中西医结合治疗老年人幽门螺杆菌相关性胃炎的疗效观察

近几年来,本院应用补阳还五汤与阿莫西林胶囊联合治疗老年人幽门螺杆菌(Hp)相关性胃炎取得了较好的疗效,现报告如下。1　资料与方法1.1　一般资料:132例均为本院经胃镜及Hp检查为Hp阳性的慢性胃炎患者,并且排除消化道肿瘤。132例患者随机均分为治疗组及对照组,治疗组中男40例,女26例,年龄55～76岁,平均病程9年。对照组中男41例,女25例,年龄57～80岁,平均病程为9.2年。中医辨证分型参照文献[1],治疗组中脾胃虚寒型22例,肝郁气滞型8例,胃阴亏虚型6例,瘀阻胃络型30例。对照组中分别为23例、9例、5例、29例。两组性别、年龄、病程等无显著性差…     

中医治疗幽门螺杆菌相关性胃炎的临床研究

[目的]讨论分析中医综合方法预防和治疗幽门螺杆菌相关性胃炎的临床效果.[方法]将2012年10月～2014年3月于我院就诊的100例幽门螺杆菌相关性胃炎患者随机均分成对照组和治疗组.对照组患者服用奥美拉唑钠肠溶胶囊、阿奠西林胶囊和克拉霉素分散片治疗;治疗组采用中医综合方法,包括：健康宣教、情志疏导、体质辨识和辨证论治相结合,服用中药汤剂予以预防和治疗,比较2组患者的临床疗效.[结果]治疗组50例患者治疗后出现胃脘痛、灼热、泛酸、饱胀及嗳气的比率显著低于对照组,差异有统计学意义（P＜0.05）;治疗组的总显效率76％,显著高于对照组的总显效率40％,差异有统计学意义（P＜0.05）.[结论]中医可有效预防幽门螺杆菌胃炎的发生,明显改善患者各临床症状,治疗幽门螺杆菌相关性胃炎效果显著.     

胃黏膜中不同形态幽门螺杆菌感染的病理学研究

目的探讨胃黏膜中不同形态幽门螺杆菌(H.pylori)感染的病理学研究,为临床诊断鉴别提供依据。方法纳入2013年1月-2014年1月福建医科大学附属第一医院接受诊治的胃炎患者230例。采用银染色法和免疫组化SP法检测患者胃黏膜活检标本。分析胃黏膜中不同形态H.pylori感染的病理学特征及关系。结果在银染切片中H.pylori表现:螺旋H.pylori以短螺旋状为主,主要分布于黏膜表面的黏液中;免疫组化染色切片中H.pylori表现:外形主要为球形和螺旋形,主要分布于黏膜表面的黏液中,部分位于间质中,而一部分在上皮细胞表面附着;螺旋状H.pylori伴球形H.pylori阳性者与阴性者性别、炎症类型、炎症程度及间质淋巴细胞数量相比,差异有统计学意义(P0.05);而黏膜类型比较,差异无统计学意义(P0.05);单纯球形H.pylori阳性者与阴性者炎症类型、黏膜类型、间质淋巴细胞数量相比,差异有统计学意义(P0.05);而性别、炎症程度比较,差异无统计学意义(P0.05)。结论球形H.pylori与螺旋状H.pylori均对胃黏膜有致病性,但相对球形H.pylori,螺旋状H.pylori致病性较弱。     

肥大细胞与幽门螺杆菌相关性胃炎

本文对３５６例慢性胃炎（胃镜活检标本）组织中幽门螺杆菌（ＨＰ）与肥大细胞（ＭＣ）关系进行了探讨。结果发现：伴ＨＰ感染的胃炎中ＭＣ计数较之无ＨＰ感染者明显增多（Ｐ＜０．０１）。且ＨＰ越多，组织中的ＭＣ数量也越多。本文结果提示：胃粘膜组织中ＭＣ可能在ＨＰ相关性胃炎的病变发展中有重要意义。     

抗幽门螺杆菌治疗近况

幽门螺杆菌(Helicobacter—pylori;HP)在人群中的感染率颇高,各地流行病学调查报告不一,西方人群中约40%,东方发展中国家在50%以上。自从1983年Warren和Marshall培养成功HP,并提出其与慢性胃炎有密切关系后,国内外广泛地开展了研究。有报道慢性胃炎病人HP检出率为78.6%,活动期达95.45%,抗HP治疗根除该菌后,不仅胃炎症状,内镜下表现好转,而且病理组织学检查亦相     

