中医药联合序贯疗法根除幽门螺杆菌相关性胃炎疗效分析

目的:探讨中医药联合序贯疗法根除幽门螺杆菌(Hp)相关性胃炎的治疗效果及相关费用情况。方法:240例慢性胃炎患者随机分为6组,平均每组40例,分别使用不同治疗方案:治疗组使用纯西药治疗,中医对照组则在序贯治疗方案基础上加用三九胃泰和/或胃苏颗粒治疗。治疗10天后停用抗生素,维持胃黏膜保护剂或三九胃泰治疗2周。停药1个月后复查Hp情况。治疗前后记录患者中医脾胃系疾病PRO量表得分情况、相关治疗费用。结果:6组患者根除率情况差异无统计学意义。6组治疗成本-效果比为:585.24元、512.08元、495.11元、635.51元、486.64元、505.10元。使用中医脾胃系疾病PRO量表对其生存质量进行评价,提示:中西医结合治疗组较纯西医治疗组患者具有较好的生存质量改善(心理领域和环境领域)。6组不良反应均较轻微,患者可耐受。结论:以埃索美拉唑、左氧氟沙星、奥硝唑三联序贯疗法加用三九胃泰治疗慢性胃炎,可获得较好的Hp根除率、成本-效果比及生存质量改善,有望作为Hp根除治疗优选方案。

Analysis of Chinese Medicine and Sequential Therapy of Eradication of Helicobacter Pylori Associated Gastritis

Objective：To evaluate treatment effect and costs with Chinese medicine combined sequential therapy to eradicate Hp associated chronic gastritis. Methods ：240 cases of chronic gastritis patients were randomly divided into six groups,with an av- erage of 40 people per group, respectively. Treatment group used pure western medicine ; control groups of Chinese medicine added Sanjiu Weitai and/or Sannjiu Weitai particle combining sequential treatment programs. Antibiotics and PPI were discontinued after 10 days sequential therapy, maintaining gastric mucosa protection agent or Sanjiu Weitai for two weeks. One month later, Hp condi- tions were recorded to compare with each group. Records of patients before and after treatment, the scores of Spleen and Stomach Disease PRO Scale （ SSD - PRO） and cost of treatment were acquired to evaluate the treatment effect. Results ： The eradicaiion rates of six groups had no significant difference. Six groups cost - effectiveness ratios were ： 585.24 yuan, 512.08 yuan,495.11 yuan ,635.51 yuan,486.64 yuan and 505.10 yuan. The quality of life was evaluated with SD - PRO,and the results demonstra- ted that combination of Chinese medicine had better quality of life improvement （ psychological dimension, and the environment dimension） compared with pure Western medicine treatment groups. The adverse reactions of six groups were mild, and the pa- tients can tolerate. Conclusion： The group of the triple sequential therapy with esomeprazole, levofloxacin and ornidazole plus San- flu Weitai capsule obtained better Hp eradication rate, cost - effectiveness and quality of life when treating chronic gastritis, and the program is expected as the preferred one of Hp eradication therapy.