清肝解幽方联合四联疗法治疗肝胃郁热型幽门螺杆菌相关性胃炎的临床疗效观察  

Clinical efficacy observation of Qinggan Jieyou prescription combined with quadruple therapy in the treatment of Helicobacter pylori-associated gastritis with liver-stomach stagnation and heat type

作　　者：张利晓 霍永利 杨倩 娄莹莹 佘延芬 ZHANG Lixiao;HUO Yongli;YANG Qian;LOU Yingying;SHE Yanfen(Hebei University of Traditional Chinese Medicine,Shijiazhuang,050091,China;Department of Spleen and Stomach Pathology,the First Affiliated Hospital of Hebei University of Traditional Chinese Medicine)

机构地区：[1]河北中医药大学,石家庄050091 [2]河北中医药大学第一附属医院脾胃病科

出　　处：《中国中西医结合消化杂志》2025年第2期94-99,共6页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：国家重点研发计划项目(No:2019YFC1712103);国家重点研发计划“中医药现代化”重点专项(No:2022YFC3500601);第五批全国中医临床优秀人才研修项目(No:国中医药人教函[2022]1号);国家中医临床研究基地建设项目(No:国中医药科技函[2018]131号);河北省中医药管理局中医药科研计划项目(No:冀中医药[2020]2号)。

摘　　要：目的:探究清肝解幽方治疗肝胃郁热型幽门螺杆菌(Helicobacter pylori,Hp)相关性胃炎的临床疗效。方法:选取2024年1月—2024年6月就诊的89例Hp相关性胃炎患者,随机分为观察组(44例)和对照组(45例)。观察组给予清肝解幽方联合含铋剂的标准四联疗法,对照组给予含铋剂的标准四联疗法,2组疗程均为2周,观察2组患者的临床疗效、中医证候积分、胃镜积分、Hp根除情况、焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分、肠道微生态水平及不良反应发生情况。结果:观察组患者临床总有效率较对照组明显升高(93.2%vs 77.8%,P<0.05),Hp根除率亦明显高于对照组(93.2%vs 77.8%,P<0.05),双歧杆菌、乳杆菌水平高于对照组(P<0.05)。观察组中医证候积分、胃镜积分(弥漫性、点状发红、黏膜皱襞肿大蛇形、胃中黏液白浊)、SAS评分、SDS评分、肠杆菌水平均较对照组降低,差异有统计学意义(P<0.05)。治疗过程中2组患者均未出现明显肝肾功能异常。结论:清肝解幽方可提高肝胃郁热型Hp相关性胃炎患者的Hp根除率,平衡肠道微生态水平,改善患者临床症状、SAS评分及SDS评分,减轻患者焦虑、抑郁情绪,值得临床推广。Objective To investigate the clinical efficacy of the Qinggan Jieyou prescription combined with quadruple therapy in the treatment of Helicobacter pylori(Hp)-associated gastritis with liver-stomach stagnation and heat type.Methods A total of 89 patients with Hp-associated gastritis from January 2024 to June 2024 were selected and randomly divided into the observation group(44 cases)and the control group(45 cases).The observation group was administered a Qinggan Jieyou prescription combined with a standard quadruple therapy containing bismuth.The control group was administered the standard quadruple therapy containing bismuth.The treatment course for both groups was two weeks in duration.The clinical efficacy,traditional Chinese medicine syndrome score,Hp eradication,gastroscopic credits,enteric microecology status,self-rating anxiety scale(SAS)score,self-rating depression scale(SDS)score and the incidence of adverse events were observed in both groups.Results The overall clinical efficacy rate was more positive in the observation group than that in the control group(93.2%vs 77.8%,P<0.05),as was the Hp eradication rate(93.2%vs 77.8%,P<0.05).The levels of bifidobacteria and lactobacillus were higher in the observation group than those in the control group(P<0.05).The traditional Chinese medicine syndrome scores,gastroscopy credits(mucosal swelling,enlarged fold,tortuous fold,sticky mucus),SAS scores,SDS scores,and enterobacteriaceae levels in the observation group were all lower than those in the control group,and there were significant differences(P<0.05).During treatment,no discernible abnormalities in liver or kidney function were observed in either group.Conclusion The integration of the Qinggan Jieyou prescription with bismuth quadruple therapy has been shown to increase the eradication rate of Hp in patients.Furthermore,this combination has been shown to equalize the intestinal micro-ecological status of the intestinal tract,improve the clinical symptoms of patients,elevate the SAS and SDS scores of patients,

关 键 词：清肝解幽方 慢性非萎缩性胃炎 幽门螺杆菌 肝胃郁热型 肠道菌群 

分 类 号：R573.3[医药卫生—消化系统]