三黄泻心汤加味联合标准三联根除Hp的疗效对比研究

目的观察三黄泻心汤加味组方(the Modified Sanhuangxiexin Decoction with Additional Herbs,MSAH)分别联合泮托拉唑+阿莫西林+克拉霉素对于根除幽门螺杆菌(Helicobacter pylori,Hp)的疗效及相关症状改善情况,并与标准三联(泮托拉唑+阿莫西林+克拉霉素)、铋剂四联(铋剂+泮托拉唑+阿莫西林+克拉霉素)疗法进行比较。方法选取2015年10月至2016年2月于我科门诊就诊、行~(13)C呼气试验提示HP感染阳性并伴有相关消化不良症状,或胃镜提示慢性胃炎、胃溃疡的患者99例,按照随机数表法分为4组,分别给予标准三联(A组)、铋剂四联(B组)、泮托拉唑+MSAH(C组)、标准三联+MSAH(D组)4种不同的方案进行HP根除治疗,比较治疗结束后各组根除率及相关症状改善情况。结果 B组与D组的根除率高于A组和C组(P<0.05),而B组、D组根除率比较差异无统计学意义(P>0.05)。C组和D组的症状改善率明显高于A组和B组(P<0.05)。四组均无严重不良反应发生。结论 MSAH联合标准三联的根除率与铋剂四联相近,且临床症状改善率高,是一种较为理想的根除Hp方案。MSAH联合泮托拉唑亦可达到一定的根除效果,为对多种抗生素过敏又急需根除Hp的患者提供了新的治疗方案,同时可以延缓抗生素的耐药问题。

Study on efficacy of the modified Sanhuangxiexin Decoction with Additional Herbs (MSAH) combined with standard triple therapy for Hp eradication

Objective To observe the efficacy of the Modified Sanhuangxiexindecoction with Additional Herbs (MSAH) combined with pantoprazole or standard triple therapy (pantoprazole+amoxicillin+clarithromycin),and comparetheir efficacy with standard triple therapy and bismuth quadruple therapy (bismuth agent+pantoprazole+amoxicillin+clarithromycin).Methods Totally99 outpatients who were diagnosed with HP infection by 13C urea breath test complicated with related symptoms of indigestion or suffered from chronic gastritis or gastric ulcer confirmed by the gastroscopyin our hospital from October 2015 to February 2016 were collected.All the patients were randomly divided into 4 groups according to the random number table,and patients in group A,group B,group C and group D were given standard triple therapy,bismuth quadruple,PPI+MSAH and standard triple therapy combined with MSAH.The efficacy of HP eradication and symptoms improvement among the four different groups were compared after treatment.Results The eradication rate of group B and group D were higher than those of group A and group C (P<0.05),and there was no significant difference between group B and group D (P>0.05).The improvement rates of symptoms in group Cand group D werehigher than those of group A and group B (P<0.05).No severe adverse reaction occurred in the four groups.Conclusion MSAH combined with standard triple therapy has similareradication efficacy with bismuth quadruple therapy with high rate of symptoms improvement,it is an ideal regimen for eradication of Hp.MSAH combined with pantoprazole also has eradication effect,itcan provide a new treatment option for patients allergic to a variety of antibiotics and urgent to eradicate Hp,and delay the issue of antibiotic resistance.