老年慢性胃炎与幽门螺杆菌感染的关系

本文报道老年慢性胃炎伴幽门螺杆菌（ＨＰ）感染的情况，并与中青年慢性胃炎伴ＨＰ感染组对照。结果表明：老年ＣＡＧ伴ＨＰ感染的发病率较对照组高，而ＣＡＧ又是老年胃癌的癌前病变，因此彻底治疗ＨＰ感染对预防老年ＣＡＧ的癌变有一定的临床意义。     

中西医结合治疗幽门螺杆菌相关性胃炎疗效观察

慢性胃炎因病因各异而分为不同类型 ,治疗方法也各有不同 ,但目前认为大多数慢性胃炎的主要病因是幽门螺杆菌 (Hp)感染[1] ,称为 Hp相关性胃炎。西药有许多根除 Hp的方案 ,但由于抗生素的毒副作用 ,耐药性的产生 ,以及同时在改善消化不良症状方面的作用有限 [2 ] ,影响其临床疗效的发挥。我们从 1 997～ 2 0 0 2年采用法莫替丁加中医辨证治疗 Hp相关性胃炎 ,效果满意 ,现报告如下。1　资料与方法1 .1　一般资料 :全部资料均来自本院住院和门诊患者 ,经胃镜检查 ,同时取幽门前区粘膜作快速尿素酶检测 (试剂盒由杭州临科生物技术有限公司提…     

老年患者幽门螺杆菌感染与胃炎活动性相关性分析

目的探讨老年患者幽门螺杆菌(Hp)感染与胃炎活动性的相关性。方法回顾性地分析2014年1月至2014年6月于北京老年医院接受胃镜及~(13)C呼气试验检查的良性上消化道疾病患者278例,依据年龄分为年龄≥60岁(老年组)111例和年龄60岁(非老年组)167例,分别观察两组患者Hp感染情况及胃黏膜组织中性粒细胞浸润与Hp感染的关系。结果老年组与非老年组比较,Hp感染率分别为27.0%(30/1 11)和36.5%(61/167),差异无统计学意义(P0.05);中性粒细胞浸润率分别为18.9%(21/111)和29.3%(49/118),差异无统计学意义(P0.05);Hp阳性和Hp阴性患者中性粒细胞浸润分别为70.3%(64/91)和3.2%(6/187),差异有统计学意义(P0.05);Hp阳性患者老年组和非老年组中性粒细胞浸润分别为63.3%(19/30)和73.8%(45/61),中性粒细胞浸分级(轻、中、重)分别为26.3%vs 17.8%,57.9%vs 71.1%,15.8%vs11.1%,差异均无统计学意义(P0.05)。结论胃黏膜急性炎症与Hp感染相关,急性炎症分级与感染年龄无关。     

加味佐金汤治疗幽门螺杆菌相关性胃炎96例

我们在临床上应用加味佐金汤治疗对幽门螺杆菌 ( Hp)感染所致相关性胃炎 ,取得较好疗效 ,现报告如下。1　资料与方法1 .1　临床资料 :96例 Hp阳性患者全部来自本院门诊。经纤维胃镜检查确诊 ,并经14 C-尿素呼气试验或组织切片染色法阳性 ;且 2个月内未服抗生素、铋剂等抗 Hp药物 ,并排除了肝、胆疾患 ,肝、肾功能检查正常者。临床表现以胃脘灼痛 ,泛酸嘈杂 ,烦躁易怒 ,口干口苦 ,舌红 ,苔黄 ,脉弦等为主要临床症状。中医辨证属脾虚肝胃郁热。 96例中男 67例 ,女 2 9例 ;年龄 1 9～ 65岁 ,平均 37.5岁 ;病程 <1年者 2 5例 ,1～3年者 40例 ,…     

A short-term eradication therapy for Helicobacter pylori acute gastritis

BACKGROUND AND AIMS: Acute gastritis, caused by an initial infection of Helicobacter pylori (H. pylori), may resolve spontaneously, but the infection sometimes becomes chronic. We examined the efficacy of a short-term H. pylori eradication therapy on acute gastritis. METHODS: Among the 15 patients with hemorrhagic acute gastritis who were randomly allocated to group A (eradication therapy) or group B (Lansoprazole, LPZ), 10 of them started to receive treatment within 1 day after the disease onset. The other five patients began the eradication therapy 4-6 days after disease onset (group C). Eradication therapy consisted of a daily oral administration of each of 30 mg lansoprazole (LPZ), once a day; 400 mg clarithromycin, twice a day; 1000 mg amoxicillin, twice a day; and 300 mg rebamipide, three times a day, for one week. If the endoscopy was normal, medication was stopped for the following 4 weeks before gastric endoscopy was performed again in order to assess H. pylori eradication. RESULTS: All group A patients were cured after the 1-week treatment and therefore, they became H. pylori negative. Group B and C patients had erosions or ulcers after the 1-week treatment and so received an additional 3-week administration of LPZ. Four weeks later, their gastritis was cured and except for one group B patient, they became H. pylori-negative. CONCLUSION: In patients with acute gastritis, caused by an initial H. pylori infection, eradication therapy was efficacious in achieving early healing. This therapy should be started as soon as possible after disease onset.     

