目的 探討猴頭健胃靈片聯(lián)合四聯(lián)療法治療幽門螺旋桿菌（Hp）陽性慢性胃炎的臨床療效。方法 選取2021年6月—2024年2月復(fù)旦大學(xué)附屬浦東醫(yī)院和上海市浦東新區(qū)洋涇社區(qū)衛(wèi)生服務(wù)中心收治的160例Hp陽性慢性胃炎患者，按隨機數(shù)字表法將所有患者分為對照組和治療組，每組各80例。對照組進行四聯(lián)方案治療，（1）早晚餐前0.5 h口服雷貝拉唑鈉腸溶膠囊，20 mg/次，2次/d；（2）早晚餐前0.5 h口服膠體果膠鉍膠囊，200 mg/次，2次/d；（3）早晚餐后口服阿莫西林膠囊，1.0 g/次，2次/d；（4）早晚餐后口服克拉霉素片，0.5 g/次，2次/d。（1）用藥4周，（2）、（3）、（4）用藥2周。治療組在對照組治療基礎(chǔ)上飯后口服猴頭健胃靈片，4 片/次，3次/d，用藥4周。兩組連續(xù)治療4周。觀察兩組臨床療效、癥狀消失時間和Hp根除率。比較兩組治療前后癥狀自評量表（SCL-90）評分、36項健康調(diào)查簡表（SF-36）評分、血清胃功能三項[胃泌素-17（G-17）、胃蛋白酶原（PG）Ⅰ、PGⅡ]和炎癥指標(biāo)[白細胞介素（IL）-1β、IL-8、C反應(yīng)蛋白（CRP）]水平的變化。結(jié)果 治療后，治療組總有效率是97.50%，顯著高于對照組的88.75%（P＜0.05）。治療組上腹痛、噯氣、反酸、腹脹、惡心消失時間短于對照組（P＜0.05）；治療組Hp根除率是72.50%，顯著高于對照組的57.50%（P＜0.05）。治療后，兩組SCL-90評分都顯著降低，而SF-36評分顯著增加（P＜0.05）；治療后，治療組SCL-90、SF-36評分改善優(yōu)于對照組（P＜0.05）。治療后，兩組血清G-17水平顯著上升，血清PGⅠ、PGⅡ、CRP、IL-1β、IL-8水平都低于治療前（P＜0.05）；治療后，治療組血清胃功能三項和CRP、IL-1β、IL-8水平改善優(yōu)于對照組（P＜0.05）。結(jié)論 猴頭健胃靈片聯(lián)合四聯(lián)療法治療Hp陽性慢性胃炎患者能有效加速消化道癥狀消除，提高Hp根除率，促進炎癥反應(yīng)及胃黏膜損害減輕，患者心理健康水平和生活質(zhì)量得到較大程度改善，值得臨床推廣應(yīng)用。

Objective To investigate the therapeutic effect of Houtou Jianweiling Tablets combined with quadruple therapy in treatment of Helicobacter pylori (Hp) positive chronic gastritis. Methods A total of 160 patients with HP positive chronic gastritis admitted to Pudong Hospital of Fudan University and Shanghai Pudong New Area Yangjing Community Health Service Center from June 2021 to February 2024 were selected and divided into control group and treatment group according to random number table method, with 80 patients in each group. Patients in control group were given quadruple therapy, (1) they were po administered with Rabeprazole Sodium Enteric Capsules 0.5 h before breakfast and dinner, 20 mg/time, twice daily. (2) They were po administered with Colloidal Bismuth Pectin Capsules 0.5 h before breakfast and dinner, 200 mg/time, twice daily. (3) They were po administered with Amoxicillin Capsules after breakfast and dinner, 1.0 g/time, twice daily. (4) They were po administered with Clarithromycin Tablets after breakfast and dinner, 0.5 g/time, twice daily. (1) were administered for 4 weeks, (2), (3), (4) were administered for 2 weeks. Patients in treatment group were po administered with Houtou Jianweiling Tablets after meals on the basis of control group, 4 tablets/times, 3 times daily, for 4 weeks. Patients in two groups were treated for 4 weeks. The clinical efficacy, symptom disappearance time and Hp eradication rate of two groups were observed. The levels of Symptom Rating Scale (SCL-90), 36-item health survey Summary Form (SF-36), serum gastric function (G-17, PG Ⅰ, PGⅡ) and inflammatory indicators (IL-1β, IL-8, CRP) before and after treatment were compared between two groups. Results After treatment, the total effective rate of treatment group was 97.50%, which was significantly higher than that of control group (88.75%, P < 0.05). The disappearance time of upper abdominal pain, belching, acid reflux, abdominal distension, and nausea in treatment group was shorter than that in control group (P < 0.05). The eradication rate of Hp in treatment group was 72.50%, which was significantly higher than 57.50% in control group (P < 0.05). After treatment, SCL-90 score was significantly decreased in both groups, but SF-36 score was significantly increased (P < 0.05). After treatment, the improvement of SCL-90 and SF-36 scores in treatment group was better than that in control group (P < 0.05). After treatment, serum G-17 level was significantly increased, but serum PG-Ⅰ, PG-ⅠⅠ, CRP, IL-1β and IL-8 levels were lower than before treatment (P < 0.05). After treatment, the improvement of serum gastric function and levels of CRP, IL-1β and IL-8 in treatment group was better than that in control group (P < 0.05). Conclusion Houtou Jianweiling Tablets combined with quadruple therapy in treatment of helicobacter pylori (Hp) positive chronic gastritis can effectively accelerate the elimination of digestive tract symptoms, and can improve the eradication rate of Hp, promote inflammatory response and reduce gastric mucosal damage, and improve the mental health level and life quality to a great extent, which is worthy of clinical application.

R975

上海浦東新區(qū)衛(wèi)生健康委員會衛(wèi)生科技項目（PW2023A-48）