/39),显著高于对照组的76.92%(30/39),差异具有统计学意义(P<0.01);试验组治疗后除身体困重外的其他中医症状单项积分及总积分降低幅度均明显大于对照组,差异具有统计学意义(P<0.05);在药物不良反应方面,对照组主要是腹泻、胃脘痛、呕吐、口干和口苦,而试验组主要是呕吐。试验组和对照组的总不良反应率分别为2.56%和23.8%,差异有统计学意义(P<0.05);此外,试验组Hp清除率(94.87%)明显高于对照组(89.74%),治疗后试验组复发率(2.70%)显著低于对照组(11.43%),两组比较差异无统计学意义(P>0.05)。结论 清幽健胃汤联合铋剂四联疗法治疗Hp相关性胃炎(脾虚湿热证)患者的临床效果显著,其能有效改善各项中医临床症状,提高临床有效率,且能大幅度降低不良反应发生的风险。Objective This study aims to observe the clinical efficacy and safety of Qingyou Jianwei Decoction(清幽健胃汤)combined with quadruple bismuth therapy in treating Helicobacter pylori(Hp)-associated gastritis with spleen deficiency and damp-heat type,providing a scientific basis for the clinical treatment of this condition.Methods Eighty patients with Hp-associated spleen deficiency and damp-heat type gastritis were selected from the fourth hospital affiliated with Heilongjiang university of Chinese medicine between January and December 2022.They were randomly divided into control and experimental groups,each comprising 40 patients,using the random number table method.The control group received quadruple bismuth therapy(rabeprazole,amoxicillin,clarithromycin,and colloidal bismuth pectin,taken orally),while the experimental group received Qingyou Jianwei Decoction in addition to the control group's treatment,administered orally once daily.The treatment period for both groups was two weeks.Clinical efficacy,TCM symptom scores,Hp eradication rates,Hp recurrence rates,and the incidence of adverse drug reactions were compared between the two groups before and after treatment.Results The study included 40 cases in both the experimental group and the control group.After treatment,the total effective rate in the experimental group was 92.31%(36/39),significantly higher than the control group's 76.92%(30/39),with a statistically significant difference(P<0.01).The reduction in individual and total scores of traditional Chinese medicine symptoms in the experimental group after treatment was notably greater than that in the control group,and the difference was statistically significant(P<0.05).Regarding adverse drug reactions,the main side effects in the control group were diarrhea,epigastric pain,vomiting,dry mouth,and bitter taste,while the experimental group primarily experienced vomiting.The overall adverse reaction rates in the experimental group and control group were 2.56%and 23.8%,respectively,with a significant d

关 键 词：清幽健胃汤 四联疗法 胃炎 幽门螺杆菌 临床疗效 脾虚湿热证 

分 类 号：R256.3[医药卫生—中医内科学]