332例幽门螺杆菌感染老年患者多次根除治疗的疗效研究

目的总结分析幽门螺杆菌（Hp）感染老年患者多次根除Hp治疗后的根除率,探讨反复多次根除Hp治疗疗效及与相关因素的关系。方法回顾性分析Hp检测阳性的老年病例332例,符合Hp根除治疗的标准,曾多次行抗Hp根除治疗,每次治疗停药1个月后均行13C-尿素呼气试验,有明确随访结果。将收集的病例进行统计学率的计算,多个率的比较采用卡方检验。结果332例老年患者经第一次抗Hp根除治疗,211例患者13C-尿素呼气试验检测证实Hp为阴性;首次治疗后检测仍为阳性的121例患者,有117例行第二次抗Hp根除治疗,89例患者治疗后行13C-尿素呼气试验证实Hp检测为阴性;检测仍为阳性的28例患者中有16例进行第三次根除治疗,13例患者治疗1个月后行13C-尿素呼气试验检测证实为阴性。结论对有根除指征的Hp反复阳性老年患者进行及时有效的根除治疗很有必要。反复多次根除治疗时,个体化调整治疗方案,以四联治疗为主,将治疗时间由1周延长为2周,对于提高Hp感染根除率可能有益。     

Light and electron microscopy study of Helicobacter pylori-associated gastritis and gastric carcinoma

ＬｉｇｈｔａｎｄｅｌｅｃｔｒｏｎｍｉｃｒｏｓｃｏｐｙｓｔｕｄｙｏｆＨｅｌｉｃｏｂａｃｔｅｒｐｙｌｏｒｉａｓｓｏｃｉａｔｅｄｇａｓｔｒｉｔｉｓａｎｄｇａｓｔｒｉｃｃａｒｃｉｎｏｍａＬＵＯＨｏｎｇＴａｏ１，ＣＨＡＮＧＷｅｎＨｕａ２ａｎｄＪＩＸｉａｏ...     

根除幽门螺杆菌前后对痘疹样胃炎治疗效果的比较

目的:评价痘疹样胃炎根除幽门螺杆菌(H.pylori)后的治疗效果以及病理变化情况,明确根除H.pylori对痘疹样胃炎的治疗意义.方法:325例痘疹样胃炎患者根据H.pylori检测结果分为阳性组(标准三联或四联疗法)与阴性组(单纯抑酸),比较治疗效果;阳性组根据复查胃镜H.pylori的结果再分为两组,比较病理情况...     

含莫西沙星三联疗法在老年幽门螺杆菌感染补救治疗中的疗效观察

目的观察含莫西沙星的三联疗法治疗老年初治失败的幽门螺杆菌（Hpylori）感染的临床疗效及不良反应。方法将94例经标准三联疗法治疗失败的Hpylori感染老年患者随机分成A组和B组,每组47例。A组给予口服雷贝拉唑20mg（2次／d）＋阿莫西林1g（2次／d）＋莫西沙星400mg（1次／d）;B组给予口服雷贝拉唑20mg（2次,d）＋枸橼酸铋钾300mg（4次／d）＋呋喃唑酮100mg（2次／d）＋阿莫两林ig（2次／d）。两组均治疗7d,治疗结束后4W进行”C尿素呼气检测试验。结果A、B两组的根除率（ITT）分别为91．5％和72．3％（P〈0．05）;不良反应发生率分别为8．5％和27．6％（P〈0．05）。结论莫西沙星三联疗法治疗仞治失败的老年幽门螺杆菌感染是一种有效,安全的治疗方案。     

HOGG1 polymorphism in atrophic gastritis and gastric cancer after Helicobacter pylori eradication

AIM:To investigate the association between Ser326Cys human oxoguanine glycosylase 1(hOGG1) polymorphism and atrophic gastritis and gastric cancer after Helicobacter pylori(H.pylori) eradication.METHODS:A total of 488 subjects(73 patients with gastric cancer,160 with atrophic gastritis after H.pylori eradication and 255 controls) were prospectively collected.Polymerase chain reaction-restriction fragment length polymorphism analysis was performed to distinguish hOGG1 Ser326Cys polymorphism.Statistical analys...     

