| 摘要: |
| 目的：观察蒲灵泻心汤联合“标准四联”治疗幽门螺杆菌（Hp）阳性寒热错杂型胃溃疡（GU）的临床疗效。方法：将42例Hp阳性寒热错杂型GU患者随机分为治疗组与对照组，每组各21例。对照组前14 d采用常规抗Hp四联疗法，后28 d采用泮托拉唑治疗；治疗组在对照组基础上加蒲灵泻心汤治疗。比较2组的Hp转阴率，中医证候积分，血清肿瘤坏死因子-α（TNF-α）、白细胞介素-8（IL-8）、表皮生长因子（EGF）、血管内皮生长因子（VEGF）的水平，评价疗效并评估药物的安全性。结果：总有效率治疗组为95.24%（20/21），对照组为71.43%（15/21），2组比较，差异有统计学意义（P＜0.05）；Hp转阴率治疗组为85.71%（18/21），对照组为71.43%（15/21），2组比较，差异有统计学意义（P＜0.05）。2组中医证候积分及血清TNF-α、IL-8、EGF、VEGF水平治疗前后组内比较及治疗后组间比较，差异均有统计学意义（P＜0.05）；2组治疗后复查血常规、肝肾功能等安全性化验指标均无明显异常。结论：蒲灵泻心汤联合“标准四联”能明显改善Hp阳性寒热错杂型GU患者的临床症状，提高Hp根治率，且药物安全性高，无明显不良反应。其机制可能是通过降低血清中胃黏膜损伤因子TNF-α、IL-8水平与升高血清胃黏膜保护因子VEGF、EGF水平，从而达到促进GU愈合的作用。 |
| 关键词: 胃溃疡 幽门螺杆菌 寒热错杂证 蒲灵泻心汤 肿瘤坏死因子-α 白细胞介素-8 表皮生长因子 血管内皮生长因子 |
| DOI： |
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| Clinical effect of Puling Xiexin decoction combined with standard quadruple therapy in treatment of Helicobacter pylori-positive gastric ulcer with intermingled heat and cold：An analysis of 21 cases |
| LUO Ting,CHEN Linzi,LIU Ting |
| (Traditional Chinese Medicine Hospital of Changsha County，Changsha 410148，Hunan，China;Xiangya School of Medicine，Central South University，Changsha 410013，Hunan，China) |
| Abstract: |
| Objective：To investigate the clinical effect of Puling Xiexin decoction combined with standard quadruple therapy in the treatment of Helicobacter pylori (Hp)-positive gastric ulcer (GU) with intermingled heat and cold.Methods：A total of 42 patients with Hp-positive GU with intermingled heat and cold were randomly divided into treatment group and control group，with 21 patients in each group.The patients in the control group were given conventional anti-Hp quadruple therapy for the first 14 days，followed by pantoprazole for 28 days，and those in the treatment group were given Puling Xiexin decoction in addition to the treatment in the control group.The two groups were compared in terms of Hp clearance rate，traditional Chinese medicine (TCM) syndrome score，and the serum levels of tumor necrosis factor-α (TNF-α)，interleukin-8 (IL-8)，epidermal growth factor (EGF)，and vascular endothelial growth factor (VEGF)，and the efficacy and safety of the drug was assessed.Results：There was a significant difference in overall response rate between the treatment group and the control group ［95.24% (20/21) vs 71.43% (15/21)，P＜0.05］，and there was also a significant difference in Hp clearance rate between the two groups ［85.71% (18/21) vs 71.43% (15/21)，P＜0.05］.Both groups had significant changes in TCM syndrome score and the serum levels of TNF-α，IL-8，EGF，and VEGF after treatment，and there were significant differences in these indicators between the two groups after treatment (P＜0.05).Reexamination after treatment showed no obvious abnormalities in safety indicators including routine blood test results and hepatic and renal function in either group.Conclusion：Puling Xiexin decoction combined with standard quadruple therapy can significantly improve the clinical symptoms of patients with Hp-positive GU with intermingled heat and cold and increase the radical treatment rate of Hp and has a favorable safety profile，with little adverse effect.This treatment method can promote the healing of GU by reducing the serum levels of TNF-α and IL-8 for inducing gastric mucosal injury and increasing the levels of VEGF and EGF for protecting gastric mucosa. |
| Key words: gastric ulcer Helicobacter pylori intermingled heat and cold Puling Xiexin decoction tumor necrosis factor-α interleukin-8 epidermal growth factor vascular endothelial growth factor |
