Effect Of Modified Sanhuang Xiexin Tang Plus Additional Herbs Combined With "Standard Quadruple Therapy" On Helicobacter Pylori Eradication As Rescue Treatment

Objective:To determine the effectiveness of modified Sanhuang Xiexin Tang（SHXXT）plus additional herbs（MSAH）[Dahuang（Radix Et Rhizoma Rhei Palmati）,Huanglian（Rhizoma Coptidis）,Huangqin（Radix Scutellariae Baicalensis）,et al.],we evaluated the efficacy of MSAH combined standard quadruple therapy containing furazolidone for eradication of Helicobacter pylori（H.pylori）and amelioration of related symptoms as rescue therapy.Methods:From April 2018 to May 2020,we enrolled 117 outpatients with dyspepsia symptoms who failed in the standard quadruple therapy used as first-line or second-line.Patients were randomly divided into 2 treatment groups:furazolidone-based standard quadruple therapy（group A;EAFB）,patients received a rescue regimen with 14-day Nexium（?）（?）,amoxicillin,furazolidone and bismuth salts;or furazolidone-based standard quadruple therapy with MSAH（group B;EAFB+MSAH）,extra MSAH were included.Comparisons of H.pylori eradication and symptom amelioration rates were made among the 2 groups at 6 weeks after group assignment.Eradication rates were evaluated by the[¹³C]or[¹⁴C]urea breath test.The total symptom score amelioration rate was calculated as follows:rate=[（symptom score before treatment-symptom score after treatment）/score before treatment]×100%.Results:A total of 117 patients were initially screened.All patients were randomly assigned to 2 groups,58 patients in group A,the other 59 in group B.11.9%（7/58）and22.0%（13/59）of the patients in each group failed to eradicate H.pylori twice in the past.There was no statistical difference in times of treatments（χ²=2.167,P=0.141>0.05）.H.pylori eradication rate in group B[88.1%（52/59）]was significantly higher than that in group A[72.4%（42/58）]（p<0.05）.There were no differences in the total symptom score among the groups before treatment.Within each group,the total symptom score after treatment was significantly lower than that before treatment.However,group B（EAFB+MSAH）demonstrated superior total symptom scores and symptom amelioration rates than group A（EAFB）.No severe adverse reactions were reported in the study.Conclusion:In this study,we compared 2 different H.pylori eradication rescue treatments:EAFB,and EAFB+MSAH,higher efficacy and higher symptom amelioration rate were found in patients who received 14-day Furazolidone-based standard quadruple therapy with MSAH.There is no difference between MSAH combined with standard quadruple therapy and standard quadruple therapy containing bismuth with regard to safety.Therefore it appears to be an ideal treatment scheme for recommended as a rescue treatment.