本文選題：消化道潰瘍 + HP感染�。� 參考：《中華中醫(yī)藥學(xué)刊》2017年06期

【摘要】：目的:觀察半夏瀉心湯加味治療HP陽(yáng)性型消化道潰瘍的臨床療效及對(duì)炎性因子、胃泌素的影響。方法:將醫(yī)院2014年3月—2016年6月收治的100例符合入組標(biāo)準(zhǔn)的HP陽(yáng)性型消化道潰瘍患者隨機(jī)分為對(duì)照組和觀察組,每組各50例,對(duì)照組給予四聯(lián)療法治療,即給予奧美拉唑、克拉霉素、阿莫西林、膠體果膠鉍聯(lián)合治療,觀察組在對(duì)照組的基礎(chǔ)再口服半夏瀉心湯加味,1天1劑,兩組均治療2周,治療前后觀察上腹部疼痛、噯氣、反酸、胃部灼熱、上腹飽脹、惡心嘔吐變化情況,采用單切面超聲方法進(jìn)行胃運(yùn)動(dòng)功能檢查,觀察胃排空時(shí)間(T)、胃竇收縮頻率(F)、胃竇收縮幅度(△A/A),采用14C-UBT方法進(jìn)行幽門(mén)螺旋桿菌檢測(cè),算出根除率,空腹抽血5 mL,采用放射免疫法檢測(cè)白介素-6(IL-6)、胃泌素(GAS),比較兩組臨床療效。結(jié)果:觀察組和對(duì)照組的HP根除率為90%和54%,差異具有統(tǒng)計(jì)學(xué)意義(χ~2=16.071,P0.05),觀察組臨床總有效率為94%和76%,差異具有統(tǒng)計(jì)學(xué)意義(Z=-3.178,P0.01)。觀察組和對(duì)照組治療后上腹部疼痛、噯氣、反酸、胃部灼熱、上腹飽脹、惡心嘔吐評(píng)分均較治療前明顯下降(P0.05),觀察組治療后上腹部疼痛、噯氣、反酸、胃部灼熱、上腹飽脹、惡心嘔吐評(píng)分明顯低于對(duì)照組(P0.05)。觀察組和對(duì)照組治療后IL-6、GAS較治療前明顯下降(P0.05),觀察組治療后IL-6、GAS明顯低于對(duì)照組(P0.05)。觀察組和對(duì)照組治療后T明顯縮短,F明顯降低,△A/A明顯升高,觀察組治療后T明顯短于對(duì)照組,F明顯低于對(duì)照,△A/A明顯高于對(duì)照組,均P0.05。結(jié)論:半夏瀉心湯加味能夠提高四聯(lián)療法治療HP陽(yáng)性型消化道潰瘍的臨床療效,能有效緩解臨床癥狀、提高HP根除率,作用機(jī)制與其改善胃排空功能、抑制局部炎癥損傷及調(diào)節(jié)血胃泌素有關(guān)。
[Abstract]:Objective: to observe the clinical effect of Banxia Xiexin decoction on HP positive peptic ulcer and its effect on inflammatory factors and gastrin. Methods: from March 2014 to June 2016, 100 patients with HP positive peptic ulcer were randomly divided into two groups: control group (n = 50) and observation group (n = 50). Clarithromycin, amoxicillin and colloidal bismuth pectin were combined to treat the patients in the observation group. In the control group, the treatment group was treated with Banxia Xiexin decoction once a day. The pain in the upper abdomen, belching, acid regurgitation, and heartburn in the stomach were observed before and after treatment. The changes of upper abdominal fullness, nausea and vomiting were examined by single section ultrasound. Gastric emptying time, antral contraction frequency, antral contraction amplitude (A / A) were observed. Helicobacter pylori was detected by 14C-UBT method. The eradication rate was calculated and the fasting blood was drawn for 5 mL. The radioimmunoassay was used to detect IL-6 and gastrin GASA. The clinical efficacy of the two groups was compared. Results: the eradication rate of HP was 90% in the observation group and 54% in the control group. The difference was statistically significant (蠂 ~ (2 +) 16.071) (P 0.05). The total clinical effective rate of the observation group was 94% and 76% (P 0.01). The difference was statistically significant. The scores of epigastric pain, belching, acid regurgitation, heartburn, upper abdominal fullness, nausea and vomiting in the observation group and the control group were significantly lower than those before treatment (P 0.05), and the pain in the upper abdomen, belching, acid regurgitation, heartburn in the stomach and fullness of the upper abdomen were observed after treatment in the observation group. The score of nausea and vomiting was significantly lower than that of the control group (P 0.05). After treatment, the levels of IL-6 buccal gas in the observation group and control group were significantly lower than those in the control group (P 0.05), and that in the observation group was significantly lower than that in the control group (P 0.05). After treatment, T of observation group and control group were significantly decreased and A / A was increased. After treatment, T of observation group was significantly shorter than that of control group, and A / A was significantly higher than that of control group (P 0.05). Conclusion: Banxia Xiexin decoction can improve the clinical effect of combined therapy on HP positive peptic ulcer, relieve clinical symptoms, increase HP eradication rate, and improve gastric emptying function. Inhibition of local inflammatory injury and regulation of blood gastrin.
【作者單位】： 奉化市中醫(yī)醫(yī)院脾胃病科;奉化市人民醫(yī)院消化內(nèi)科;
【分類(lèi)號(hào)】：R573.1

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