本文關(guān)鍵詞： 幽門螺桿菌 中西醫(yī)結(jié)合治療 四聯(lián)療法 根除率 慢性胃炎　出處：《南京中醫(yī)藥大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：比較辨證用藥聯(lián)合“四聯(lián)療法”與“四聯(lián)療法”對(duì)幽門螺桿菌(Hp)根除率的差別；觀察辨證用藥聯(lián)合“四聯(lián)療法”與“四聯(lián)療法”在根治Hp過程中對(duì)慢性胃炎癥狀改善程度的影響。 方法：采用隨機(jī)對(duì)照方法,將60例經(jīng)檢查確診為Hp感染的慢性胃炎患者,分成兩組。對(duì)照組30例,予“標(biāo)準(zhǔn)四聯(lián)療法”方案(奧美拉唑20mg、阿莫西林1.0g、克拉霉素0.5g、枸櫞酸鉍鉀220mg,bid),試驗(yàn)組30例,予“標(biāo)準(zhǔn)四聯(lián)療法”的同時(shí)服用辨證用藥,兩組療程均為10天。治療結(jié)束4周后行13C尿或14C尿素酶呼氣試驗(yàn)檢查,統(tǒng)計(jì)分析兩組Hp根除率情況,臨床癥狀改善情況,并評(píng)價(jià)其安全性。 結(jié)果：慢性胃炎伴Hp感染的中醫(yī)證型總體分布規(guī)律為：脾胃濕熱(37.9%)肝胃不和(31.0%)脾胃虛弱(20.7%)胃陰不足(10.3%)。根除率,對(duì)照組為72.4%,試驗(yàn)組為93.3%,試驗(yàn)組與對(duì)照組相比較,差異具有統(tǒng)計(jì)學(xué)意義(P0.05),除此之外,辨證用藥聯(lián)合四聯(lián)療法對(duì)于患者胃脘痞滿不適、胃脘疼痛、噯氣、食欲減退等臨床癥狀的緩解率有顯著提高作用,但差異無統(tǒng)計(jì)學(xué)意義(P0.05)。兩組的總體有效率,對(duì)照組為62.1%,試驗(yàn)組為93.3%,試驗(yàn)組癥狀總體有效率顯著高于對(duì)照組,但是差異無統(tǒng)計(jì)學(xué)意義(P0.05)。對(duì)照組有1例因服藥期間出現(xiàn)皮疹而終止試驗(yàn)。試驗(yàn)組未發(fā)生不良事件,兩組不良事件發(fā)生率相比較差異無統(tǒng)計(jì)學(xué)意義(P0.05),具有可比性。 結(jié)論：辨證用藥聯(lián)合“四聯(lián)療法”與“四聯(lián)療法”治療慢性胃炎伴Hp感染,兩者Hp根除率差異有統(tǒng)計(jì)學(xué)意義(P0.05)；辨證用藥可以顯著提高Hp相關(guān)性慢性胃炎患者胃脘痞滿不適、胃脘疼痛、噯氣、食欲不振等臨床癥狀緩解率。
[Abstract]:Objective: to compare the eradication rate of Helicobacter pylori (HP) with the combination of syndrome differentiation and quadruple therapy. To observe the effect of syndrome differentiation combined with "quadruple therapy" and "quadruple therapy" on the improvement of chronic gastritis in the course of radical cure of HP. Methods: sixty patients with chronic gastritis diagnosed as HP infection were divided into two groups by random control, the control group (30 cases), the control group (30 cases), the control group (30 cases) and the control group (30 cases). "Standard quadruple therapy" regimen (omeprazole 20 mg, amoxicillin 1.0 g, clarithromycin 0.5 g, bismuth potassium citrate 220 mg bid) was given to 30 patients in the experimental group. After 4 weeks of treatment, 13C urine or 14C urease breath test was performed. The HP eradication rate, clinical symptom improvement and safety of the two groups were statistically analyzed. Results: the general distribution of TCM syndrome types of chronic gastritis with HP infection was as follows: spleen and stomach dampness and heat 37.9) liver and stomach disharmony 31.0) spleen and stomach deficiency 20.7) stomach deficiency and stomach deficiency. Eradication rate was 72.4 in the control group and 93.3in the experimental group. The comparison between the experimental group and the control group was compared with that in the control group. The difference was statistically significant (P 0.05). In addition, syndrome differentiation combined with quadruple therapy could significantly improve the remission rate of clinical symptoms such as epigastric fullness, epigastric pain, belching, anorexia, etc. But the difference was not statistically significant (P 0.05). The total effective rate of the two groups was 62.1 in the control group and 93.3 in the experimental group. The overall effective rate of symptoms in the experimental group was significantly higher than that in the control group. But there was no significant difference between the two groups (P 0.05). In the control group, there was no adverse event in one case due to rash during medication, and there was no significant difference in the incidence of adverse events between the two groups, which was comparable. Conclusion: treatment of chronic gastritis with HP infection by syndrome differentiation combined with "quadruple therapy" and "tetralogy therapy" has significant difference in HP eradication rate (P 0.05), differentiation of symptoms and signs can significantly increase epigastric fullness and discomfort in patients with HP associated chronic gastritis. Abatement rate of clinical symptoms such as epigastric pain, belching, loss of appetite and so on.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R573.3

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