摘要
背景世界上50%以上的人口感染幽门螺杆菌(Helicobacter pylori,H.pylori).临床主要通过四联疗法治疗H.pylori相关性胃炎,近年来,中西医联合疗法不断发展,使用自拟脾胃调和汤治疗幽门螺杆菌相关性胃炎能够在一定程度上提高治疗效果,值得临床进一步研究.目的探讨自拟脾胃调和汤辅助四联疗法治疗H.pylori相关性胃炎的疗效及对免疫-炎症、肠道菌群调控效应.方法采用随机信封法将2018-07/2020-05月我院收治的108例H.pylori相关性胃炎患者分为两组,各54例.对照组采用四联疗法,观察组采用自拟脾胃调和汤辅助四联疗法.比较两组总有效率、中医证候积分、免疫功能指标(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))、炎症指标转化生长因子-β1(TGF-β1)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、白介素-32(IL-32)、C反应蛋白(CRP)、肠道菌群、不良反应.结果观察组总有效率为96.30%,高于对照组的81.48%(P<0.05);治疗2 wk后观察组胃脘疼痛持续时间、胃脘疼痛程度、脘腹痞胀、口苦或黏、口臭、恶心呕吐、大便黏滞评分低于对照组(P<0.05);治疗2 wk后观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)高于对照组(P<0.05);治疗2 wk后观察组TGF-β1、TNF-α、IL-6、IL-32、CRP低于对照组(P<0.05);观察组治疗2 wk后双歧杆菌、乳杆菌、肠球菌、肠杆菌与治疗前比较,差异无统计学意义(P>0.05);观察组不良反应总发生率3.70%与对照组9.26%比较,差异无统计学意义(P>0.05).结论自拟脾胃调和汤辅助四联疗法治疗H.pylori相关性胃炎效果显著,能有效缓解临床症状,调节机体免疫、炎症反应,且具有良好肠道菌群调控效应,安全可靠,值得临床推广应用.
BACKGROUND More than 50%of the world’s population are infected with Helicobacter pylori(H.pylori).Clinically,H.pylori-associated gastritis is mainly treated with quadruple therapy.In recent years,combined Chinese and Western medicine therapy has been continuously developed.The use of self-made Spleen-Stomach Healing Decoction in the treatment of H.pylori-associated gastritis can improve the therapeutic effect to a certain extent,which is worthy of further clinical research.AIM To investigate the efficacy of self-made Spleen-Stomach Tiaohe Decoction-assisted quadruple therapy in the treatment of H.pylori-related gastritis and its regulatory effects on immune-inflammation and the intestinal flora.METHODS From July 2018 to May 2020,108 patients with H.pylori-related gastritis treated at our hospital were divided into either a control group or an observation group using a random envelope method,with 54 cases in each group.The control group was treated with quadruple therapy,and the observation group was treated with self-made Spleen-Stomach Tiaohe Decoction-assisted quadruple therapy.The total effective rate,TCM syndrome score,immune function indexes(CD3^(+)T cells,CD4^(+)T cells,and CD4^(+)/CD8^(+)ratio),and inflammation indexes[transforming growth factor-β1(TGF-β1),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-32(IL-32),and C-reactive protein(CRP)],intestinal flora,and adverse reactions were compared between the two groups.RESULTS The total effective rate of the observation group was 96.30%,which was signfciantly higher than that(81.48%)of the control group(P<0.05).After 2 wk of treatment,the scores of epigastric pain,abdominal distension,bitter or sticky mouth,bad breath,nausea and vomiting,and stool viscosity in the observation group were significantly lower than those of the control group(P<0.05);the percentages of CD3^(+)T cells and CD4^(+)T cells as well as CD4^(+)/CD8^(+)ratio in the observation group were significantly higher than those of the control group(P<0.05);and serum levels of TGF-β1,TNF-α,IL-6,IL-32,and CRP in the observation group were significantly lower than those of the control group(P<0.05).Bifidobacterium,Lactobacillus,Enterococcus,and Enterobacter in the observation group after 2 wk of treatment were not significantly different from those before treatment(P>0.05).There was no significant difference in the total incidence of adverse reactions between the observation group(3.70%)and the control group(9.26%;P>0.05).CONCLUSION Self-made Spleen-Stomach Tiaohe Decoction-assisted quadruple therapy is effective in treating H.pylori-related gastritis.It can effectively relieve clinical symptoms,regulate immune and inflammatory responses,and has a good regulatory effect on the intestinal flora regulation.It is safe and reliable,and is worthy of clinical application.
作者
王瑞华
王申
Rui-Hua Wang;Shen Wang(Department of Gastroenterology,Ningbo Town Longsai Hospital,Ningbo 315200,Zhejiang Province,China)
出处
《世界华人消化杂志》
CAS
2021年第14期796-803,共8页
World Chinese Journal of Digestology
关键词
幽门螺杆菌相关性胃炎
四联疗法
自拟脾胃调和汤
中医证候积分
炎症指标
肠道菌群
免疫功能指标
Helicobacter pylori-related gastritis
Quadruple therapy
Self-made Spleen-Stomach Tiaohe Decoction
TCM syndrome score
Inflammation index
Intestinal flora
Immune function index
作者简介
通讯作者:王瑞华,研究生,主治医师,研究方向:胃炎,胃溃疡,胰腺炎等消化内科常见病,315200,浙江省宁波市镇海区招宝山街道胜利路356号,宁波市镇海龙赛医院消化内科.chui14967696@163.com。
