翟建宁　金小晶

摘要目的：探討益气化湿方联合西药治疗幽门螺杆菌（Hp）感染性胃炎患者对胃黏膜的影响。方法：选取2016年1月至2017年9月收治的Hp感染性胃炎患者118例，依据随机数字表法分为观察组与对照组，每组59例。对照组以常规西药进行治疗，观察组在对照组的基础上加用益气化湿方治疗，2组均连续治疗1个月。比较2组临床疗效及Hp清除效果；统计并比较治疗前后2组中医症状积分及胃黏膜状况。结果：治疗后观察组的总有效率与Hp阴转率分别为9153%、8814%，显著高于对照组的7797%、6949%（P<005）；与治疗前比较，治疗后2组胃脘胀痛、纳差、神疲乏力、大便稀溏、四肢不温等中医症状积分均显著下降（P<005），且观察组显著低于对照组（P<005）；与治疗前比较，治疗后2组胃黏膜炎性反应细胞浸润、腺体密度、黏膜厚度及腺体形态等积分均显著下降（P<001），且观察组显著低于对照组（P<005或P<001）。结论：益气化湿方联合西药治疗Hp感染性胃炎显著缓解患者临床症状，改善其胃黏膜状况，提升Hp清除效果。

关键词幽门螺杆菌；感染；胃炎；中西医结合；益气化湿方；疗效；胃黏膜

Effects of Yiqi Huashi Recipe Combined with Western Medicine on Gastric Mucosa in Patients with Helicobacter Pylori Infection Gastritis

Zhai Jianning1，Jin Xiaojing2

（1 Department of Spleen and Stomach Diseases，Wuhu Hospital of Traditional Chinese Medicine，Wuhu 241000，China； 2 Department of Gastroenterology，the Third Affiliated Hospital of Nanjing University of Chinese Medicine，Nanjing 210001，China）

AbstractObjective：To explore the effects of Yiqi Huashi Recipe combined with western medicine on gastric mucosa in patients with Helicobacter pylori （Hp） infection gastritis.Methods：A total of 118 cases of Hp infected gastritis treated by outpatient department and inpatient department of our hospital were divided into observation group and control group according to the random number table method，with 59 cases in each group.Control group was treated with routine western medicine，and observation group was treated with Yiqi Huashi Recipe on the basis of control group.Both groups were treated for 1 month continuously.The clinical curative effect and Hp clearance effect of 2 groups were counted and compared before and after treatment； The traditional Chinese medicine （TCM） syndrome scores and gastric mucosal status in 2 groups before and after treatment were statisticed and compared.Results：After treatment，the total effective rate and Hp negative conversion rate in observation group were 9153% and 8814% respectively，which were significantly higher than the 7797%，6949% in control group （P<005）.Compared with before treatment，the scores of TCM symptoms such as stomachache，anorexia，fatigue，loose stool，unwarm limbs in 2 groups after treatment significantly decreased （P<001）.The observation group was significantly lower than control group （P<005 or P<001）.Compared with before treatment，the infiltration of inflammatory cells，density of gland，thickness of mucosa and gland morphology scores decreased significantly in 2 group after treatment significantly decreased （P<001），and observation group was significantly lower than control group （P<005 or P<001）.Conclusion：Yiqi Huashi Recipe combined with western medicine to treat Hp infectious gastritis significantly alleviates the clinical symptoms，improves the gastric mucosal condition，and promotes the Hp clearance effect，which is worthy of clinical promotion.

Key WordsHelicobacter pylori； Infection； Gastritis； Integrated traditional Chinese and western medicine； Yiqi Huashi Recipe； Curative effect； Gastric mucosa

中图分类号：R2895；R573文献标识码：Adoi：10.3969/j.issn.1673-7202.2018.08.019

幽门螺杆菌（Helicobacter pylori，Hp）是消化性溃疡和慢性胃炎的主要致病菌之一，Hp感染性胃炎患者初期症状以食量减小、食欲下降、腹胀反胃等为主，后期恶心呕吐、烧心、反酸、上腹部疼痛等症状更为常见[12]。Hp感染性胃炎病程较长、根治较难，西医主要通过抑制和清除Hp、抗炎等治疗Hp感染性胃炎及相关性疾病，其中三联疗法作为常见一线治疗方案虽可使Hp阴转率高达70%～85%，但仍有部分患者尚为未取得理想疗效，且Hp感染性胃炎的治疗周期较长，长期用药引发的耐药问题也限制了其临床应用[34]。中医将Hp感染性胃炎纳入“反胃”“胃脘疼痛”的范畴，该疾病的辨证分型以脾胃湿热型为多见，因此主张遵循益气化湿、理气健脾及清热解毒等治则[56]。本研究探讨益气化湿方联合西药治疗Hp感染性胃炎对患者胃黏膜的影响。现报道如下。……