摘要
目的:1.观察益气消溃汤治疗脾虚挟热型Hp相关性消化性溃疡的临床疗效。2.探讨益气消溃汤治疗消化性溃疡,抗Hp感染的作用。
方法:选择脾虚挟热型Hp相关性消化性溃疡60例,随机分为中药组、西药组、中西结合组,中药组给予益气消溃汤,西药组给予雷尼替丁、阿莫西林、甲硝唑西药三联疗法,中西结合组给予中西结合治疗,疗程为2周,停药1月后观察比较治疗前后各观察指标的变化。
结果:1.胃镜疗效及中医证候疗效比较,中西结合组优于单纯中药组和西药组,差异有统计学意义(P＜0.05),中药组与西药组比较,差异无统计学意义(P＞0.05);2.中西结合组在改善临床症状方面更具优势,可明显改善胃脘疼痛、神疲懒言、肢体倦怠、食后腹胀、口干口苦、吞酸等临床症候。与西药组比较,差异有统计学意义(P＜0.05),但与中药组比较,差异无统计学意义(P＞0.05);3.三组Hp根除率比较,中西结合组稍优于中药组和西药组,但三组比较,差异无统计学意义(P＞0.05)。4.临床应用益气消溃汤过程中,未发现不良反应。
结论:益气消溃汤结合雷尼替丁三联疗法治疗脾虚挟热型Hp相关性消化性溃疡疗效确切,可明显改善临床证候。益气消溃汤临床应用中未发现副作用,有其临床实用价值。
Objctive:To observe the clinical effect of YiQiXiaoKui Decpction(YQXKD) in treating Hilicobacter Pylori-related Peptic Ulcer of Splenic Asthenia and Heat-inclusion(HPPUSAH) and counteracting Hilicobacter Pylori(Hp).
Method:60 patients with YQXKD HPPUSAH were divided randomly into three groups:traditional Chinese drug treated group(20 cases),western medicine control group(20 cases) and the medium doctor combines cured group(20 cases).Traditional Chinese drug group was treated with YQXKD, while trilogy treatment of Ranitidine,Amoxicillin and Metronidazole was given western medicine control group,and two method was given The medium doctor combines cured group.The course of treatment is one month. The changes of patents' clinical syndromes and indices were observed and compared before and after treatment.
Result:Compared effect of gastro-scope and syndrome of traditional Chinese medicine,the medium doctor combines cured group is best.There were statistics differences between the two groups of the medium doctor combines cured and traditional Chinese drug treated(P＜0.05).But there were no statistics differences between the two groups of traditional Chinese drug treated group and western medicine cured group(P＞0.05).The medium doctor combines group was best in improving the clinical syndromes.It can effective against the patents' clinical syndromes,such as stomach pain,mind tiredness,limbs languor,abdominal distention after meal,dry mouth,bitter taste of mouth,swallow sour etc.Compared with western medicine control group,there were significantly superior to those in western medicine group (P＜0.05).But there were no statistics differences between the two groups of traditional Chinese drug treated group and western medicine cured group (P＞0.05).The medium doctor combines cured group is best in deracinating Hp rate,but there were no statistics differences between any two groups (P＞0.05).There were no adverse in YQXKD clinical application.
Conclusions:The effect of the medium doctor combines is certain in treating YQXKD HPPUSAH.It can effective against the patents' clinical syndromes. It is effective and no side effect in YQXKD clinical application.
