目的：观察祛菌通幽汤替代抗生素治疗幽门螺杆菌(HP)相关性胃病的疗效,并探讨其作用机制。方法236例患者中,初治患者140例,随机分成治疗组80例和对照组60例；复治患者96例,随机分成治疗组56例和对照组40例。对照组予西药四联疗法：初治患者使用雷贝拉唑钠肠溶胶囊＋胶体果胶铋＋阿莫西林胶囊＋克拉霉素分散片；复治患者予雷贝拉唑钠肠溶胶囊＋胶体果胶铋＋甲硝唑片＋左氧氟沙星片。治疗组均使用雷贝拉唑钠肠溶胶囊＋胶体果胶铋＋祛菌通幽汤。疗程为2周。治疗后1、3、6个月时复查碳14-尿素呼气试验,观察HP转阴、临床症状改善情况及不良反应。结果2组HP转阴率、总有效率及HP复发率比较,差异有统计学意义(P＜0.05)；2组症状控制率比较,差异有统计学意义(P＜0.01)；治疗组未见明显不良反应。结论雷贝拉唑钠肠溶胶囊、胶体果胶铋联合祛菌通幽汤能有效抑杀HP,促进HP转阴,减少HP复发,促进胃黏膜炎症修复和溃疡愈合,改善症状,不良反应少,治疗HP相关性胃病有一定疗效。%Objective To observe the curative effect of Qujun Tongyou Decoction instead of antibiotics in treatment of Helicobacter pylori (HP) associated gastric disease, and explore the mechanism of action. Methods In 236 patients, 140 cases of newly diagnosed patients were randomly divided into treatment group of 80 cases and control group of 60 cases, 96 cases of retreatment patients were randomly divided into treatment group of 56 cases and control group of 40 cases. The control group was given western quadruple therapy:newly diagnosed patients with rabeprazole sodium enteric-coated capsules+colloidal bismuth pectin+Amoxicillin Capsules+clarithromycin dispersible tablets;retreatment patients with rabeprazole sodium enteric-coated capsules+colloidal bismuth pectin+metronidazole tablets+levofloxacin tablets. The treatment group was given rabeprazole sodium enteric coated capsules and colloidal bismuth pectin plus Qujun Tongyou Decoction. All patients were treated for 2 weeks. 1, 3, 6 months after treatment, 14C-urea breath test was detected, HP negative rate, recurrence rate, clinical symptoms, and adverse reaction were observed. Results HP negative rate, the total effective rate and the recurrence rate in treatment group were different with the control group (P<0.05). There was significant difference in the rate of symptom control between treatment group and the control group (P<0.01). No adverse reaction showed in treatment group. Conclusion Rabeprazole sodium enteric-coated capsules and colloidal bismuth pectin combined with Qujun Tongyou Decotion can effectively inhibit and kill HP, promote the repair and healing of ulcer, control symptoms, reduce HP recurrence, lessen adverse reaction, is effective in the treatment of HP associated gastric diseases.
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