慢性胃炎不同中医证型与幽门螺杆菌根除率的相关性研究

【目的】通过抗幽门螺杆菌(Hp)治疗,观察慢性胃炎患者不同中医证型对其根除率的影响。【方法】将符合纳入标准的180例Hp感染的慢性胃炎患者分成脾胃虚弱型、脾胃湿热型、肝郁气滞型各60例,每组再随机分为三联组和四联组两个亚组,每个亚组30例。按三联疗法或四联疗法标准方案给予抗Hp治疗10 d,对其根除率进行比较。【结果】(1)Hp总根除率为78.3%,无论采用三联疗法还是四联疗法,均提示脾胃虚弱组Hp根除率最低,总根除率仅为61.7%,低于脾胃湿热组的88.3%和肝郁气滞组的85.0%(P0.05或P0.01);而脾胃湿热组与肝郁气滞组比较,差异无统计学意义(P0.05)。(2)共有10例患者发生如恶心呕吐、胃痛胃胀等不良反应,其中脾胃虚弱组8例,脾胃湿热组及肝郁气滞组各1例,脾胃虚弱组的不良反应发生率明显高于脾胃湿热组和肝郁气滞组(P0.05)。【结论】不同中医证型的慢性胃炎患者的Hp根除率不同,无论是三联疗法还是四联疗法,脾胃虚弱型的Hp根除率均低于脾胃湿热型和肝郁气滞型。

Correlation of Traditional Chinese Medicine Syndrome Types of Chronic Gastritis with Helicobacter pylori Eradication Rate

Objective To investigate the correlation of traditional Chinese medicine (TCM) syndrome types of chronic gastritis with Helicobacter pylori (Hp) eradication rate after anti-Hp treatment. Methods A total of 180 chronic gastritis patients with Hp infection were differentiated into spleen-stomach insufficiency syndrome, spleen-stomach dampness-heat syndrome, and liver depression and qi stagnation syndrome, and each syndrome group had 60 cases. Patients in each group were evenly divided into two subtypes, and were treated with triple therapy or quadruple therapy for 10 days respectively. After treatment, the Hp eradication rate in each group was compared. Results (1) The overall Hp eradication rate was 78.3%. No matter after triple therapy or quadruple therapy, patients with spleen-stomach insufficiency syndrome had the lowest Hp eradication rate (61.7%), which was lower than that of the patients with spleen-stomach damp-heat syndrome (88.3%) and the patients with liver depression and qi stagnation syndrome (85.0%), the difference being statistical significance (P < 0.05 or P < 0.01). However, the difference of Hp eradication rate between spleen-stomach damp-heat group and liver depression and qi stagnation group was not statistically significant (P>0.05). (2) A total of 10 cases had adverse reaction such as nausea and vomiting, stomachache, and gastric distention, 8 cases from spleen-stomach insufficiency group, one from spleen-stomach dampness-heat group, and one from liver depression and qi stagnation group. Spleen-stomach insufficiency group had higher incidence of adverse reaction than the other two groups (P < 0.05). Conclusion The Hp eradication rate after anti-Hp treatment varied in chronic gastritis patients with different TCM syndrome types, and the rate in patients with spleen-stomach insufficiency syndrome was lower than that of the patients with spleen-stomach damp-heat syndrome and the patients with liver depression and qi stagnation syndrome no matter after triple therapy or quadruple therapy.