引文
[1]中国幽门螺杆菌科研协作组.中国人群幽门螺杆菌感染的流行病学调查.中华医学会消化病学会第四次全国幽门螺杆菌学术会议论文汇编,2005:1-8
[2]陈灏珠.实用内科学。第12版.北京:人民卫生出版社.2005:1866-1877
[3]王吉耀.现代消化科手册.上海:上海科学技术文献出版社.2003:179-193
[4]郑筱萸.中药新药临床研究指导原则(试行).第1版.北京:中国医药出版社.2002:151-155
[5]田德禄.中医内科学.第7版.北京:人民卫生出版社.2002:177-185
[6]陆为民,单兆伟,沈洪.关于幽门螺杆菌感染中医药治疗对策的思考.中国中西医结合脾胃杂志,2000,8(4):232-233
[7]黄绍刚,周福生,黄穗平,等.消化性溃疡发病与复发的中医病机探徽.新中医,2005,37(3):6-7
[8]张万岱,陈治水,危北海,等.消化性溃疡的中西结合诊治方案(草案).中国中西结合消化杂志,2005,13(2):136-138
[9]王添生,伍运生.消化性溃疡的中医药治疗.中国中医药杂志,2004,2(3):152-153
[10]韦艳碧,覃冬林,陈树光.辨证治疗幽门螺杆菌阳性消化性溃疡76例观察.浙江中医杂志,2002,37(1):8-9
[11]丁远富.辩证论治消化性溃疡.中华实用中西结合杂志,2004,17(9):1316
[12]刘兴山,刘秀华,刘玉坤.根幽愈疡汤治疗幽门螺杆菌相关性消化性溃疡96例临床观察.山东中医杂志,2004,23(1):16-18
[13]邵可立.清热化湿法治疗Hp相关性消化性溃疡40例.浙江中医学院学报,2001,25(2):24
[14]吕善东.自拟抗溃疡散治疗消化性溃疡疗效观察.广西中医药,2003,26(5):10-12
[15]罗龚.愈疡汤治疗幽门螺杆菌相关性消化性溃疡56例总结.湖南中医杂志,2006,22(1):5-6
[16]张宝凤,韩玉山,杨健.荆花胃康胶丸治疗消化性溃疡的临床观察.天津中医 药,2004,21(3):201
[17]窦艳,王向东,梁浩,等.荆花胃康胶丸治疗幽门螺杆菌相关性消化性溃疡的疗效和安全性.中国新药杂志,2004,13(7):650-652
[18]王洪京,王印光,张建腾,等.灭幽愈疡合剂治疗HP相关性消化性溃疡临床研究.山东中医杂志,2000,19(12):715-716
[19]王克馥,李宪红,陈玉政.克幽胶囊治疗HP相关性消化性溃疡临床研究.浙江中西医结合杂志,2002,12(7):402-403
[20]蒙木荣,何小萍,庞学丰,等.胃疡安胶囊治疗幽门螺杆菌阳性消化性溃疡40例.江苏中医,2000,21(2):14-15
[21]屠德敬,钦丹萍.中西医结合治疗幽门螺杆菌相关消化性溃疡.浙江中西医结合杂志,2005,15(7):405-406
[22]孔令彪.中西药结合治疗幽门螺杆菌阳性消化性溃疡86例临床观察.北京中医,2006,25(4):195-197
[23]金亚晶.中西医结合治疗幽门螺杆菌感染阳性消化性溃疡29例.辽宁中医杂志,2005,3(6):579
[24]曾慧莲.中西医结合治疗幽门螺杆菌相关性消化性溃疡70例疗效观察.现代中西医结合杂志,2004,13(3):286-287
[25]张天哲.张铁民.徐应军.幽门螺杆菌感染的细菌学和流行病学研究进展.国外医学·流行病学传染病学分册,2004,31(2):116-118
[26]萧树东,刘文忠.重视对幽门螺杆菌感染临床结局多样他的研究.中华内科杂志,1999,38:437-438.
