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目的:观察五味清胆方联合西药序贯疗法对Hp VG脾胃湿热证患者胃小凹分类及组织学的影响。方法:将135例Hp VG脾胃湿热证患者分为3组:联合组采用中药联合西药三联疗法治疗,中药组单用中药治疗,西药组单用西药三联疗法治疗。3组疗程均为90d。治疗前后进行内镜下临床证候评估、病变胃黏膜胃小凹形态学观察及病理组织学检查。结果:(1)治疗前后内镜下各临床证候积分比较,除西药组对胆汁反流改善不明显外(P>0.05),3组对其他证候改善效果均有统计学意义(P<0.01或P<0.05),3组之间比较,联合组均优于中药组及西药组(P<0.01);其中对黏膜潮红、充血水肿、胆汁反流改善中药组亦优于西药组(P<0.01);对隆起糜烂改善中药组与西药组差异无统计学意义(P>0.05)。(2)治疗后3组胃小凹形态学及病理组织学比较,联合组均优于中药组、西药组(P<0.05);中药组与西药组差异无统计学意义(P>0.05)。结论:五味清胆方与西药具有协同增效作用,其通过联合西药三联进行Hp清除治疗后序贯联用PPI制剂治疗,具有促进病变胃黏膜腺体修复、变异细胞逆转,对Hp VG脾胃湿热证患者病变胃小凹及组织学有影响,从而对此类患者早期癌变有干预作用。
Objective: To observe the effect of “Wu Wei Qing Gan Fang” combined with western medicine sequential therapy on the classification of gastric pits and histology in Hp VG spleen-stomach damp-heat syndrome patients. Methods: One hundred and thirty-five patients with Hp VG spleen-stomach damp-heat syndrome were divided into three groups: the combined group was treated with traditional Chinese medicine combined with western medicine triple therapy, the traditional Chinese medicine group was treated with traditional Chinese medicine alone, and the western medicine group was treated with western medicine triple therapy alone. Three groups of treatment are 90d. Before and after treatment, endoscopic clinical syndromes were evaluated, morphological changes of gastric mucosal pits and histopathological examination were observed. Results: (1) Before and after treatment, the scores of clinical syndromes in endoscopy showed no significant improvement except bile reflux in western medicine group (P> 0.05), and the effect of other syndromes in three groups was statistically significant (P < 0.01 or P <0.05). In the three groups, the combination group was superior to the traditional Chinese medicine group and western medicine group (P <0.01). The improvement of mucous membrane flushing, congestion and edema, <0.01). There was no significant difference between the traditional Chinese medicine group and the Western medicine group in improving the erosive erosion (P> 0.05). (2) The morphological and pathological histology of gastric pits in the three groups after treatment were better than those in the traditional Chinese medicine group and western medicine group (P <0.05). There was no significant difference between the traditional Chinese medicine group and the western medicine group (P> 0.05). Conclusion: Wuwei Qingqi Recipe has synergistic effect with western medicine. It can be used in combination with western medicine to treat Hp after sequential treatment with PPI preparation. It has the effects of repairing gastric mucosal gland, reversing the variant cells and dampness of spleen and stomach of Hp VG Syndrome patients with gastric lesser and histological impact, and thus early intervention of such patients have an effect on cancer.