中西医结合根除幽门螺杆菌感染临床疗效观察

目的：观察中西医结合根除幽门螺杆菌（Hp）感染的疗效。方法：选择有上消化道症状，1个月内未用过抗生素或抑酸药，胃镜诊断为慢性胃炎、消化性溃疡或反流性食管炎患者。快速尿素酶试验或组织学Hp阳性，^14 C-尿素呼气试验（^14C—UBT）阳性患者。共85例，随机分成两组。中西医结合组42例，给予灭幽散，1天1剂，分3次餐前服用，同时口服奥美拉唑胶囊，1次20mg，1天2次，连续4周；西药三联组43例，给予克拉霉素片，1次0．25g，甲硝唑片，1次0．4g，奥美拉唑胶囊，1次20mg，1天2次，均口服，连续1周。疗程结束后4周，复查^14C-UBT。结果：治疗2周后症状消失率，中西医结合组80．9％，西药三联组83．7％；Hp根除率，中西医结合组66．6％，西药三联组72．0％。差异无显著性意义（P〉0．05）。因药物不良反应中断治疗，中西医结合组4．76％，西药三联组16．2％（P〉0．05）。结论：中西医结合根除幽门螺杆菌感染疗效确切，不良反应较少，特别适用于对抗生素耐药或有严重不良反应的患者。也可作为一种二线治疗方案。

Clinical Curative Effect Observation of Integration of Traditional Chinese and Western Medicine on Eradication of HP infection

Objective:To obverse the curative effect of integration of traditional Chinese and western medicine(TCWM) on eradication of HP infection.Methods:85 patients with chronic gastritis or peptic ulcer or reflux esophagitis diagnosed by gastroscopy without using antibiotics and antisecretory drugs during 1 month with the positive HP by the rapid urease test and the histology were chosen and randomly divided into the TCWM group(42 cases) and the triple western medicine(TWM) group(43 cases).The TCWM group was treated bv one dose of Mieyou powder per day and Omeprazole 20 mg twice a day for 4 weeks.The TWM group was treated by Clarithromycine 0.25.Metronidazole 0.4 and Omeprazole 20 mg twice a day for 1 week.The clinical symptoms were observed after therapy.The case of negative 14C-UBT 4 weeks after therapy was regarded as eradication.9 cases stopped treatment for side effect were regarded as no effect.Results:The ratios of symptom disappeared in the TCWM group and the TWM group were 80.9% and 83.7% respectively.The ratios of eradication of the TCWM group and the TWM group were 66.6% and 72.0% respectively.There were no significant difference(P>0.05).The ratios of stopped therapy for side effect of two groups were 4.76% and 16.2% respectively(P>0.05).Conclusion:Integration of traditional Chinese and western medicine has good effect on eradication of HP infection.which is especially suitable for those with antibiotic resistance or severe adverse side effects.