| Purposes:1.To observe the clinical efficacy of self-made chuyou formula combined with" Standard quadruple therapy" in the treatment of drug-resistant Helicobacter pylori gastritis(Hp),and the efficacy of self-made Chinese herbal formula in the eradication of drug-resistant Helicobacter pylori.In addition,this study aims to validate the advantages of the integrated Chinese and western regimens in eradicating drug-resistant Helicobacter pylori compared with the single western regimen,and the effective therapeutic regimens for HP.2.To explore the protective effect and mechanism of Chuyou Formula on mice gastritis model induced by Helicobacter pylori(H.pylori).Methods:1.Clinical study:78 patients with drug-resistant Helicobacter pylori infection who had been diagnosed as positive in our outpatient department from March 20 to March 22 and who had received the failed treatment of Western medicine quadruplex eradication were selected.According to the principle of random allocation,78 patients were divided into the control group and the observation group,with 39 cases in each group.The control group was given 1.0 g amoxicillin dispersible tablets twice a day,20 mg rabeprazole enteric coated tablets twice a day,2.0 g bismuth potassium citrate granules twice a day,and 0.5 g levofloxacin tablets once a day.On this basis,the observation group was also given self-made decoction of traditional Chinese medicine,100 mL in the morning and 100 mL in the evening,twice a day for oral treatment for 2 weeks.After 45 days,the eradication rate,adverse reaction rate and improvement rate of clinical symptoms of the two schemes were calculated and evaluated.2.Basic research:establishment of mouse H Pylori gastritis model was divided into blank control group,model group and Chuyou Formula intervention group.The degree of inflammation was judged by pathological section of gastric tissue,and H Determination of Pylori Urease A DNA Expression to Determine the Effect of Chuyou Formula on H The influence of the colonization of the Pylori.Finally,the expression of HMGB1,TLR4,Myd88 mRNA in mice was detected and analyzed by real-time fluorescent PCR.Results:1.Clinical research:(1)Comparison of Hp eradication rate:13C was rechecked one month after the withdrawal of western medicine.The results showed that 28 cases in the control group turned negative and 11 cases were positive.The Hp eradication rate was about 71.8%.In the observation group,36 cases turned negative and 3 cases were positive.The eradication rate of Hp was about 92.3%.Statistics showed that there was a significant difference in the eradication rate between the two groups(P<0.01).(2)Comparison of symptomatic effect after treatment:in the control group,15 patients were cured,17 patients showed therapeutic effect,7 patients had no significant therapeutic effect,and the total effective rate was about 82.1%;In the observation group,18 cases were cured,19 cases showed therapeutic effect,2 cases were ineffective,and the total effective rate was about 94.9%.The statistical results showed that the total effective rate of the observation group was significantly higher than that of the control group,and there was a significant difference between the two groups(P<0.01).Comparison of symptom scores before treatment:There was no significant difference between the two groups in symptom scores before treatment(P>0.05),which was comparable.(3)Comparison of adverse reaction rate:during the treatment period,there were 7 patients in the control group and 2 patients in the observation group with mild symptoms such as abdominal distension,diarrhea,gastrointestinal dysfunction and increased number of stool.Diarrhea was a common clinical reaction,which did not require special treatment.It disappeared spontaneously during the medication period or after the end of the course of treatment,and did not affect the treatment.The incidence of adverse reactions was 17.9%in the control group and 5.1%in the observation group.The incidence of adverse reactions in the two groups was statistically significant(P<0.05).2.Basic research:Hp can increase the mRNA expression of HMGB1,TLR4 and My88.However,Chuyou Recipe can inhibit the increase of the above gene expression caused by Hpi.This suggests that the TLR4 signaling pathway can be affected by the addition of Chuyou Recipe.Conclusion:1.Clinical research:This study uses the self-made Chuyou Formula combined with the standard quadruple therapy to treat drug resistant chronic gastritis,which has reliable efficacy,high eradication rate,less adverse reactions,and high safety.It is an ideal method for treating drug resistant chronic gastritis,and is worthy of clinical promotion and application.2.Basic research:Chuyou Recipe can reduce H.Pylori infection causes gastric inflammation and inhibits H H The increase of expression of pylori Urease A DNA,TLR4 mRNA and Myd88 mRNA promoted the expression of HMGB1 mRNA. |
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