柴芍胃炎颗粒对HP耐药患者胃粘膜肠化逆转点观察

发布时间：2018-07-11 13:33

本文选题：胃炎颗粒 + HP耐药　；参考：《西南医科大学》2017年硕士论文

【摘要】：目的:观察应用我院已故名老中医周德端教授在1996年创研出的幽胃康冲剂(即现在的柴芍胃炎颗粒)结合抗HP疗法治疗耐幽门螺杆菌(Helicobacter pylori,Hp)患者,观察患者胃黏膜肠化及逆转点情况,并同步观察胃炎颗粒联合抗Hp治疗是否助于提高HP根除率及降低其耐药率。方法:对Hp感染患者进行胃镜及镜下活检(及病理)检查选择伴肠化病人60例。随机分组,A组(胃炎颗粒组)给予胃炎颗粒,服药方法:柴芍胃炎颗粒每天早、中、晚各一次,每次一包,疗程14天;B组(胃炎颗粒联合三联疗法组)给予胃炎颗粒及标准三联疗法,服药方法:柴芍胃炎颗粒每天早、中、晚各一次,每次一包,雷贝拉唑肠溶片20mg,阿莫西林1.0 g,克拉霉素0.5 g,每天两次,饭后服用,疗程14天;C组(三联疗法组)给予标准三联疗法,服药方法同B组三联疗法,疗程14天。在0.5年、1年、1.5年复查胃镜、HP、在相同部位胃黏膜组织病检,HP感染者则检测其耐药率。根据检测结果进行数据统计与分析。结果:(1)H.pylori根除率比较,B组(85%)A组(55%)C组(45.0%),有统计学差异(p0.05)。(2)效果观察方面,在色素胃镜下,B组(胃炎颗粒联合三联疗法组)给予胃炎颗粒及标准三联疗法组总有效率为90.0%,C组总有效率50%,B组总有效率为50%,B组总有效率明显高于前两者(p0.05);(3)病检疗效观察方面,B组(胃炎颗粒联合三联疗法组)总有效率为85%,C组(三联疗法组)总有效率45%,A(胃炎颗粒组)组总有效率为55%,中西结合治疗组总有效率明显高于前两者(p0.05);(4)在病理组织学方面,三组患者胃粘膜炎症、肠上皮化生水平治疗后均有所改善,统计学差异(P0.05)。结论:三组在防治幽门螺杆菌方面都有一定效果,胃炎颗粒及标准三联疗法组疗明显优于西药组和中药组,能有效地提高H.pylori根除率,逐渐的提高机体免疫状态,调节自身平衡,改善患者的生存质量,并能减轻胃黏膜的炎症反应,修复胃粘膜,在一定程度上能逆转肠化生,可能预防及减缓慢性萎缩性胃炎向癌症的进一步改变。
[Abstract]:Objective: to observe the treatment of Helicobacter pylori (Helicobacter pylori) resistance in patients with Helicobacter pylori (Helicobacter pylori) resistance by using Youweikang granule (now Chaishao gastritis granule) and anti-HP therapy, which was founded in 1996 by the late Professor Zhou Deduan, a famous old Chinese medicine, in our hospital. The intestinal metaplasia and reversal point of gastric mucosa were observed, and whether the combination of gastritis granule and anti-HP could increase the eradication rate of HP and reduce the drug resistance rate. Methods: gastroscopy and biopsy (and pathology) were performed in 60 patients with HP infection. Group A (gastritis granule group) was randomly divided into two groups: group A (gastritis granule group) was given gastritis granule, taking medicine method: Chaishao gastritis granule every morning, middle, late, once every time, one pack each time, For 14 days, group B (gastritis granule combined with triple therapy group) was given gastritis granule and standard triple therapy. Rabeprazole enteric-coated tablets 20 mg, amoxicillin 1.0 g, clarithromycin 0.5 g, twice a day after meals, group C (triple therapy group) was given standard triple therapy for 14 days. In 0.5 years, 1 year and 1.5 years, the rate of drug resistance was detected in HP infected patients with gastric mucosal disease at the same site. According to the results of the test data statistics and analysis. Results: (1) the eradication rate of H.pylori in group B (85%), group A (55%) and group C (45.0%) was significantly different (p0.05). (2). The total effective rate of group B (gastritis granule combined with triple therapy group) and standard triple therapy group was 90.0%. The total effective rate of group B was 50%. The total effective rate of group B was significantly higher than that of group B (p0.05); (3). The total effective rate of group B was significantly higher than that of group B (p0.05); (3). Effect observation: the total effective rate of group B (gastritis granule combined with triple therapy group) is 85%, the total effective rate of group C (triple therapy group) is 45%, the total effective rate of group A (group of gastritis granules) is 55, the total effective rate of group B is significantly higher than that of group B (combined with traditional Chinese medicine and western medicine), and the total effective rate of group B is significantly higher than that of group C (group C). (p0. 05); (4) in histopathology, Three groups of patients with gastric mucosal inflammation, intestinal metaplasia level were improved after treatment, statistical difference (P0.05). Conclusion: all the three groups have certain effects in prevention and treatment of Helicobacter pylori. The treatment of gastritis granules and standard triple therapy group is better than that of western medicine group and traditional Chinese medicine group, which can effectively increase the eradication rate of H.pylori, gradually improve the immune state of the body, and regulate self balance. Improving the patients' quality of life, reducing the inflammation of gastric mucosa, repairing gastric mucosa, reversing intestinal metaplasia to a certain extent, may prevent and slow down the further change from chronic atrophic gastritis to cancer.
【学位授予单位】：西南医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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