清胃汤联合四联疗法治疗幽门螺杆菌阳性胃溃疡临床研究

目的:观察清胃汤联合四联疗法治疗幽门螺杆菌(HP)阳性胃溃疡的临床疗效,初步探讨相关机制。方法:将86例HP阳性胃溃疡患者按照随机数字表法分为治疗组和对照组各43例,对照组予以四联疗法,治疗组予以清胃汤联合四联疗法,疗程均为6周,比较两组治疗前后中医证候评分、HP根除率、溃疡复发率和血清转化生长因子-β1(TGF-β₁)、细胞外调节蛋白激酶 1/2(ERK1/2)和表皮生长因子受体(EGFR)水平,治疗前后对两组进行胃镜检查,比较两组溃疡直径、底部厚苔面积、再生上皮面积和溃疡周围黏膜充血面积,并比较两组胃镜疗效。结果:治疗组治疗后胃脘疼痛、胸胁胀满、嗳气反酸、纳差食少、胃脘烧灼感评分均低于对照组(均P<0.05),溃疡直径、底部厚苔面积、溃疡周围黏膜充血面积均小于对照组(均P<0.05),再生上皮面积大于对照组(P<0.05); 血清TGF-β₁水平低于对照组(P<0.05),ERK1/2、EGFR水平均高于对照组(均P<0.05),胃镜疗效、HP根除率均高于对照组(均P<0.05),复发率低于对照组,差异具有统计学意义(P<0.05)。结论:清胃汤联合四联疗法可有效改善中医证候,促进溃疡愈合,提高HP根除率和内镜疗效,降低溃疡复发率,治疗HP阳性胃溃疡效果显著,其机制可能与调节患者血清TGF-β₁、ERK1/2、EGFR含量有关。

Effect of Qingwei decoction combined with quadruple therapy on helicobacter pylori positive gastric ulcer and its related mechanism

Objective:To observe the clinical effect of Qingwei decoction combined with quadruple therapy in the treatment of helicobacter pylori(HP)positive gastric ulcer and to preliminarily explore the related mechanism.Methods:86 patients with HP positive gastric ulcer were divided into two groups according to random number table method,with 43 patients in each group.The control group received quadruple therapy,and the treatment group received traditional Chinese medicine Qingwei decoction combined with quadruple therapy,with a course of 6 weeks,compare the two groups before and after treatment of TCM syndrome score,HP eradicate rate,ulcer recurrence rate and serum levels of transforming growth factorβ1(TGF-β1),extracellular regulated protein kinase 1/2(ERK1/2)and epidermal growth factor receptor(EGFR)levels.Gastroscopy was performed in both groups before and after treatment.The diameter of ulcer,the area of thick coating at the bottom,the area of regenerated epithelium and the area of hyperemic mucosa around ulcer were compared between the two groups,and the efficacy of gastroscopy was compared between the two groups.Results:After treatment,the scores of gastral cavity pain,fullness chest and hypochondrium,belching acid regurgitation,poor appetite,and gastral cavity burning sensation in the treatment group were all lower than those in the control group(all P<0.05).The ulcer diameter,the area of thick coating at the bottom,the area of hyperemic mucosa around the ulcer were smaller than those in the control group(all P<0.05),and the area of regenerated epithelium was larger than that in the control group(P<0.05).Serum TGF-β1 level was lower than the control group(P<0.05),ERK1/2,EGFR level were higher than the control group(all P<0.05),gastroscopy efficacy,HP eradication rate were higher than the control group(all P<0.05),recurrence rate was lower than the control group(P<0.05),the differences were statistically significant.Conclusion:Qingwei decoction combined with quadruple therapy can effectively improve traditional Chinese medicine syndrome,promote ulcer healing,increase HP eradication rate and endoscopy efficacy,reduce ulcer recurrence rate,and significantly treat HP positive gastric ulcer.The mechanism may be related to the regulation of serum TGF-β1,ERK1/2 and EGFR in patients.