Research On The Curative Effect And Related Factors Of The New Plan Of Integrated Traditional Chinese And Western Medicine To Eradicate Hp

Background:helicobacter pylori(abbreviated as H.pylori)is a kind of gram-negative bacterium found in the stomach.H.pylori is resistant to gastric acid and requires extremely high growth conditions.which requires high growth conditions.It is also the only bacteria found to survive in gastric acid-rich environment.Its infection may be associated with occupation,drinking water,eating habits,living conditions,education degree and other factors.H.pylori has received wide attention due to its infectivity and extensive pathogenicity.Studies show that H.pylori infection is an important cause of digestive system diseases and is related to the occurrence of many extragastrointestinal diseases,which make the eradication treatment of H.pylori of great significance.At present,the treatment programs of eliminating H.pylori in western medicine include the application of two kinds of antibiotics,and the continuous development of the antibiotics resistance in recent years has led to a decrease in the eradication rate of H.pylori year by year.Therefore,how to reduce the use of antibiotics in the treatment of H.pylori is an urgent problem to be solved.The research on traditional Chinese medicine(TCM)intervention in treating H.pylori infection is increasing,and showed that many traditional Chinese medicines have the effect of killing h.pylori.Jinghua weikang Jiaowan has been demonstrated by a number of clinical studies and animal experiments to have the effect of anti-H.pylori;it can not only assist in eradicating H.pylori,but also significantly improve the symptoms.In view of this,the instructor made a large number of clinical observations in the early stage,and innovatively proposed replacing an antibiotic with Jinghua Weikang Jiaowan to form a single antibiotic treatment approach integrating TCM and western medicine(hereinafter referred to as the "new TCM-WM integrated treatment").In the case of reducing the use of an antibiotic,a better H.pylori eradication effect is still achieved.Therefore,it is of great value to carry out further clinical research on this new treatment approach and explore the influencing factors related to the curative effect.Objective:to further verify the efficacy and safety of the "new TCM-WM integrated treatment" by comparing it with the traditional quadruple therapy.Studying the relationship between H.pylori and general conditions such as occupation,diet and living conditions,as well as TCM syndrome and constitution type is helpful to deepen the understanding of H.pylori infection,provide a basis for preventing and treating H.pylori infection through toning body constitution,adjusting diet and daily life,and guide the use of TCM based on syndrome differentiation approach to promote the accurate application of the "new TCM-WM integrated treatment".Methods:a comparative study of observational efficacy was used.A total of 119 patient cases whose examination results were positive in the C13 urea breath test in the Department of Gastroenterology,Dongzhimen Hospital,Beijing University of Chinese Medicine were enrolled as the study objects.Among the 119 objects,60 were divided into the observation group and 59 in the control group.In the observation group,each patient took rabeprazole sodium enteric-coated capsules(20mg)once a day,amoxicillin dispersible tablets(1000mg)twice a day,Jinghua Weikang Jiaowan(160 mg)3 times a day,and colloidal bismuth pectin capsules(150 mg)4 times a day.In the control group,20mg rabeprazole sodium enteric-coated capsules were given once a day,amoxicillin dispersible tablets(1000mg)twice a day,clarithromycin dispersible tablets(500mg)twice a day,and colloidal bismuth pectin capsules(150mg)4 times a day.The course of treatment in both groups was 14 days.Questionnaire surveys including general data,TCM symptom score table,TCM syndrome type interpretation,TCM Constitution Classification and Judgment Table were conducted;general information,TCM syndrome type and TCM constitution before treatment,the 13C urea exhalation results and the TCM symptom scores(including tongue image)pre-treatment and a month after treatment,occurrences of adverse reactions(symptoms)during the medication were collected and analyzed.SPSS 20.0 software was used for data processing,collation and statistical analysis.Results:(1)among the 119 study cases of H.pylori infection,spleen-stomach damp-heat syndrome was most common in TCM syndromes,accounting for 40.3%,followed by spleen-stomach weakness syndrome(31.1%).In TCM constitution,Yang deficiency constitution was more common(22.7%),followed by mild constitution(19.3%),moist-heat constitution(14.3%)and phlegm-damp constitution(12.6%).(2)In the observation group,under the "new TCM-WM integrated treatment",the H.pylori eradication rate was 86.7%,higher than that of the traditional quadruple therapy in the control group(83.1%).(3)Regarding the H.pylori eradication rate of different syndrome types,the eradication rate of stomach collateral stasis,spleen-stomach weakness and liver stomach in-coordination was higher in the observation group,while the control group had a higher eradication rate of gastric collateral stasis and spleen-stomach moist-heat syndrome.(4)In terms of H.pylori eradication rate of different constitutions,the rate of damp-heat constitution,blood stasis and special(allergic)constitution was higher in the observation group,while in the control group,Qi deficiency,phlegm dampness,blood stasis and special(allergic)constitution had a higher eradication rate.(5)Both groups were effective in improving the symptoms,especially in the observation group,and the difference between the two groups was statistically significant(P<0.05).(6)There was no obvious change in tongue color and tongue shape before and after eradicating H.pylori;the proportion of yellow coating on the tongue decreased,and there was no statistical value(P>0.05);In aspects of tongue coating classification,the coating surface changed from thick and greasy coating to thin coating(P<0.05).(7)There was no correlation between the H.pylori eradication efficacy of the "new TCM-WM integrated treatment" and factors such as gender,age,marriage,height,body mass index,sm oking,drinking,occupation,education,living conditions,dishware,dining out,work pressure,TCM syndrome type and TCM constitution(P>0.05),but the eradication rate was correlated with body weight and DOB value(P<0.05).(8)No adverse reactions occurred in the 60 study objects in the observation group,and 2 cases among the 59 study objects in the control group showed adverse reactions,indicating that the "new TCM-WM integrated treatment" was more prominent in reducing adverse reactions.Conclusion:1)The "new TCM-WM integrated treatment" has a higher eradication rate than the traditional quadruple therapy,but the statistical difference is not obvious,which may be related to the small number of samples.2)The "new TCM-WM integrated treatment" is superior to the traditional quadrangle therapy in improving H.pylori clinical symptoms and reducing adverse reactions.3)The TCM syndromes of H.pylori infection are mostly spleen-stomach moist-heat syndrome;the constitution of TCM is dominated by biased constitution,in which Yang deficiency is more common;after the eradication of H.pylori,most of the tongue coating changes from thick and greasy to thin.4)The efficacy of the "new TCM-WM integrated treatment" in eradicating H.pylori may be related to body weight and DOB value.