摘要
目的探讨健脾活血方对幽门螺杆菌(Hp)根除后萎缩性胃炎患者的临床疗效及血清胃蛋白酶原(PG)的影响。方法经14C呼气试验确诊为Hp感染的患者为观察对象,经四联抗Hp治疗,选择Hp根除成功、胃镜病理仍报萎缩性胃炎的300例患者,采用前瞻性、双盲、随机对照研究分为观察组和对照组,每组各150例。对照组给予胃复春片治疗,观察组给予中药健脾活血方治疗,两组均连续治疗6个月后观察两组患者的疗效,并复查胃镜、病理及胃蛋白酶指标。通过比较两组治疗方案的疗效及对PG指标、胃黏膜组织病理学积分的影响,分析健脾活血方对Hp根除后萎缩性胃炎患者的临床疗效及血清PG的影响。结果观察组有效率为84%,对照组有效率为60.67%,观察组明显高于对照组(χ^2=20.404,P<0.05)。同时,两组患者PG Ⅰ、PGR水平均较治疗前水平升高(均P<0.05),且观察组的PG Ⅰ、PGR水平均高于对照组(均P<0.05),而治疗前后两组的PGI水平均无明显变化(P>0.05)。此外,经治疗后,两组患者的慢性炎症、异型增生及肠上皮化生病理积分均明显下降(P<0.05),且观察组慢性炎症、异型增生病理积分均明显低于对照组(均P<0.05)。在治疗期间及治疗后3个月内,两组患者均未出现明显不良事件。结论健脾活血方对改善Hp根除后萎缩性胃炎患者的胃黏膜病理状态临床效果较好,且能改善PG指标,值得临床推广。
Objective To explore the effect of Jianpi Huoxue Formula on the clinical fficacy and serum pepsinogen in patients with gastric precancerous lesions after Helicobacter pylori eradication.Methods From October 2016 to October 2017,patients diagnosed as Hp infection by 14 carbon breath test in our hospital were taken as the study objects.After the treatment of quadruple anti Hp therapy,300 patients who were sucessfully eradicated and still reported atrophy by gatroscopy and pathology were selected.According to the random number table method,they were divided into observation group and control group,150 cases in each group.The control group was treated with Weifuchun tablet,the observation group was treated with Jianpi Huoxue Formula,and the two groups were treated for 6 months.And gastroscope,pathology and pepsin were examined.By comparing the therapeutic effect of the two groups,the influence of the two groups on the index of pepsinogen(PG)and the histopathological score of gastric mucosa.To analyze the effect of Jianpi Huoxue Formula on the clinical eficacy and serum PG of patients with gastric precancerous lesions after Helicobacter pylori eradication were analyzed.Results The ffctive rate was 84%in the observation group and 60.67%in the control group,significantly higher than that in the control group(χ^2=20.404,P<0.05).At the same time,the levels of PGI and PGR in the two groups were higher than those before treatment(all P<0.05),and the levels of PG Ⅰ and PGR in the observation group were higher than those in the control group(all P<0.05),but there was no significant change in the levels of PG Ⅱ in the two groups before and after treatment(P>0.05).In addition,after treatment,the scores of chronic inflammation,heteroplasia and intestinal Metaplasia in the two groups were significantly lower(P<0.05),and the scores of chronic inflammation,heteroplasia in the observation group were significantly lower than those in the control group(all P<0.05).During and 3 months after the treatment,there was no significant adverse event in both groups.Conclusion Jianpi Huoxue Formula has a good clinical effect on improving the pathological state of gastric mucosa in patients with gastric precancerous lesions after Hp eradication,and it can better improve the PG index,which is worthy of clinical promotion.
出处
《浙江临床医学》
2020年第12期1735-1737,共3页
Zhejiang Clinical Medical Journal
基金
浙江省嘉兴市科技计划项目(2017BY18035)。
关键词
健脾活血方
幽门螺杆菌
萎缩性胃炎
血清胃蛋白酶原
Jianpi Huoxue Formula
Helicobacter pylori
Precancerous lesions of gastric cancer
Serum pepsinogen