[27]张万岱,徐钾民.幽门螺杆菌研究现状及国内共识.中国中西结合脾胃杂志,2000,8:129-134
[28]谢勇,吕农华,徐萍,等.CagA和机体免疫反应在幽门螺杆菌致病中的作用及相互关系.中华微生物学和免疫学杂志,2000,20:309-311
[29]Leunk RD,Johnson PT,David BC,Kraft WG,Morgan DR.Cytotoxic activity in broth-culture filtrates of Campylobacter pylori.J Med Microbiol 1988;26:93-99
[30]Ghiara P,Marchetti M,Blaser MJ,Tummuru MK,Cover TL,Segal ED,Tompkins LS,Rappuoli R.Role of the Helicobacter pylori virulence factors vacuolating cytotoxin,CagA,and urease in a mouse model of disease.Infect Immun 1995;63:4154-416
[31]余菲菲,张静,陈月秀,等.幽门螺杆菌cagA基因稳定转染胃上皮细胞及其对细胞的作用.中国人兽共患病学报,2006,22(1):29-32
[32]Crabtree JE,Rembacken B,Lindley IJD,Moran AP.Preferential induction of interleukin-8 from gastric epithelial cell lines by Helicobacter pylori liopopolysaccharide.Gut 1995;37:A31
[33]Young GO Stemmer N,Lastovica A,van derMerwe EL,Louw JA,Modlin IM,Marks IN.Helicobacter pylori lipopolysaccharide stimulates gastric mucosal pepsinogen secretion.Aliment Pharmacol Ther 1992;6:169-177
[34]Marshall BJ.Helicobacter pylori.Am J Gastroenterol 1994;89:(SSupp1)S116-S128
[35]Xu JK,Goodwin CS,Cooper M,Robinson J.Intracellular vaculization caused by theurease of Helicobacter pylori.J,Infect Dis 1990;161:1302-1304
[36]Windsor HM,O'Rourke J.Bacteriology and taxonomy of Helicobacter pylori.Gastroenterol Olin North Am 2000:29:633-648
[37]叶任高.内科学.第5版:人民卫生出版社.2002,391-410
[38]丁保国,樊冬梅,刘红建.胃粘膜幽门螺杆菌感染与慢性胃炎的关系.中国慢性病预防与控制,2005,13(1):26-27
[39]张万岱,姚永莉.幽门螺杆菌感染相关性疾病的中西结合诊治进展.中华医学会消化病学会第四次全国幽门螺杆菌学术会议论文汇编,2005:156-160
[40]丁爱仙,陈红军.奥美拉唑三联用药治疗幽门螺杆菌阳性消化性溃疡的疗效观察.中国乡村医药杂志,2005,12(6):17-18
[41]宗立永.寇会玲.郭金霞.奥美拉唑治疗消化性溃疡90例临床疗效观察.中华腹部疾病杂志,2004,4(4):253-254
[42]杨洪兵,陈若飞,戴海英,等.潘托拉唑、阿莫西林、呋喃唑酮短程三联疗法根治幽门螺杆菌.中华实用中西医杂志,2006,19(20):2446-2447
[43]朱风尚,陈锡关,张东伟,等.埃索美拉唑为基础的三联疗法治疗Hp阳性十二指肠溃疡临床研究.同济大学学报(医学版),2006,27(4):50-52
[44]朱莹,郑朝辉.益气消溃汤治疗消化性溃疡的临床观察.湖南中医学院学报,1997,17(1):13-14
[45]雷载权.中药学.第6版.上海:上海科学技术出版社,1995
