發(fā)布時間：2018-07-11 13:33

  本文選題：胃炎顆粒 + HP耐藥　； 參考：《西南醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:觀察應(yīng)用我院已故名老中醫(yī)周德端教授在1996年創(chuàng)研出的幽胃康沖劑(即現(xiàn)在的柴芍胃炎顆粒)結(jié)合抗HP療法治療耐幽門螺桿菌(Helicobacter pylori,Hp)患者,觀察患者胃黏膜腸化及逆轉(zhuǎn)點(diǎn)情況,并同步觀察胃炎顆粒聯(lián)合抗Hp治療是否助于提高HP根除率及降低其耐藥率。方法:對Hp感染患者進(jìn)行胃鏡及鏡下活檢(及病理)檢查選擇伴腸化病人60例。隨機(jī)分組,A組(胃炎顆粒組)給予胃炎顆粒,服藥方法:柴芍胃炎顆粒每天早、中、晚各一次,每次一包,療程14天;B組(胃炎顆粒聯(lián)合三聯(lián)療法組)給予胃炎顆粒及標(biāo)準(zhǔn)三聯(lián)療法,服藥方法:柴芍胃炎顆粒每天早、中、晚各一次,每次一包,雷貝拉唑腸溶片20mg,阿莫西林1.0 g,克拉霉素0.5 g,每天兩次,飯后服用,療程14天;C組(三聯(lián)療法組)給予標(biāo)準(zhǔn)三聯(lián)療法,服藥方法同B組三聯(lián)療法,療程14天。在0.5年、1年、1.5年復(fù)查胃鏡、HP、在相同部位胃黏膜組織病檢,HP感染者則檢測其耐藥率。根據(jù)檢測結(jié)果進(jìn)行數(shù)據(jù)統(tǒng)計與分析。結(jié)果:(1)H.pylori根除率比較,B組(85%)A組(55%)C組(45.0%),有統(tǒng)計學(xué)差異(p0.05)。(2)效果觀察方面,在色素胃鏡下,B組(胃炎顆粒聯(lián)合三聯(lián)療法組)給予胃炎顆粒及標(biāo)準(zhǔn)三聯(lián)療法組總有效率為90.0%,C組總有效率50%,B組總有效率為50%,B組總有效率明顯高于前兩者(p0.05);(3)病檢療效觀察方面,B組(胃炎顆粒聯(lián)合三聯(lián)療法組)總有效率為85%,C組(三聯(lián)療法組)總有效率45%,A(胃炎顆粒組)組總有效率為55%,中西結(jié)合治療組總有效率明顯高于前兩者(p0.05);(4)在病理組織學(xué)方面,三組患者胃粘膜炎癥、腸上皮化生水平治療后均有所改善,統(tǒng)計學(xué)差異(P0.05)。結(jié)論:三組在防治幽門螺桿菌方面都有一定效果,胃炎顆粒及標(biāo)準(zhǔn)三聯(lián)療法組療明顯優(yōu)于西藥組和中藥組,能有效地提高H.pylori根除率,逐漸的提高機(jī)體免疫狀態(tài),調(diào)節(jié)自身平衡,改善患者的生存質(zhì)量,并能減輕胃黏膜的炎癥反應(yīng),修復(fù)胃粘膜,在一定程度上能逆轉(zhuǎn)腸化生,可能預(yù)防及減緩慢性萎縮性胃炎向癌癥的進(jìn)一步改變。
[Abstract]:Objective: to observe the treatment of Helicobacter pylori (Helicobacter pylori) resistance in patients with Helicobacter pylori (Helicobacter pylori) resistance by using Youweikang granule (now Chaishao gastritis granule) and anti-HP therapy, which was founded in 1996 by the late Professor Zhou Deduan, a famous old Chinese medicine, in our hospital. The intestinal metaplasia and reversal point of gastric mucosa were observed, and whether the combination of gastritis granule and anti-HP could increase the eradication rate of HP and reduce the drug resistance rate. Methods: gastroscopy and biopsy (and pathology) were performed in 60 patients with HP infection. Group A (gastritis granule group) was randomly divided into two groups: group A (gastritis granule group) was given gastritis granule, taking medicine method: Chaishao gastritis granule every morning, middle, late, once every time, one pack each time, For 14 days, group B (gastritis granule combined with triple therapy group) was given gastritis granule and standard triple therapy. Rabeprazole enteric-coated tablets 20 mg, amoxicillin 1.0 g, clarithromycin 0.5 g, twice a day after meals, group C (triple therapy group) was given standard triple therapy for 14 days. In 0.5 years, 1 year and 1.5 years, the rate of drug resistance was detected in HP infected patients with gastric mucosal disease at the same site. According to the results of the test data statistics and analysis. Results: (1) the eradication rate of H.pylori in group B (85%), group A (55%) and group C (45.0%) was significantly different (p0.05). (2). The total effective rate of group B (gastritis granule combined with triple therapy group) and standard triple therapy group was 90.0%. The total effective rate of group B was 50%. The total effective rate of group B was significantly higher than that of group B (p0.05); (3). The total effective rate of group B was significantly higher than that of group B (p0.05); (3). Effect observation: the total effective rate of group B (gastritis granule combined with triple therapy group) is 85%, the total effective rate of group C (triple therapy group) is 45%, the total effective rate of group A (group of gastritis granules) is 55, the total effective rate of group B is significantly higher than that of group B (combined with traditional Chinese medicine and western medicine), and the total effective rate of group B is significantly higher than that of group C (group C). (p0. 05); (4) in histopathology, Three groups of patients with gastric mucosal inflammation, intestinal metaplasia level were improved after treatment, statistical difference (P0.05). Conclusion: all the three groups have certain effects in prevention and treatment of Helicobacter pylori. The treatment of gastritis granules and standard triple therapy group is better than that of western medicine group and traditional Chinese medicine group, which can effectively increase the eradication rate of H.pylori, gradually improve the immune state of the body, and regulate self balance. Improving the patients' quality of life, reducing the inflammation of gastric mucosa, repairing gastric mucosa, reversing intestinal metaplasia to a certain extent, may prevent and slow down the further change from chronic atrophic gastritis to cancer.
【學(xué)位授予單位】：西南醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 趙軍艷;趙蕊;趙瑞紅;;化濕和胃法治療萎縮性胃炎伴腸化及不典型增生療效觀察[J];中國社區(qū)醫(yī)師;2016年25期

