中西医结合治疗幽门螺旋杆菌阳性消化性溃疡44例

目的:观察清幽I号方联合四联疗法对消化性溃疡(PU)幽门螺杆菌(Hp)的根除率及对溃疡复发的影响。方法:88例PU患者随机按数字法分为对照组和观察组各44例。对照组服用奥美拉唑,20 mg/次,2次/d;枸橼酸铋钾片,2粒/次,2次/d;阿莫西林胶囊,1 g/次,2次/d;克拉霉素,500 mg/次,2次/d。疗程为14 d。14 d后再采用法莫替丁,20 mg/次,1次/d,再治疗14 d。观察组在对照组治疗的基础上加用清幽I号方,1剂/d,常规水煎分2次服用,共28 d。记录治疗后Hp清除情况;采用组织学再生黏膜成熟度评价溃疡愈合质量;进行1年随访观察复发情况。结果:观察组总体疗效有效率为97.73%,对照组为81.82%,观察组优于对照组(P<0.05);观察组Hp清除率为90.9%,对照组为75%,观察组Hp清除率高于对照组(P<0.05);观察组再生黏膜组织学成熟度评价优于对照组(P<0.05);对照组13例复发,复发率45.16%,观察组8例复发,复发率20%,观察组复发率低于对照组(P<0.05);观察组平均复发时间(10.1±1.93)个月长于对照组的(8.7±1.84)个月(P<0.05)。结论:在常规四联疗法的基础上加服清幽I号方能提高Hp清除率,提高溃疡愈合质量,减少/延缓PU复发,提高临床疗效。

Treatment of Combination of Traditional Chinese and Western Medicine in 44 Cases with Helicobacter Pylori Positive Peptic Ulcer

Objective: Observe the eradication rate of helicobacter pylori(Hp) of peptic ulcer(PU)and ulcer recurrence in patients treated with Qingyou 1st decoction combined with quadruple therapy. Method: Eighty-eight patients were randomly divided into control group and observation group (44 cases,respectively). Patients in control group received oral administration of omeprazole(20 mg each time), bismuth potassium citrate tablets(2 pieces each time)amoxicillin capsule(1 g each time)and clarithromycin(500 mg each time) twice a day. After 14 days of treatment Famotidine would continue to be used for at a dosage of 20 mg each time (once a day) for another 14 days. Based on the treatment of control group, patients in observation group added decoct medicinal herbs-Qingyou 1st decoction, (1 does per day, taken at two times) for another 28 days. Clearance of Hp was recorded after treatment. Quality of ulcer healing was evaluated with histologic regenerative mucosal maturity. One-year follow-up was made to observe ulcer recurrence. Result: The total curative efficacy in observation group was 97.73%, which is higher than that in control group (81.82%), the difference was statistically significant (P<0.05). Hp clearance rate in observation group was 90.9%, which is higher than that in control group (75%, P<0.05). Histological maturity of regenerative mucosa in observation group was superior to that in control group (P<0.05). Number of cases of ulcer recurrence in control group was 13, and rate of recurrence was 45.16%, while number of ulcer recurrencee in observation group were 8, rate of ulcer recurrence was 20%, which in observation group was lower than that in control group(P<0.05). The average time of ulcer recurrence in observation group(10.1±1.93)months were longer than which in control group(8.7±1.84)months (P<0.05). Conclusion: On basis of routine quadruple therapy, added Qingyou 1st decoction can improve Hp clearance rate and the quality of ulcer healing. The combined method is able to reduce/delay PU recurrence and enhance the clinical curative effect.