Helicobacter pylori eradication in the healing of atrophic gastritis: A one-year prospective study

Objective. Whether gastric atrophy or intestinal metaplasia heals after successful treatment of Helicobacter pylori (H. pylori) infection is still a matter of controversy. The aim of this article was to clarify whether, after one year, H. pylori eradication is associated with healing in glandular atrophy and intestinal metaplasia in the corpus and antrum. Material and methods. Ninety-two H. pylori-positive peptic ulcer patients with atrophic gastritis (panatrophy, antral or corpus predominant) participated in the baseline study, 1-year prospective follow-up data being available from 76 patients. Mean age was 58±12.6 years (mean±SD) and the male/female ratio 2/1. The patients participated in an H. pylori eradication study in which they randomly received active eradication therapy. Endoscopy was performed before H. pylori eradication therapy and after 8 and 52 weeks, with specimens examined according to the Sydney system. Results. Of the 92 patients, 8 (9%) had panatrophy, 58 (63%) had antral- and 26 (28%) had corpus-predominant atrophic gastritis. After H. pylori eradication, the mean atrophy score declined in patients with antral-predominant atrophy from 1.5 (mean) to 0.7 (p<0.05), in corpus-predominant atrophy from 1.7 to 0.2 (p=NS) and in patients with panatrophy from 1.2 to 0.8 (p=NS). Atrophy healing was seen in 55% of antral-predominant atrophy patients who had successful H. pylori eradication.The mean antral atrophic score in one year declined in patients with duodenal ulcer (from 1.0 mean to 0.4) whereas it remained the same (1.3) in those with gastric ulcer (p<0.05). Conclusions. Atrophy can diminish or even disappear, especially in the antrum, during a 1-year follow-up after eradication of infection. Atrophy progression seems milder in patients with duodenal ulcer than in patients with gastric ulcer.     

Gastro-oesophageal reflux and duodenogastric reflux before and after eradication in Helicobacter pylori gastritis

OBJECTIVE: Helicobacter pylori and duodenogastric reflux (DGR) are both associated with chronic gastritis, peptic ulcer and gastric cancer. The nature of their interrelationship remains unclear. H. pylori eradication has also been reported to result in new or worsening acid gastro-oesophageal reflux (GOR). The aim of this study was to investigate the relationship between GOR, DGR and H. pylori infection. METHOD: 25 patients with H. pylori gastritis underwent ambulatory 24-hour oesophageal and gastric pHmetry and gastric bilirubin monitoring before and 12 weeks after H. pylori eradication, confirmed by 14C urea breath testing (UBT). Ten healthy subjects served as a control group. RESULTS: There were no differences between patient and control groups for gastric alkaline exposure or gastric bilirubin exposure (P> 0.25 in all categories). Oesophageal acid reflux was higher in the study group (P< 0.02). No differences were detected in oesophageal acid reflux, gastric alkaline exposure, or gastric bilirubin exposure (P = 0.35, 0.18 and 0.11, respectively) before and after eradication. CONCLUSIONS: Acid GOR is not increased by H. pylori eradication. DGR in patients with H. pylori gastritis is similar to that in healthy, non-infected subjects. H. pylori eradication produces no change in GOR or DGR. In patients with chronic gastritis, H. pylori infection and DGR appear to be independent of each other.     

中西医结合根除幽门螺杆菌对萎缩性胃炎核因子-κB表达的影响

[目的]观察以胃舒散为主的三联疗法（胃舒散、呋喃唑酮和克拉霉素）治疗幽门螺杆菌（Hp）阳性慢性萎缩性胃炎（CAG）的临床效果及其对核因子-κB（NF-κB）表达的影响。[方法]41例Hp阳性CAG患者服用胃舒散2．0g，呋喃唑酮0．1g，各3次／d，克拉霉素0．25g，2次／d，1周后再继服胃舒散4周。治疗前及治疗结束1年后行内镜及病理组织学检查，取活检观察病理组织学改变及NF-κB表达变化，采用银染色法、^14C-尿素呼气试验或快速尿素酶试验检测Hp。[结果]三联疗法结束1年后，Hp根除率为85．4％；根除Hp能显著减轻患者胃窦部慢性炎症（P〈0．05）和活动程度（P〈0．01），下调NF-κB表达（P〈0．01），但胃炎的萎缩和肠化生等病理无明显改变。[结论]以胃舒散为主的三联疗法对Hp有较高根除率。根除Hp可抑制NF-κB的表达，减轻活动性炎症，但近期观察对萎缩、肠化生等病理改变无明显作用。