| Helicobacter pylori(Hp)can be colonized in the gastric mucosa layer,leading to gastritis,peptic ulcer,chronic atrophic gastritis,gastric cancer and other digestive tract diseases.Successful eradication of Hp can improve gastric mucosa atrophy and intestinal metaplasia caused by chronic infection,and prevent the occurrence of gastric cancer.Due to increased antibiotic resistance of Hp strains and patient compliance,the eradication rate of Hp has been decreasing year by year.Especially after the failure of initial eradication treatment,antibiotics that have already been applied may develop secondary resistance,with limited choices of antibiotics and a higher risk of antibiotic related adverse reactions,significantly limiting the success rate of remedial treatment.Jinghua Weikang Capsules is the most widely used traditional Chinese patent medicines and simple preparations in the eradication of Hp.The preliminary clinical research of this topic has shown that different remedial treatment methods containing Jinghua Weikang Capsules can achieve a higher eradication rate,but it is not clear whether stable eradication and reinfection are achieved.Maintaining the negative status of Hp after successful treatment is of great significance to improve the status of gastric mucosa and prevent damage from progressing to gastric cancer.Therefore,based on the previous clinical research,this study selected patients who had negative breath results after one month of discontinuation,that is,successfully treated,as the research subjects.The breath results and clinical symptoms of different remedial and eradication treatment plans containing Jinghua Weikang Jiaowan were observed at the 6th and 12th months of discontinuation,and their midterm and long-term efficacy was evaluated,providing a clinical basis for the long-term efficacy of integrated Chinese and Western medicine in treating Hp.ObjectiveTo observe the effectiveness of the remedial treatment plan containing Jinghua Weikang Jiaowan on the recurrence rate of Hp and the improvement of mid to long term symptoms,and to analyze the risk factors for Hp recurrence,using a four day bismuth solution containing amoxicillin and furazolidone as a control.MethodsThis study adopts the mixed cohort study method to collect the general data of the patients who participated in the Multicenter Randomized Controlled Clinical Study on the Remedial Treatment Scheme with Jinghua Weikang Capsules to Eradicate Drug resistant Helicobacter Pylori Infection from January 2019 to March 2022.Among them,the treatment group A is the 14 day scheme of Jinghua Weikang combined with triple therapy The treatment group B adopts the 14 day plan of Jinghua Weikang combined with triple therapy and the 14 day plan of Jinghua Weikang continuous treatment,the treatment group C adopts the 10 day plan of Jinghua Weikang combined with quadruple therapy,and the control group adopts the 14 day plan of bismuth quadruple therapy.Patients who meet the case screening criteria are called to undergo 13C-UBT testing at the 6th and 12th months of discontinuation and fill out the symptom score questionnaire at the 6th and 12th months for those who agree to join this study.Evaluate the efficacy indicators based on Hp recurrence rate and long-term symptom improvement effectiveness.ResearchThis study included a total of 298 patients,including 71 in treatment group A,78 in treatment group B,70 in treatment group C,and 79 in control group.Hp recurrence rate:At the 6-month node,the Hp recurrence rate in Group A was 7.0%(5/71),Group B was 1.3%(1/78),Group C was 4.3%(3/70),and the Hp recurrence rate in the control group was 5.1%(4/79).The inter group comparison showed P>0.05,with no statistically significant difference;At the 12 month node,the Hp recurrence rate in Group A was 7.1%(3/42),Group B was 6.8%(3/44),Group C was 2.4%(1/42),and the control group was 9.1%(4/44).The inter group comparison showed P>0.05,and the difference was not statistically significant.At the end of the two follow-up visits,the total follow-up person year was 298 × 0.5+172 x 1=321,with a total of 24 recurrent cases and an annual recurrence rate of 7.4%(24/321).The influencing factors of Hp recurrence:Cox regression single and multiple factor analysis was used to analyze the influencing factors of Hp recurrence.The results showed that gender,age,BMI,marital status,education level,work nature,smoking history,and frequency of drinking yogurt were not significantly correlated with recurrence(P>0.05).Family members had Hp infection,frequency of eating out,and previous eradication times,all of which were closely related to Hp recurrence(P<0.05).Long term symptom efficacy:In terms of overall symptom scores,the total symptom scores of the four groups after 6 and 12 months of discontinuation were significantly lower than those after 1 month of discontinuation,and the difference was statistically significant(P<0.05).The overall symptoms of all groups of patients improved in the long term.At 6 months of discontinuation,there was a difference in the total symptom score among the four groups,and the improvement of the total symptom score in Group B was better than that in the control group(P<0.05).In terms of individual symptom scores,the scores of some individual symptoms in Group A,Group B,Group C,and the control group were significantly reduced(P<0.05);All symptom scores in Group B were significantly reduced(P<0.05).At 6 and 12 months of discontinuation,Group B showed better improvement in belching and acid reflux compared to the control group(P<0.05).There was no statistically significant difference in the scores of other individual symptoms between the groups.There was no statistically significant difference in total symptom score and individual symptom score among the four groups after 12 months of discontinuation(P>0.05).ConclusionThe recurrence rate of Jinghua Weikang combined with triple therapy for 14 days,Jinghua Weikang continuous therapy for 14 days,and Jinghua Weikang combined with bismuth quadruple therapy for 10 days were lower than that of bismuth quadruple therapy for 14 days.Prolonging the administration time of Jinghua Weikang in the treatment plan and combining Jinghua Weikang capsules in the bismuth quadruple therapy can reduce the long-term recurrence rate.Family members with Hp infection,frequency of going out to eat,and previous eradication times may be risk factors for Hp recurrence.It is necessary to regularly monitor the infection status of high-risk populations.The long-term symptom relief of the remedial treatment plan containing Jinghua Weikang Jiao wan is better than that of bismuth quadruple therapy. |
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