中医辨证用药联合“四联疗法”对慢性胃炎伴幽门螺杆菌感染的临床疗效观察

发布时间：2018-03-02 09:02

本文关键词： 幽门螺杆菌中西医结合治疗四联疗法根除率慢性胃炎　出处：《南京中医药大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：比较辨证用药联合“四联疗法”与“四联疗法”对幽门螺杆菌(Hp)根除率的差别；观察辨证用药联合“四联疗法”与“四联疗法”在根治Hp过程中对慢性胃炎症状改善程度的影响。方法：采用随机对照方法,将60例经检查确诊为Hp感染的慢性胃炎患者,分成两组。对照组30例,予“标准四联疗法”方案(奥美拉唑20mg、阿莫西林1.0g、克拉霉素0.5g、枸橼酸铋钾220mg,bid),试验组30例,予“标准四联疗法”的同时服用辨证用药,两组疗程均为10天。治疗结束4周后行13C尿或14C尿素酶呼气试验检查,统计分析两组Hp根除率情况,临床症状改善情况,并评价其安全性。结果：慢性胃炎伴Hp感染的中医证型总体分布规律为：脾胃湿热(37.9%)肝胃不和(31.0%)脾胃虚弱(20.7%)胃阴不足(10.3%)。根除率,对照组为72.4%,试验组为93.3%,试验组与对照组相比较,差异具有统计学意义(P0.05),除此之外,辨证用药联合四联疗法对于患者胃脘痞满不适、胃脘疼痛、嗳气、食欲减退等临床症状的缓解率有显著提高作用,但差异无统计学意义(P0.05)。两组的总体有效率,对照组为62.1%,试验组为93.3%,试验组症状总体有效率显著高于对照组,但是差异无统计学意义(P0.05)。对照组有1例因服药期间出现皮疹而终止试验。试验组未发生不良事件,两组不良事件发生率相比较差异无统计学意义(P0.05),具有可比性。结论：辨证用药联合“四联疗法”与“四联疗法”治疗慢性胃炎伴Hp感染,两者Hp根除率差异有统计学意义(P0.05)；辨证用药可以显著提高Hp相关性慢性胃炎患者胃脘痞满不适、胃脘疼痛、嗳气、食欲不振等临床症状缓解率。
[Abstract]:Objective: to compare the eradication rate of Helicobacter pylori (HP) with the combination of syndrome differentiation and quadruple therapy. To observe the effect of syndrome differentiation combined with "quadruple therapy" and "quadruple therapy" on the improvement of chronic gastritis in the course of radical cure of HP. Methods: sixty patients with chronic gastritis diagnosed as HP infection were divided into two groups by random control, the control group (30 cases), the control group (30 cases), the control group (30 cases) and the control group (30 cases). "Standard quadruple therapy" regimen (omeprazole 20 mg, amoxicillin 1.0 g, clarithromycin 0.5 g, bismuth potassium citrate 220 mg bid) was given to 30 patients in the experimental group. After 4 weeks of treatment, 13C urine or 14C urease breath test was performed. The HP eradication rate, clinical symptom improvement and safety of the two groups were statistically analyzed. Results: the general distribution of TCM syndrome types of chronic gastritis with HP infection was as follows: spleen and stomach dampness and heat 37.9) liver and stomach disharmony 31.0) spleen and stomach deficiency 20.7) stomach deficiency and stomach deficiency. Eradication rate was 72.4 in the control group and 93.3in the experimental group. The comparison between the experimental group and the control group was compared with that in the control group. The difference was statistically significant (P 0.05). In addition, syndrome differentiation combined with quadruple therapy could significantly improve the remission rate of clinical symptoms such as epigastric fullness, epigastric pain, belching, anorexia, etc. But the difference was not statistically significant (P 0.05). The total effective rate of the two groups was 62.1 in the control group and 93.3 in the experimental group. The overall effective rate of symptoms in the experimental group was significantly higher than that in the control group. But there was no significant difference between the two groups (P 0.05). In the control group, there was no adverse event in one case due to rash during medication, and there was no significant difference in the incidence of adverse events between the two groups, which was comparable. Conclusion: treatment of chronic gastritis with HP infection by syndrome differentiation combined with "quadruple therapy" and "tetralogy therapy" has significant difference in HP eradication rate (P 0.05), differentiation of symptoms and signs can significantly increase epigastric fullness and discomfort in patients with HP associated chronic gastritis. Abatement rate of clinical symptoms such as epigastric pain, belching, loss of appetite and so on.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R573.3

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