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[目的]观察以胃舒散为主的三联疗法(胃舒散、呋喃唑酮和克拉霉素)治疗幽门螺杆菌(Hp)阳性慢性萎缩性胃炎(CAG)的临床效果及其对核因子-κB(NF-κB)表达的影响。[方法]41例Hp阳性CAG患者服用胃舒散2.0g,呋喃唑酮0.1g,各3次/d,克拉霉素0.25g,2次/d,1周后再继服胃舒散4周。治疗前及治疗结束1年后行内镜及病理组织学检查,取活检观察病理组织学改变及NF-κB表达变化,采用银染色法、14C-尿素呼气试验或快速尿素酶试验检测Hp。[结果]三联疗法结束1年后,Hp根除率为85.4%;根除Hp能显著减轻患者胃窦部慢性炎症(P<0.05)和活动程度(P<0.01),下调NF-κB表达(P<0.01),但胃炎的萎缩和肠化生等病理无明显改变。[结论]以胃舒散为主的三联疗法对Hp有较高根除率。根除Hp可抑制NF-κB的表达,减轻活动性炎症,但近期观察对萎缩、肠化生等病理改变无明显作用。
[Objective] To observe the clinical effect of Weishe San-based triple therapy (Weishu powder, furazolidone and clarithromycin) on Helicobacter pylori (Hp) -positive chronic atrophic gastritis (CAG) and its effect on nuclear factor-κB NF-κB) expression. [Method] 41 patients with Hp-positive CAG were treated with Weishuosan 2.0g, Furazolidone 0.1g, each 3 times / d, clarithromycin 0.25g twice daily for 1 week and then Weiweishu for 4 weeks. Before treatment and 1 year after the end of treatment, endoscopy and histopathological examination were performed. Histopathological changes and changes of NF-κB expression were observed by biopsy. Hp was detected by silver staining, 14C-urea breath test or rapid urease test. [Results] The Hp eradication rate was 85.4% after one year of triple therapy. Eradication of Hp could significantly reduce chronic inflammation (P <0.05) and activity (P <0.01) and downregulate the expression of NF-κB in gastric antrum 0.01), but the atrophy of gastritis and intestinal metaplasia and other pathological no significant change. [Conclusion] The triple therapy with Ganshu San as the main treatment has a high Hp eradication rate. Eradication of Hp can inhibit the expression of NF-κB, reduce active inflammation, but the recent observation of atrophy, intestinal metaplasia and other pathological changes had no significant effect.