144例低超基准值幽门螺杆菌感染患者临床特点及中医辨证治疗

Clinical characteristics of 144 Helicobacter pylori infected patients with low delta over baseline values and treatment of TCM syndrome differentiation

  • 摘要:
      目的  探讨低载量幽门螺杆菌(Hp)感染人群的临床特点,并观察中医药治疗效果。
      方法  收集144例13C-尿素呼气试验阳性超基准值(DOB)>4.0~ < 16.0患者的临床资料,将患者分为四联组(质子泵抑制剂、铋剂联合2种抗生素)和中药组(中草药或中成药),每组72例。四联组疗程为2周,中药组为4周,停药后复查。观察低DOB值Hp感染人群中医辨证特点、中药治疗规律,比较2组患者临床疗效及不良反应发生情况。
      结果  低载量Hp感染患者以脾胃湿热证为主,使用频率前3位的中成药:荆花胃康胶丸、摩罗丹、胃复春;使用频率前3位的中草药:蒲公英、黄连、黄芩。治疗后,中药组临床症状改善及不良反应发生情况优于四联组,差异有统计学意义(P < 0.05);中药组与四联组Hp根除率比较,差异无统计学意义(P>0.05)。
      结论  低载量Hp感染患者以脾胃湿热证为主,辨证论治中药治疗Hp感染有较好的疗效,在改善临床症状、减少不良反应方面具有显著优势。

     

    Abstract:
      Objective  To investigate the clinical characteristics of Helicobacter pylori (Hp) infected patients with low delta over baseline (DOB) values and observe the efficacy of TCM therapy.
      Methods  Clinical data of 144 cases who was diagnosed with positive results by 13C-urea breath testdelta over baseline (DOB) value ranging from>4.0 to < 16.0 were collected. The above patients were divided into quadruple therapy group (72 cases, proton pump inhibitor, bismuth and two antibiotics) and TCM group (72 cases, Chinese herbal medicine or Chinese patent medicine). The treatment duration was 2 weeks for quadruple therapy group, and 4 weeks for TCM group, and all cases were reexamined. TCM syndrome differentiation characteristics of Hp infected patients with low DOB values and the law of TCM therapy were observed; the clinical effects and adverse reactions were compared between the two groups.
      Results  TCM syndromes of Hp infected patients with low DOB values were mainly syndrome of dampness and heat of spleen and stomach; as for the usage frequency of Chinese patent medicine, the top three were JingHua Weikang Capsule, MoLuo Dan, Weifu Chun; as for the usage frequency of Chinese herb medicine, the top three were Pugongying, Huanglian, and Huangqin. The TCM group had better results for clinical symptoms improvement and incidence of adverse reactions than that of the quadruple therapy group (P < 0.05). There was no statistical difference in eradication rate between the quadruple therapy group and the TCM group (P>0.05).
      Conclusion  Hp infected patients with low DOB values are featured with syndrome of dampness and heat in the spleen and stomach. The therapy of TCM syndrome differentiation has better curative effects on Hp infected patients, and has significant advantages in improving clinical symptoms and reducing adverse reactions.

     

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