目的 探討清胃止痛微丸聯(lián)合二聯(lián)療法治療伴有幽門螺桿菌（Hp）感染的消化性潰瘍的臨床療效。方法 納入2024年2～6月就診于新鄉(xiāng)醫(yī)學(xué)院第三附屬醫(yī)院的合并Hp感染的消化性潰瘍患者150例，隨機(jī)分為對(duì)照組和治療組，每組各75例。對(duì)照組口服富馬酸伏諾拉生片，1片/次，2次/d，同時(shí)口服阿莫西林膠囊，4粒/次，3次/d。治療組在對(duì)照組的基礎(chǔ)上口服清胃止痛微丸，1袋/次，3次/d。兩組患者均治療14 d。觀察兩組患者臨床療效，比較治療前后兩組患者臨床癥狀積分及腹痛、反酸緩解至少50%所需時(shí)間，Hp清除率，胃泌素-17、胃蛋白酶原Ⅰ（PGⅠ）和胃蛋白酶原ⅠⅠ（PGⅠⅠ）水平，及炎癥因子白細(xì)胞介素-6（IL-6）、白細(xì)胞介素-17（IL-17）和腫瘤壞死因子-α（TNF-α）水平。結(jié)果 治療后，對(duì)照組總有效率為84.00%，顯著低于治療組總有效率94.67%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P＜0.05）。治療后，兩組臨床癥狀積分均顯著降低（P＜0.05），且治療組臨床癥狀積分顯著低于對(duì)照組（P＜0.05）。治療后，治療組腹痛及反酸癥狀緩解至少50%所需時(shí)間均顯著低于對(duì)照組（P＜0.05）。治療后，對(duì)照組Hp清除率為81.33%，顯著低于治療組Hp清除率93.34%（P＜0.05）。治療后，兩組兩組胃泌素-17、PGⅠ、PGⅠⅠ、IL-6、IL-17和TNF-α水平均顯著降低（P＜0.05），且治療組這些因子水平均顯著低于對(duì)照組（P＜0.05）。結(jié)論 清胃止痛微丸聯(lián)合二聯(lián)療法治療伴有Hp感染的消化性潰瘍患者療效顯著、安全性高，能快速改善患者臨床癥狀，主要與改善消化道黏膜屏障功能及降低機(jī)體的炎癥狀態(tài)有關(guān)。

Objective To investigate the clinical efficacy of Qingwei Zhitong Micro-Pills combined with dual therapy in treatment of peptic ulcer associated with Helicobacter pylori (Hp). Methods Patients (150 cases) with peptic ulcer associated with Hp in the Third Affiliated Hospital of Xinxiang Medical University from February 2024 to June 2024 were randomly divided into control and treatment group, and each group had 75 cases. Patients in the control group were po administered with Vonoprazan Fumarate Tablets, 1 tablet/time, twice daily, and they were administered with Amoxicillin Capsules at the same time, 4 grains/time, three times daily. Patients in the treatment group were po administered with Qingwei Zhitong Micro-Pills on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical evaluations were evaluated, and the clinical symptom scores and the time required for at least 50% remission of abdominal pain and acid reflux, Hp clearance rate, the levels of gastrin-17, PGⅠ and PGⅠⅠ, IL-6, IL-17 and TNF-α in two groups before and after treatment were compared. Results After treatment, the total effective rate in the control group was 84.00%, which was significantly lower than that in the treatment group (94.67%), the difference between two groups was statistically significant (P < 0.05). After treatment, the clinical symptom scores in two groups were significantly reduced (P < 0.05), and the clinical symptom scores in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the time required for abdominal pain and acid reflux symptoms to be relieved by at least 50% in the treatment group was significantly lower than that in the control group (P < 0.05). After treatment, the Hp clearance rate in the control group was 81.33%, which was significantly lower than that in the treatment group (93.34%, P < 0.05). After treatment, the levels of gastrin-17, PGⅠ, PGⅠⅠ, IL-6, IL-17 and TNF-α were significantly reduced in two groups (P < 0.05), and the levels of these factors in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusions Qingwei Zhitong Micro-Pills combined with dual therapy has a significant clinical efficacy in treatment of peptic ulcer associated with Hp infection, and can rapidly improve the clinical symptoms, which is mainly related to improving the function of digestive mucosa and reducing the inflammatory state.

R975

河南省中醫(yī)藥科學(xué)研究專題項(xiàng)目（2024ZY3088）；河南省醫(yī)學(xué)教育研究項(xiàng)目（Wjlx2022102）；中醫(yī)藥傳承與創(chuàng)新人才（210999904）