何璠　　郑伟伟　　曾耀明

[關键词] 幽门螺杆菌阳性;慢性非萎缩性胃炎;清胃祛湿颗粒;疗效;安全性

[中图分类号] R573.3          [文献标识码] B          [文章编号] 1673-9701（2021）14-0059-04

Discussion on safety of stomach-clearing dampness-dispelling granules combined with bismuth-containing quadruple therapy in Hp positive CNAG

HE Fan ZHENG Weiwei ZENG Yaoming

Department of Gastroenterology， the Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine Wenzhou Hospital of Traditional Chinese Medicine， Wenzhou   325000， China

[Abstract] Objective To investigate the clinical efficacy and safety of stomach-clearing dampness-dispelling granules combined with bismuth-containing quadruple therapy on patients with Hp positive CNAG. Methods A total of 130 patients who were diagnosed with Hp positive CNAG and admitted to our hospital from October 2018 to September 2019 were extracted into groups for research. They were randomly divided into two groups， the control group （n=65， bismuth-containing quadruple therapy applied singly） and the observation group （n=65， stomach-clearing dampness-dispelling granules combined with bismuth-containing quadruple therapy applied）. The therapeutic effects and safety were contrasted between the two groups. Results The eradication rate of Hp and total therapeutic effects in the observation group were significantly higher than those in the control group after evaluation（P<0.05）. Before treatment， no statistically significant differences were observed in various symptom scores and total scores between the two groups（P>0.05）. After treatment， the scores of both groups were decreased， and a lower level was presented in the observation group than in the control group， with statistically significant differences（P<0.05）. The recurrence rate of Hp eradication patients in the observation group within six months was significantly lower than that in the control group（P<0.05）. During the treatment period， no adverse reactions were observed in the observation group， while 8 patients with adverse reactions were observed in the control group. Conclusion The stomach-clearing dampness-dispelling granules combined with bismuth-containing quadruple therapy on patients with Hp positive CNAG can enhance the therapeutic effect， relieve the clinical symptoms， reduce the recurrence rate， and is of high safety， which is of great significance for promotion.

[Key words] Hp （helicobacter pylori） positive; CNAG（chronic non-atrophic gastritis）; Stomach-clearing dampness-dispelling granules; Therapeutic effect; Safety

慢性非萎缩性胃炎指胃黏膜未发生萎缩性改变，是临床常见的一种消化系统疾病[1]。大部分罹患该病的患者无明显的临床特征，只能通过胃镜检查发现，所存在的症状表现为上腹疼痛、上腹胀满、身体疲重等，胃镜检查下可见红斑、出血、黏膜粗糙水肿等。该病病情较长，缠绵难愈，容易反复发作，若未能及时发现治疗，也会存在病情加重发展成萎缩性胃炎，甚至胃癌的可能性[2-3]。目前，临床对慢性非萎缩性胃炎的发病机制尚未明确，普遍认为幽门螺杆菌（Helicobacter pylori，Hp）感染是诱发该病及使病情加重的主要原因，根除Hp，可以减轻胃黏膜的炎症，同时延缓甚至阻止胃黏膜向萎缩、异型增生等更严重的方向发展，是预防发展成胃癌的重要措施[4]。现阶段西医一般采用以抗生素为主的三联、四联疗法等根治Hp，但对抗生素应用的不规范，导致其耐药性和副作用逐渐增高，因此临床疗效并不理想，寻求根治Hp的新的方法显得至关重要[5]。Hp在中医归属为“邪气”的范畴，即为外感六淫，其中包括Hp的感染。近年来，有不少研究针对该病采用中医中药治疗，通过辨证分型论治，取得较好疗效，且副作用少，对改善症状、减少复发有重要意义[6]。本次研究针对临床所选病例，取清胃祛湿颗粒联合铋剂四联治疗，并探讨其疗效及安全性，旨在指导临床，现报道如下。……