中药内服联合隔姜艾灸治疗Hp阳性慢性萎缩性胃炎伴肠化的疗效观察

目的观察中药内服联合隔姜艾灸治疗Hp阳性慢性萎缩性胃炎(CAG)伴肠化的临床疗效。方法将92例患者采用统计软件(SAS软件)生成的随机表分为观察组和对照组各46例。两组均给予铋剂四联根除方案进行常规治疗。对照组在常规治疗基础上给予叶酸治疗。观察组在对照组的基础上给予中药内服联合隔姜艾灸治疗。两组均连续治疗12周。观察两组治疗前后的中医证候积分、血清胃蛋白酶原(PG)Ⅰ、PGⅡ、PGR(PGⅠ/PGⅡ)、胃泌素-17(G-17)水平。治疗结束1个月后复查胃镜和幽门螺杆菌(Hp),比较两组的临床效果。结果观察组的临床总有效率为91.30%,Hp转阴率为93.48%,明显优于对照组(P<0.05)。两组治疗后中医证候积分、胃黏膜炎症、腺体萎缩及肠化积分均明显下降,血清PGⅠ、PGR比值和G-17水平均升高,PGⅡ水平明显低于治疗前,且观察组优于对照组(P<0.05)。两组均无明显不良反应。结论中药内服联合隔姜艾灸治疗CAG伴肠化患者疗效显著,可有效改善患者临床症状,降低炎性反应,保护胃黏膜,改善胃黏膜萎缩及肠化,促使Hp转阴,且安全可靠,值得临床进一步研究探讨。

Clinical observation on treatment of Hp-positive chronic atrophic gastritis accompanied with intestinal metaplasia by oral Traditional Chinese Medicine combined with Ginger moxibustion

Objective To observe the clinical efficacy of oral Traditional Chinese Medicine(TCM)combined with ginger moxibustion for treatment of Helicobacter pylori(Hp)-positive chronic atrophic gastritis(CAG)accompanied with intestinal metaplasia.Methods Ninety-two patients were randomly divided into observation group and control group by SAS software,with 46 cases in each group.The two groups were given routine treatment of tincture quadruple eradication.The control group received folic acid treatment on the basis of the routine treatment and the observation group was given oral TCM and ginger moxibustion plus the same routine treatment as the control group.Both of the two groups were treated continuously for 12 weeks.The TCM syndrome scores,the levels of serum pepsinogen(PG)Ⅰ,PGⅡ,PGR(PGⅠ/PGⅡ)and gastrin-17(G-17)were observed in the two groups before and after treatment.The patients were reexamined by gastroscopy and the reexamination of Hp was performed one month after treatment in both groups,and their clinical effects were compared.Results The total clinical effective rate of the observation group was 91.30%,and the negative rate of Hp was 93.48%,which was significantly better than those of the control group(P<0.05).The TCM syndrome scores,gastric mucosal inflammation,gland atrophy and intestinal metastasis scores were obviously decreased,and the levels of serum PGⅠ,PGR ratio and G-17 were increased,the level of PGⅡof the two groups after treatment was significantly lower than those before treatment and the improvement of the observation group was better than that of the control group(P<0.05).There were no obvious adverse reactions in the two groups.Conclusion Oral TCM combined with ginger moxibustion is effective in treatment of CAG accompanied with intestinal metaplasia,which can effectively improve the clinical symptoms,reduce the inflammatory reaction,protect the gastric mucosa,improve the gastric mucosal atrophy and intestinal metaplasia,and promote Hp to turn negative.The combination therapy is safe and reliable and is worthy of further clinical research.