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目的探讨三联方案联合温胃舒胶囊对幽门螺杆菌(Hp)阳性胃溃疡患者血清胃蛋白酶原(PG)及组织三叶因子1(TFF1)水平的影响。方法选取2012年1月至2014年6月于重庆北部新区第一人民医院接受治疗的128例Hp阳性并经胃镜确诊为胃溃疡的患者,根据随机数字表法将患者分为对照组和观察组,每组64例。对照组采用三联疗法(阿莫西林+埃索美拉唑+替硝唑)治疗,观察组在三联疗法基础上联用温胃舒胶囊治疗,两组疗程均为4周。治疗前后采用胃镜观察两组胃溃疡情况,采用ELISA法测定血清PG水平,采用蛋白印迹法测定胃黏膜组织中TFF1蛋白表达水平。结果观察组总有效率为96.88%,复发率为3.12%,对照组总有效率为78.12%,复发率为15.62%,两组间差异具有统计学意义(P<0.05)。观察组和对照组Hp转阴率分别为93.75%和75.00%,两组间差异无统计学意义(P>0.05)。观察组治疗后胃窦及胃体溃疡直径显著小于对照组(P<0.05)。此外,观察组治疗后胃黏膜组织中TFF1蛋白表达水平(P<0.05)及血清PG水平(P<0.01)显著低于对照组。结论三联方案联合温胃舒胶囊可有效改善Hp阳性胃溃疡患者的治疗效果,降低复发率,这可能与温胃舒胶囊能下调PG及TFF1表达水平有关。
Objective To investigate the effects of triple therapy with Wen Weishu capsule on serum pepsinogen (PG) and tissue factor of trefoil 1 (TFF1) in patients with Helicobacter pylori (Hp) positive gastric ulcer. Methods From January 2012 to June 2014, 128 Hp-positive patients diagnosed as gastric ulcer by Gastroscope were enrolled in the First People’s Hospital of North Chongqing New District from January 2012 to June 2014. Patients were divided into control group and observation group according to random number table method , 64 cases in each group. The control group was treated with triple therapy (amoxicillin + esomeprazole + tinidazole). The observation group was treated with Wen Weishu capsule on the basis of triple therapy, and the two courses of treatment were 4 weeks. Gastroscopy was used to observe the gastric ulcer in both groups before and after treatment. Serum PG level was measured by ELISA. The expression of TFF1 protein in gastric mucosa was detected by Western blotting. Results The total effective rate was 96.88% in the observation group, the recurrence rate was 3.12%. The total effective rate in the control group was 78.12% and the recurrence rate was 15.62%. The difference between the two groups was statistically significant (P <0.05). The negative conversion rates of Hp in the observation group and the control group were 93.75% and 75.00% respectively, with no significant difference between the two groups (P> 0.05). The diameters of gastric antrum and gastric ulcer in the observation group were significantly less than those in the control group (P <0.05). In addition, the expression of TFF1 protein in gastric mucosa (P <0.05) and serum PG level (P <0.01) in observation group were significantly lower than those in control group. Conclusion The triple combination of Wen Weishu capsule can effectively improve the therapeutic effect of Hp-positive gastric ulcer patients and reduce the recurrence rate, which may be related to the Wen Weishu capsule can down-regulate the expression of PG and TFF1.