[46]郑虎占,董泽宏,佘靖.中药现代研究与应用.第1版.北京:学苑出版社,1997:1-6卷
[47]黄可儿,李燕舞,王汝俊,等.黄芪总苷对脾虚大鼠壁细胞胃泌素受体作用的研究.广州中医药大学学报,2006,23(1):42-44
[48]张子理,陈蔚文.黄芪和白术对胃粘膜损伤药理作用的初步研究.中华实用中西医杂志,2006,19(4):470-471
[49]李备,周岐新.黄连抗消化性溃疡的药理学研究进展.中国药房,2005,16(14):1107-1109
[50]吴艳玲,朴惠善.蒲公英的药理研究进展.时珍国医国药,2004,15(8):519-520
[51]栾好波.白芍的现代药理研究与临床应用.中国临床医药研究杂志,2005,135:14653-14654
[52]于辉,李春香,宫凌涛,等.甘草的药理作用概述.现代生物医学进展,2006,6(4):77-79
[53]陈海娇.北药甘草的药理学研究进展.吉林农业科技学院学报,2006,15(2):15-18
[1]Warren JR,Marshall BJ.Unidentified Curved bacilli on gastric epithelium in active chronic gastritis[J]:Lancet,1983,11(3):1273
[2]中国幽门螺杆菌科研协作组.中国人群幽门螺杆菌感染的流行病学调查.中华医学会消化病学会第四次全国幽门螺杆菌学术会议论文汇编,2005:1-8
[3]杨国红.杨国红教授治疗幽门螺杆菌相关性胃炎经验.河南中医,2005,25(1):25-26
[4]陆为民,单兆伟,沈洪.关于幽门螺杆菌感染中医药治疗对策的思考.中国中西医结合脾胃杂志,2000,8(4):232-233
[5]吕冠华.幽门螺杆菌感染与脾胃湿热的关系探析.辽宁中医杂志,2004,34(1):16-17
[6]张闽光,朱国曙.糜烂性胃炎中医分型与幽门螺杆菌感染的相关研究.现代中西医结合杂志,2002,11(1):7-8
[7]陈国忠,罗伟生,李桂贤.十二指肠溃疡辨证分型与溃疡分期、幽门螺杆菌感染的关系探讨.广西中医学院学报,2004,7(2):14-17
[8]王昊,孙星亮.HP相关性疾病辨证分型及治疗.辽宁中医杂志,2003,30(3): 194
[9]郑惠虹.中医治疗幽门螺杆菌感染50例初步观察.浙江中西医结合杂志,2002,12(11):674-675
[10]蔡子鸿,洪清娴,洪振鑫.慢性胃病辨证分型与Hp感染相关性研究.实用中医药杂志,2002,18(3):6-7
[11]陈壮林,徐辉甫.穿心莲片辅助治疗儿童幽门螺杆菌相关性胃炎45例.中国中西结合杂志,2001,21(7):549
[12]张世林,贺小燕.金银花治疗幽门螺杆菌相关性消化性溃疡的临床对照研究.中国中西结合杂志,2000,20(4):284-285
[13]陈莉莉.蒲公英配合德诺治疗幽门螺杆菌阳性慢性浅表性胃炎44例.中国中西医结合杂志,2002,22(3):229-230
[14]王云阁,尹俊凤,王福猛,等.黄连素联合甲硝唑治疗幽门螺杆菌相关性胃炎186例.滨州医学院学报,2001,24(4):369
[15]陈磐华.中药治疗幽门螺杆菌感染的观察.中国中医药信息杂志,2000,7(2):65
[16]唐海宁.中医分阶段治疗慢性胃炎HP阳性的临床观察.上海中医药杂志,2000,34(7):26-27
[17]姜国平,盛建文,方艳滨,等.安中饮治疗幽门螺杆菌相关性胃炎30例.世界华人消化杂志,2004,12(12):2919-2920
[18]毛水泉,钱冬生,胡再永,等.清解抗萎汤治疗慢性萎缩性胃炎并幽门螺杆菌感染32例临床观察.中国中医药科技,2004,11(6):373-374
[19]王德润.清幽汤治疗幽门螺杆菌相关性胃溃疡53例.中医研究,2004,17(2):38-39
[20]王印光,姚德才,王洪京,等.灭幽愈疡合剂治疗幽门螺杆菌相关性消化性溃疡实验研究.山东中医杂志,2001,20(9):545-546
[21]于文涛,余延芬,徐华洲,等.胃康胶囊治疗幽门螺杆菌相关性胃炎的实验研究.河北中医,2001,23(4):309-312
[22]马志红,牛丽颖,崔利剑,等.胃舒胶囊治疗幽门螺杆菌相关性胃炎的实验研究.中药药理与临床,2005,21(3):41-43