2 劉晏;劉元霞;李瓊;樂琦琦;徐瑛;;安中復(fù)元方治療慢性萎縮性胃炎合并腸化的臨床觀察[J];中成藥;2015年12期

3 王革麗;李巖;;標(biāo)準(zhǔn)三聯(lián)加大黃、黃連及黃芩根除幽門螺桿菌療效的比較[J];中國中西醫(yī)結(jié)合消化雜志;2015年12期

4 王保亮;陳洪國;;中藥治療幽門螺桿菌相關(guān)性感染[J];中醫(yī)臨床研究;2015年16期

5 孔振;;化濁解毒方治療慢性萎縮性胃炎癌前病變的臨床研究[J];中醫(yī)臨床研究;2015年07期

6 鄭逢民;鄭樂樂;鄭中堅;;消痞愈萎湯聯(lián)合胃復(fù)春片治療慢性萎縮性胃炎伴胃黏膜腸上皮化生或異型增生64例臨床觀察[J];中醫(yī)雜志;2015年04期

7 宗湘裕;王萬卷;劉寶珍;杜長海;趙景成;;慢性萎縮性胃炎中醫(yī)證型與幽門螺桿菌感染、病理分級的相關(guān)性研究[J];現(xiàn)代中西醫(yī)結(jié)合雜志;2015年04期

8 陸登輝;徐大志;李潔;;益胃化瘀解毒法治療萎縮性胃炎伴腸化不典型增生臨床觀察[J];浙江中醫(yī)雜志;2015年01期

9 劉呈艷;阮時寶;;黃榮宗教授自擬胃炎方加味治療慢性萎縮性胃炎伴腸化和(或)不典型增生30例[J];福建中醫(yī)藥;2013年04期

10 弓淑珍;侯麗穎;;劉友章治療胃癌前病變經(jīng)驗[J];河北中醫(yī);2009年11期

相關(guān)會議論文 前1條

1 李佃貴;孟憲鑫;王彥剛;蘇春芝;;化濁解毒治療慢性萎縮性胃炎的常用治療法則[A];中華中醫(yī)藥學(xué)會脾胃病分會第二十三次全國脾胃病學(xué)術(shù)交流會論文匯編[C];2011年

相關(guān)碩士學(xué)位論文 前1條

1 陳占鳳;慢性萎縮性胃炎中醫(yī)證型與幽門螺桿菌感染及相關(guān)性研究[D];黑龍江中醫(yī)藥大學(xué);2012年

，

本文編號：2115368