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益氣活血清熱化濕方對(duì)消化性潰瘍Hp根除率的影響及對(duì)Hp球形變的觀察

發(fā)布時(shí)間:2018-05-29 17:44

  本文選題:益氣活血 + 清熱化濕; 參考:《遼寧中醫(yī)雜志》2016年05期


【摘要】:目的:觀察益氣活血清熱化濕方對(duì)Hp(+)的消化性潰瘍Hp根除率、潰瘍愈合情況的影響;探討Hp在根除過程中可能出現(xiàn)的球形變異。方法:采用隨機(jī)數(shù)字表法將80例Hp陽性的消化性潰瘍患者分成對(duì)照組及治療組,每組40例。兩組均給予西藥標(biāo)準(zhǔn)三聯(lián)療法,療程2周,在此基礎(chǔ)上對(duì)照組給予奧美拉唑鎂腸溶片20 mg,1次/d,服用4周。治療組聯(lián)合中藥益氣活血清熱化濕方治療,2次/d,總療程均為6周。總療程結(jié)束后2周行14C呼氣試驗(yàn)(urea breathe test,UBT);復(fù)查胃鏡觀察并記錄潰瘍的愈合情況,統(tǒng)計(jì)治療后內(nèi)鏡下潰瘍愈合的有效率;胃體、胃竇各取1塊組織行快速尿素酶試驗(yàn)(rapid urease test,RUT);取胃竇組織行免疫組化法(gastric mucosa immunohistochemistry test,GMIT)檢測(cè)Hp。記錄并評(píng)估上述3種不同檢測(cè)方法的檢測(cè)結(jié)果,確定最終的根除率。結(jié)果:治療組內(nèi)鏡療效總有效率為97.5%(39/40),明顯優(yōu)于對(duì)照組87.5%(35/40)(P0.05)。治療組Hp根除率77.5%(31/40),亦明顯高于對(duì)照組55%(22/40)(P0.05)。治療后三種檢測(cè)方法得出的Hp陽性總個(gè)數(shù)分別為UBT(12個(gè))、RUT(8個(gè))、GMIT(24個(gè)),呼氣試驗(yàn)、快速尿素酶試驗(yàn)Hp陽性檢出率均低于免疫組化法(P0.05)。免疫組化染色涂片中發(fā)現(xiàn)大量球形幽門螺桿菌。結(jié)論:益氣活血清熱化濕方結(jié)合標(biāo)準(zhǔn)三聯(lián)法較單純標(biāo)準(zhǔn)三聯(lián)療法能更為有效地促進(jìn)潰瘍的愈合,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.
【作者單位】: 無錫市中醫(yī)醫(yī)院;
【基金】:江蘇省科委社會(huì)發(fā)展基金(BS2006506)
【分類號(hào)】:R573.1

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