半夏泻心汤加味治疗HP阳性型消化道溃疡的临床疗效及对炎性因子、胃泌素的影响

发布时间：2018-04-30 01:16

本文选题：消化道溃疡 + HP感染　；参考：《中华中医药学刊》2017年06期

【摘要】：目的:观察半夏泻心汤加味治疗HP阳性型消化道溃疡的临床疗效及对炎性因子、胃泌素的影响。方法:将医院2014年3月—2016年6月收治的100例符合入组标准的HP阳性型消化道溃疡患者随机分为对照组和观察组,每组各50例,对照组给予四联疗法治疗,即给予奥美拉唑、克拉霉素、阿莫西林、胶体果胶铋联合治疗,观察组在对照组的基础再口服半夏泻心汤加味,1天1剂,两组均治疗2周,治疗前后观察上腹部疼痛、嗳气、反酸、胃部灼热、上腹饱胀、恶心呕吐变化情况,采用单切面超声方法进行胃运动功能检查,观察胃排空时间(T)、胃窦收缩频率(F)、胃窦收缩幅度(△A/A),采用14C-UBT方法进行幽门螺旋杆菌检测,算出根除率,空腹抽血5 mL,采用放射免疫法检测白介素-6(IL-6)、胃泌素(GAS),比较两组临床疗效。结果:观察组和对照组的HP根除率为90%和54%,差异具有统计学意义(χ~2=16.071,P0.05),观察组临床总有效率为94%和76%,差异具有统计学意义(Z=-3.178,P0.01)。观察组和对照组治疗后上腹部疼痛、嗳气、反酸、胃部灼热、上腹饱胀、恶心呕吐评分均较治疗前明显下降(P0.05),观察组治疗后上腹部疼痛、嗳气、反酸、胃部灼热、上腹饱胀、恶心呕吐评分明显低于对照组(P0.05)。观察组和对照组治疗后IL-6、GAS较治疗前明显下降(P0.05),观察组治疗后IL-6、GAS明显低于对照组(P0.05)。观察组和对照组治疗后T明显缩短,F明显降低,△A/A明显升高,观察组治疗后T明显短于对照组,F明显低于对照,△A/A明显高于对照组,均P0.05。结论:半夏泻心汤加味能够提高四联疗法治疗HP阳性型消化道溃疡的临床疗效,能有效缓解临床症状、提高HP根除率,作用机制与其改善胃排空功能、抑制局部炎症损伤及调节血胃泌素有关。
[Abstract]:Objective: to observe the clinical effect of Banxia Xiexin decoction on HP positive peptic ulcer and its effect on inflammatory factors and gastrin. Methods: from March 2014 to June 2016, 100 patients with HP positive peptic ulcer were randomly divided into two groups: control group (n = 50) and observation group (n = 50). Clarithromycin, amoxicillin and colloidal bismuth pectin were combined to treat the patients in the observation group. In the control group, the treatment group was treated with Banxia Xiexin decoction once a day. The pain in the upper abdomen, belching, acid regurgitation, and heartburn in the stomach were observed before and after treatment. The changes of upper abdominal fullness, nausea and vomiting were examined by single section ultrasound. Gastric emptying time, antral contraction frequency, antral contraction amplitude (A / A) were observed. Helicobacter pylori was detected by 14C-UBT method. The eradication rate was calculated and the fasting blood was drawn for 5 mL. The radioimmunoassay was used to detect IL-6 and gastrin GASA. The clinical efficacy of the two groups was compared. Results: the eradication rate of HP was 90% in the observation group and 54% in the control group. The difference was statistically significant (蠂 ~ (2 +) 16.071) (P 0.05). The total clinical effective rate of the observation group was 94% and 76% (P 0.01). The difference was statistically significant. The scores of epigastric pain, belching, acid regurgitation, heartburn, upper abdominal fullness, nausea and vomiting in the observation group and the control group were significantly lower than those before treatment (P 0.05), and the pain in the upper abdomen, belching, acid regurgitation, heartburn in the stomach and fullness of the upper abdomen were observed after treatment in the observation group. The score of nausea and vomiting was significantly lower than that of the control group (P 0.05). After treatment, the levels of IL-6 buccal gas in the observation group and control group were significantly lower than those in the control group (P 0.05), and that in the observation group was significantly lower than that in the control group (P 0.05). After treatment, T of observation group and control group were significantly decreased and A / A was increased. After treatment, T of observation group was significantly shorter than that of control group, and A / A was significantly higher than that of control group (P 0.05). Conclusion: Banxia Xiexin decoction can improve the clinical effect of combined therapy on HP positive peptic ulcer, relieve clinical symptoms, increase HP eradication rate, and improve gastric emptying function. Inhibition of local inflammatory injury and regulation of blood gastrin.
【作者单位】：奉化市中医医院脾胃病科;奉化市人民医院消化内科;
【分类号】：R573.1

【相似文献】