1. 河北中医学院附属医院
2. 河北中医学院研究生学院
纸质出版:2019
移动端阅览
[1]杜艳茹,章蒙,任玉青,狄紫蕊,任雪童,王彦刚.胃康安对幽门螺杆菌相关性胃炎患者血清胃泌素-17及胃蛋白酶原的影响[J].中医杂志,2019,60(12):1051-1055.
DU Yanru, ZHANG Meng, REN Yuqing, et al. Effects of Weikangan(胃康安) on Serum Gastrin-17 and Pepsinogen in Patients with Helicobacter Pyloriassociated Gastritis[J]. Journal of Traditional Chinese Medicine2019, 60(12): 1051-1055.
[1]杜艳茹,章蒙,任玉青,狄紫蕊,任雪童,王彦刚.胃康安对幽门螺杆菌相关性胃炎患者血清胃泌素-17及胃蛋白酶原的影响[J].中医杂志,2019,60(12):1051-1055. DOI: 10.13288/j.11-2166/r.2019.12.013.
DU Yanru, ZHANG Meng, REN Yuqing, et al. Effects of Weikangan(胃康安) on Serum Gastrin-17 and Pepsinogen in Patients with Helicobacter Pyloriassociated Gastritis[J]. Journal of Traditional Chinese Medicine2019, 60(12): 1051-1055. DOI: 10.13288/j.11-2166/r.2019.12.013.
目的观察胃康安联合四联杀菌疗法治疗幽门螺杆菌(Hp)相关性胃炎的临床疗效及可能作用机制。方法将220例Hp相关性胃炎患者随机分为胃康安组、安慰剂组各110例。两组均给予标准四联杀菌疗法:奥美拉唑肠溶片每次20 mg
每日2次;奥硝唑分散片每次0. 5 g
每日2次;阿莫西林分散片每次1. 0 g
每日2次;枸橼酸铋钾颗粒每次1. 0 g
每日4次
以上药物均口服2周。胃康安组予胃康安中药方每日1剂
安慰剂组予安慰剂每日1剂
两组均治疗1个月。分别于治疗前和停药1个月后比较两组患者中医症状(包括胃脘胀满或疼痛、恶心呕吐、饮食减少、嗳气泛酸、口干口苦)积分、胃黏膜改变情况(包括充血、水肿、糜烂和出血点)
计算症状缓解时间、Hp根除率
检测血清胃泌素-17、胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)水平
并计算症状缓解时间、Hp根除率
判定临床疗效。结果胃康安组治愈30例
显效41例
有效34例
无效5例
总有效率95. 45%。安慰剂组治愈20例
显效32例
有效38例
无效20例
总有效率81. 81%
治疗组总有效率高于安慰剂组(P <0. 05)。治疗后两组间比较
胃康安组各中医症状积分及血清PGⅠ、PGⅡ水平均低于安慰剂组
血清胃泌素-17水平高于安慰剂组(P <0. 05)。胃康安组症状缓解的时间为(9. 0±3. 7)天
安慰剂组为(16. 1±5. 1)天
胃康安组症状缓解早于安慰剂组(P <0. 05)。胃康安组患者胃黏膜充血、水肿、糜烂和出血点好转例数均明显多于安慰剂组(P <0. 05)。胃康安组、安慰剂组Hp根除率分别为64. 55%、47. 22%
胃康安组根除率明显高于安慰剂组(P <0. 05)。结论胃康安联合四联杀菌疗法治疗Hp相关性胃炎在提高临床疗效、缓解症状、促进胃黏膜修复、提高根除Hp率方面优于单用四联杀菌疗法
升高血清胃泌素-17水平和降低血清PGⅠ、PGⅡ水平可能是其机制之一。
Objective To observe the clinical efficacy and possible mechanism of Weikangan(胃康安) combined with quadruple sterilization in the treatment of Helicobacter pylori(Hp)-associated gastritis.Methods A total of 220 patients with Hp-associated gastritis were randomly divided into a Weikangan group and a placebo group
with 110 cases in each group.Both groups were given standard quadruple sterilization:omeprazole enteric tablets20 mg each time
twice a day;ornidazole dispersible tablets 0.5 g each time
twice a day;amoxicillin dispersible tablets 1.0 g each time
twice a day;bismuth potassium citrate particles 1.0 g each time
4 times a day.The above drugs are taken orally for 2 weeks.The Weikangan group was given one dose of Weikangan Chinese herbal medicine daily
and the placebo group was given a placebo once a day.Both groups were treated for 1 month.Traditional Chinese medicine(TCM) symptoms(including stomach distension or pain
nausea and vomiting
diet reduction
eructation and acid regurgitation
dry mouth and bitter mouth) scores
gastric mucosal changes(including congestion
edema
erosion and bleeding point) were compared before treatment and 1 month after drug withdrawal.The symptom relief time
Hp eradication rate was calculated.The serum gastrin-17
pepsinogen I(PGⅠ)
pepsinogenⅡ(PGⅡ) levels were detected.The clinical efficacy was determined.Results In the Weikangan group
30 cases were cured
41 cases markedly effective
34 cases effective
and 5 cases ineffective.The total effective rate was95.45%.In the placebo group
20 cases were cured
32 cases markedly effective
38 cases effective
20 cases ineffective
and the total effective rate was 81.81%.The total effective rate of the treatment group was higher than that of the placebo group(P < 0.05).After treatment
the TCM symptom scores and serum PGⅠ and PGⅡ levels in the Weikangan group were lower than those in the placebo group
and serum gastrin-17 level was higher than that in the placebo group(P < 0.05).The time of symptom relief in the Weikangan group was(9.0 ± 3.7) days
and that in the placebo group was(16.1 ± 5.1) days.The symptom relief in the Weikangan group was earlier than that in the placebo group(P < 0.05).The cases of gastric mucosal hyperemia
edema
erosion and bleeding point improvement in the Weikangan group were significantly greater than those in the placebo group(P < 0.05).The eradication rates of Hp in the Weikangan group and the placebo group were 64.55% and 47.22%
respectively.The eradication rate of the Weikangan group was significantly higher than that of the placebo group(P < 0.05).Conclusion Weikangan combined with quadruple bactericidal therapy for Hp-related gastritis is superior to single use of quadruple bactericidal therapy in improving clinical efficacy
relieving symptoms
promoting gastric mucosal repair and improving eradication rate of Hp.Elevated serum gastrin-17 level and lowering serum PGⅠ and PGⅡ levels may be one of its mechanisms.
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