Efficacy Observation Of Modified Banxia Xiexin Decoction Combined With Dual Therapy On Hp-related Gastritis (spleen Deficiency And Damp-heat Syndrome)

Objective: To observe the efficacy and safety of Jiawei Banxia Xie Xin Decoction combined with dual therapy in the treatment of patients with Hp-related gastritis.Methods: A total of 180 patients with Hp-related gastritis who met the requirements in the outpatient department of Chongqing Hospital of Traditional Chinese Medicine from December 2019 to January 2021,and the syndrome of spleen deficiency and damp-heat syndrome were randomly divided into Chinese and Western groups,modified dual therapy group,and bismuth-containing quadruple therapy group.Modified Ban Xia Xie Xin Decoction plus flavor combined with dual therapy(esomeprazole magnesium enteric-coated tablets 20 mg Bid + amoxicillin 0.75 g Qid),modified dual therapy(esomeprazole magnesium enteric-coated tablets 20 mg Qid +Amoxicillin Xilin 0.75 g Qid),bismuth quadruple(esomeprazole magnesium enteric-coated tablets 20 mg Bid + colloidal pectin bismuth capsule 0.2g Bid +amoxicillin 1g Bid + clarithromycin sustained-release tablets 500 mg Bid)therapy for 14 days,Follow up regularly,fill in the curative effect score sheet,and review the C13/14 C breath test 4 weeks after the end of the treatment.And use SPSS 26.0 software to statistically analyze the data,analyze the clinical efficacy and safety of modified Ban Xia Xie Xin Decoction combined with dual therapy on Hp-related gastritis with spleen deficiency and damp-heat syndrome.Results:1.General information: Before treatment There was no statistically significant difference in scores and other aspects among modified Ban Xia Xie Xin Decoction combined with dual therapy group,modified dual therapy group and bismuth-containing quadruple group in terms of gender,age,and TCM syndromes(P>0.05),and the three groups were equally comparable.2.Hp eradication rate: the eradication rate in the Chinese and Western group and modified dual therapy group was 89.66% and 91.38%,and the eradication rate in the bismuth-containing quadruple therapy group was75.44%.There was no significant difference in the eradication rate between the Chinese and Western group and the double group(P >0.05),and the eradication rates of the modified dual therapy group were significantly higher than the bismuth-containing quadruple group(P <0.05).3.Comparison of TCM symptom scores: The total symptom scores of the three groups of patients and the main symptom scores were different between before and after the group(P<0.05).The scores of patients after treatment,the total scores of symptoms of combined Chinese and Western therapy,and the scores of symptoms of upper abdominal distension,anorexia and bismuth-containing quadruple regimen and modified double regimen were compared between groups.The differences after treatment were statistically significant(P<0.05);The total symptom score of the modified dual regimen and the bismuth-containing quadruple regimen were significantly different after treatment(P<0.05);the upper abdominal distension and anorexia symptoms scores of the modified dual regimen were compared with the treatment of the bismuth-containing quadruple regimen The difference after treatment was not statistically significant(P>0.05);there was no significant difference in the upper abdominal pain symptom scores of the three treatment plans after treatment(P>0.05).4.The total curative effect of TCM syndrome: the total effective rate of integrated traditional Chinese and western therapy is 100.00%;the total effective rate of modified two-group therapy is 98.28%;the total effective rate of bismuth-containing quadruple therapy is 91.23%.According to statistical analysis,there is a statistically significant difference between traditional Chinese and western medicine and quadruple therapy containing bismuth(P<0.05),and there is no statistically significant difference between traditional Chinese and western medicine and modified dual therapy(P>0.05).There was no significant difference in bismuth-containing quadruple therapy(P>0.05).5.The curative effect of main symptoms of traditional Chinese medicine:There are differences in the results of the main symptoms of the three groups of patients.Among them,the upper abdominal distension and anorexia of the combined Chinese and Western treatment are better than the bismuth-containing quadruple treatment.The difference is statistically significant(P<0.05).There is no significant difference in the efficacy of upper abdominal distension and anorexia compared with the bismuth-containing quadruple treatment regimen(P<0.05).The overall effective rate of the combined Chinese and Western treatment regimen is higher than that of the modified double regimen;the three treatment options treat patients’ upper abdominal pain and discomfort symptoms There was no significant difference in efficacy(P>0.05).6.Comparison of adverse reactions among the three groups of patients:the bismuth-containing quadruple therapy group contains bitterness due to oral administration of clarithromycin,and the bitterness of the mouth is not included in the adverse reaction observation index.During the entire clinical observation process,1 patient in the Chinese and Western group developed insomnia with a mild degree;in the modified dual therapy group,5 cases had adverse reactions,and 4 cases had a mild degree,including 3 cases of dizziness and headache,1 case of insomnia,and 1 case.The rash appeared to be severe and reached the termination standard;7 patients in the bismuth-containing quadruple group had adverse reactions,including 2dizziness and headache,2 insomnia,1 nausea,1 drowsiness,and 1 diarrhea.Termination criteria.The χ2 test showed that there was no significant difference in the incidence of adverse reactions in the three groups.Conclusions: Modified Ban Xia Xie Xin Decoction combined with dual therapy(esomeprazole magnesium enteric-coated tablets 20 mg Bid +amoxicillin 0.75 g Qid)in the treatment of Hp-related gastritis with spleen deficiency and damp-heat syndrome has no significant difference in Hp eradication rate compared with modified dual therapy.The eradication rate of the two groups was significantly higher than that of bismuth-containing quadruple therapy;in terms of symptoms,the improvement of symptoms in patients with modified Ban Xia Xie Xin Decoction combined with dual therapy was significantly better than that of bismuth quadruple therapy,modified dual therapy,and modified dual therapy There is no significant difference in symptom improvement with bismuth quadruple therapy;the incidence of adverse reactions in the three groups has no significant difference;there is no abnormality in the safety indicators of the three groups.In summary,for patients with Hp-related gastritis with spleen deficiency and damp-heat syndrome,it is more recommended to use modified Banxia Xiexin Decoction combined with dual therapy.