三联疗法对幽门螺杆菌相关性慢性浅表性胃炎中医证型的影响

[摘要] 目的 通过三联疗法抗幽门螺杆菌（Hp）治疗，观察Hp相关性慢性浅表性胃炎患者在治疗前后中医证型的变化，探讨三联疗法对Hp相关性慢性浅表性胃炎患者中医证型的影响，以指导中医药的治疗。 方法 将符合纳入标准的90例慢性浅表性胃炎患者按三联疗法标准方案给予抗Hp治疗，14 d为1个疗程。分别在治疗前后进行中医辨证分型。 结果 经三联疗法治疗后，脾胃湿热证型较治疗前增多，肝胃不和证型较治疗前减少，差异具有统计学意义（P < 0.05）；脾胃虚弱证型较治疗前增多，但差异无统计学意义（P > 0.05）。 结论 Hp相关性慢性浅表性胃炎患者经三联疗法治疗后中医证型发生了变化，具有向湿热转变的规律，三联疗法治疗后患者脾胃湿热证型较治疗前增多。

[关键词] 幽门螺杆菌；慢性浅表性胃炎；三联疗法；中医证型

[中图分类号] R256.3 [文献标识码] A [文章编号] 1673-7210（2012）08（b）-0108-02

Inf1uence of triple therapy on traditional Chinese medicine syndromes of Helicobacter Pylori associated chronic superficial gastritis

LIU Yanjing JIN Xuezhu JIA Qiuying

Department of Gastroenterology, the Affiliated Hospital of Changchun University of Traditional Chinese Medicine, Jilin Province, Changchun 130021, China

[Abstract] Objective To research the changes on traditional Chinese medicine syndromes of Helicobacter Pylori associated gastritis (HPAG) before and after triple therapy, discuss the influence of triple therapy on traditional Chinese medicine syndromes of HPAG, in order to guide the following Chinese medicine treatment. Methods 90 patients with chronic superficial gastritis met inclusion criteria were given triple therapy to treat Hp, the one course of treatment was 14 days. The patient's TCM syndrome type was recorded before and after the treatment. Results Syndrome of dampness-heat of spleen and stomach increased and syndrome of liver stomach disharmony reduced after triple therapy, the results were statistically significant (P < 0.05). Syndrome of weakness of the spleen and the stomach were increased, but there was significant difference (P ＞ 0.05). Conclusion Traditional Chinese medicine syndromes of the patients with HPAG changed after triple therapy. The syndrome evolution regularity transfers to dampness-heat of spleen and stomach syndrome. Syndrome of dampness-heat of spleen and stomach increased significantly after triple therapy which compare with before treatment.

[Key words] Helicobacter Pylorid; Chronic superficial gastritis; Triple therapy；Traditional Chinese medicine syndromes

幽门螺杆菌（Hp）是慢性胃炎、消化性溃疡、胃癌、胃黏膜相关淋巴组织（MACT）淋巴瘤等消化道疾病的重要致病因素。全世界自然人群的感染率高达50.0%，说明人群对Hp的感染率非常高[1]。我国幽门螺杆菌科研协作组在2002年1月～2004年6月对人群Hp感染的调查显示：中国自然人群Hp的感染率约为54.76%，血清学阳性范围为40.0%～90.0%（平均59.0%）[2]。Hp持续感染，可以使慢性浅表性胃炎发展成萎缩性胃炎，进而发生肠上皮化生、非典型增生，最终可导致胃腺癌的发生。医学的进步大幅度提高了胃炎、胃溃疡和十二指肠溃疡患者彻底治愈的机会，从而提高了患者的生活质量。目前有关中药和中成药抗Hp疗效的研究较多，而对三联疗法治疗Hp相关性慢性胃炎前后中医证型变化则报道甚少。本研究采用前瞻性的研究方法，通过标准三联疗法抗Hp治疗，观察患者治疗前后中医证型的变化，研究三联疗法对患者中医证型的影响。