抗幽合剂联合西药治疗盘锦地区幽门螺杆菌阳性慢性胃炎的临床观察

发布时间：2018-06-27 06:19

  本文选题：抗幽合剂 + 幽门螺杆菌　； 参考：《辽宁中医药大学》2016年硕士论文

【摘要】：目的:观察抗幽合剂联合西药四联疗法治疗盘锦地区幽门螺杆菌阳性的慢性胃炎患者的幽门螺杆菌根除情况、症状改善以及中医脾胃疾病患者报告临床结局(PRO)量表[1]评分变化情况。方法:将符合纳入标准的75例患者,采用随机化方法,随机分为三组,每组25例。其中A组予西药四联(奥美拉唑20mg、克拉霉素胶囊500mg、左氧氟沙星片200mg、枸橼酸铋钾220mg)治疗,BID,14天。B予西药四联治疗+中药辨证论治汤剂,BID,14天。C组予西药四联治疗+抗幽合剂,BID,14天。入组当天对所有患者进行症状评分(附录1)及PRO量表(附录2)评分,安全评价(血尿便常规,肝肾功能,心电图)。入组2周后予停药,进行症状评分并记录不良事件。停药4周后复查14C尿素呼气试验,复查血尿便常规,肝肾功能,心电图,再次行PRO量表评分,记录不良事件。用spss22.0统计软件分析结果,观察各组Hp根除率和症状改善情况以及中医脾胃疾病患者报告临床结局(PRO)量表评分变化情况。结果:1.A组(西药组)Hp根除率72%,B组(西药+中药辨证)Hp根除率84%,C组(西药+抗幽合剂)Hp根除率80%。2.C组治疗后症状评分均较治疗前明显改善(P0.01),3.PRO量表评分中,C组与治疗前比较消化不良、反流、排便、精神状态、社会功能积分变化具有显著差异(P0.01),总体状态和健康满意存在统计学差异(P0.05),C组在消化不良积分改善优于B组(P0.05),C组在健康满意积分改善优于A组(P0.05)。结论:抗幽合剂联合西药四联,可以有效的提高慢性胃炎合并幽门螺杆菌阳性的患者幽门螺杆菌根除率,改善患者症状积分及PRO量表积分,并且在PRO量表中健康满意项积分改善优于单纯西药四联疗法,值得临床进一步研究和推广。
[Abstract]:Objective: to observe the eradication of Helicobacter pylori in patients with chronic gastritis with positive Helicobacter pylori in Panjin area. Symptom improvement and the changes of clinical outcome (pro) scale [1] in patients with spleen and stomach diseases in TCM were reported. Methods: 75 patients who met the inclusion criteria were randomly divided into three groups, 25 cases in each group. Group A was given western medicine (omeprazole 20 mg, clarithromycin 500 mg, levofloxacin 200 mg, bismuth potassium citrate 220mg) for 14 days. B was given western medicine for 14 days. Symptom score (Appendix 1) and pro scale (Appendix 2), safety evaluation (hematuria routine, liver and kidney function, ECG) were performed on the same day. After 2 weeks, the drug was stopped, symptom score and adverse events were recorded. After 4 weeks of withdrawal, 14C urea breath test was reexamined, hematuria routine, liver and kidney function, electrocardiogram, pro scale score and adverse events were recorded again. The results of spss22.0 statistical software were used to observe the HP eradication rate and symptom improvement and the clinical outcome (pro) scale scores of the patients with spleen and stomach diseases in traditional Chinese medicine (TCM). Results 1. The eradication rate of HP in group A (western medicine group) and group B (differentiation of traditional Chinese medicine and western medicine) was significantly improved after treatment. The eradication rate of HP in group C (anti-you mixture for western medicine) was significantly improved compared with that before treatment (P0.01). The scores of reflux, defecation, mental state and social function were significantly different (P0.01). There was statistical difference between general state and health satisfaction (P0.05). The improvement of indigestion score in group C was better than that in group B (P0.05). The improvement of score of health satisfaction in group C was better than that in group A (P0.05). Conclusion: the combination of Kangyou mixture and western medicine can effectively improve the eradication rate of Helicobacter pylori in patients with chronic gastritis and Helicobacter pylori positive patients, and improve the symptom score and pro scale score of patients with chronic gastritis and Helicobacter pylori positive patients. The improvement of the score of health satisfaction item in pro scale is better than that of western medicine combined therapy alone, which is worthy of further clinical study and popularization.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R573.3
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本文编号：2072966