Hu Fu-lian
Department of Gastroenterology, First Hospital, Peking University, Beijing, China.
Zhonghua Yi Xue Za Zhi. 2010 Jan 12;90(2):75-8.
To evaluate the efficacy of Chinese patent medicine wenweishu /yangweishu in the treatment of Helicobacter pylori (H. pylori) positive patients with chronic gastritis and peptic ulcer.
A randomized, controlled and multicenter trial was conducted in 642 H. pylori positive patients with chronic gastritis or peptic ulcer. They were randomized to three groups: PCM group (n = 222, pantoprazole 40 mg twice a day, clarithromycin 500 mg twice a day, metronidazole 400 mg twice a day, for 7 days); PCM plus wenweishu group (n = 196); and PCM plus yangweishu group (n = 224). (14)C breath test was performed 4 weeks after therapy. For the patients with gastric ulcer, ulcer healing was determined by endoscopy after therapy.
Intention-to-treat H. pylori eradication rate for PCM group, PCM plus wenweishu group, and PCM plus yangweishu group were 57.2% (127/222), 62.2% (122/196), 60.3% (135/224), respectively (P = 0.295, 0.512). Per-protocol H. pylori eradication rates were 62.3% (127/204), 70.1% (122/174), 65.2% (135/207), respectively (P = 0.108, 0.532).Per-protocol analysis gastric ulcer healing rate were 61.9% (13/21) 100.0% (18/18), 86.4% (19/22) respectively. The healing rate in PCM plus wenweishu groups was statistically significantly higher than the rate in PCM group (P = 0.004). The rates of symptom relief in PCM plus wenweishu groups and PCM plus yangweishu were statistically significantly higher than the rate in PCM group (both P < 0.01). Side-effects were rare and comparable between groups.
Although PCM combined with wenweishu or yangweishu in the treatment of H. pylori positive patients with chronic gastritis and peptic ulcer can not reach a significantly higher eradication rate, it can increase the rates of both gastric ulcer healing and symptom relief.
评价中成药温胃舒/养胃舒治疗幽门螺杆菌(H. pylori)阳性慢性胃炎及消化性溃疡患者的疗效。
对642例H. pylori阳性慢性胃炎或消化性溃疡患者进行随机对照多中心试验。将他们随机分为三组:质子泵抑制剂(PCM)组(n = 222,泮托拉唑40 mg,每日2次,克拉霉素500 mg,每日2次,甲硝唑400 mg,每日2次,共7天);PCM加温胃舒组(n = 196);PCM加养胃舒组(n = 224)。治疗4周后进行¹⁴C呼气试验。对于胃溃疡患者,治疗后通过内镜检查确定溃疡愈合情况。
PCM组、PCM加温胃舒组和PCM加养胃舒组的意向性治疗H. pylori根除率分别为57.2%(127/222)、62.2%(122/196)、60.3%(135/224)(P = 0.295,0.512)。符合方案分析的H. pylori根除率分别为62.3%(127/204)、70.1%(122/174)、65.2%(135/207)(P = 0.108,0.532)。符合方案分析的胃溃疡愈合率分别为61.9%(13/21)、100.0%(18/18)、86.4%(19/22)。PCM加温胃舒组的愈合率显著高于PCM组(P = 0.004)。PCM加温胃舒组和PCM加养胃舒组的症状缓解率显著高于PCM组(均P < 0.01)。副作用少见,且组间相当。
虽然PCM联合温胃舒或养胃舒治疗H. pylori阳性慢性胃炎及消化性溃疡患者不能显著提高根除率,但可提高胃溃疡愈合率和症状缓解率。