益气活血清热化湿方对消化性溃疡Hp根除率的影响及对Hp球形变的观察

发布时间：2018-05-29 17:44

本文选题：益气活血 + 清热化湿　；参考：《辽宁中医杂志》2016年05期

【摘要】：目的:观察益气活血清热化湿方对Hp(+)的消化性溃疡Hp根除率、溃疡愈合情况的影响;探讨Hp在根除过程中可能出现的球形变异。方法:采用随机数字表法将80例Hp阳性的消化性溃疡患者分成对照组及治疗组,每组40例。两组均给予西药标准三联疗法,疗程2周,在此基础上对照组给予奥美拉唑镁肠溶片20 mg,1次/d,服用4周。治疗组联合中药益气活血清热化湿方治疗,2次/d,总疗程均为6周。总疗程结束后2周行14C呼气试验(urea breathe test,UBT);复查胃镜观察并记录溃疡的愈合情况,统计治疗后内镜下溃疡愈合的有效率;胃体、胃窦各取1块组织行快速尿素酶试验(rapid urease test,RUT);取胃窦组织行免疫组化法(gastric mucosa immunohistochemistry test,GMIT)检测Hp。记录并评估上述3种不同检测方法的检测结果,确定最终的根除率。结果:治疗组内镜疗效总有效率为97.5%(39/40),明显优于对照组87.5%(35/40)(P0.05)。治疗组Hp根除率77.5%(31/40),亦明显高于对照组55%(22/40)(P0.05)。治疗后三种检测方法得出的Hp阳性总个数分别为UBT(12个)、RUT(8个)、GMIT(24个),呼气试验、快速尿素酶试验Hp阳性检出率均低于免疫组化法(P0.05)。免疫组化染色涂片中发现大量球形幽门螺杆菌。结论:益气活血清热化湿方结合标准三联法较单纯标准三联疗法能更为有效地促进溃疡的愈合,提高Hp的根除率。
[Abstract]:Objective: to observe the effect of Yiqi Huoxue Qingre Huazheng recipe on HP eradication rate and ulcer healing in peptic ulcer of HP and to explore the possible spherical variation of HP in the course of eradication. Methods: 80 patients with HP positive peptic ulcer were randomly divided into control group and treatment group with 40 cases in each group. The two groups were treated with standard triple therapy of western medicine for 2 weeks. The control group was given omeprazole magnesium enteric-coated tablets 20 mg / d once a day for 4 weeks. The treatment group combined with traditional Chinese medicine Yiqi Huoxue Qingre Huazheng recipe for two times a day, the total course of treatment was 6 weeks. 14C breath test urea breathe test was performed 2 weeks after the total course of treatment. The healing rate of ulcer was observed and recorded under gastroscopy, and the effective rate of ulcer healing under endoscope was counted. One piece of antral tissue was taken for rapid urease test and urease test for RUTT, and gastric mucosa immunohistochemistry test was used to detect HpMIT in antral tissue. To record and evaluate the detection results of the above three different detection methods and determine the final eradication rate. Results: the total effective rate of endoscopy in the treatment group was 97.5 / 39 / 40, which was significantly better than that in the control group (87.5%, 40%, P 0.05). The HP eradication rate of the treatment group was significantly higher than that of the control group. After treatment, the total number of HP positive detected by the three methods was UBT (12 UBT) (8 GMIT (24), breath test, rapid urease test). The positive rate of HP was lower than that of immunohistochemical method (P0.05). A large number of spherical Helicobacter pylori were found in immunohistochemical staining. Conclusion: the triple therapy of supplementing qi, activating blood circulation, clearing away heat and removing dampness is more effective than standard triple therapy in promoting ulcer healing and increasing HP eradication rate.
【作者单位】：无锡市中医医院;
【基金】：江苏省科委社会发展基金(BS2006506)
【分类号】：R573.1

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