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目的观察半夏泻心汤结合西药三联抗Hp方案治疗幽门螺旋杆菌(Hp)阳性胃癌前病变患者的临床疗效及对胃癌患病率的影响和作用机制。方法选取医院消化科就诊的胃癌前病变患者148例,随机分为观察组和对照组,每组74例。对照组使用三联疗法抗Hp方案治疗,观察组加以半夏泻心汤加减口服治疗。分别对2组患者治疗前后血清G-17及血清硫氧还蛋白-1(TRX-1)水平进行检测,分析2组治疗有效率,使用自主研发的胃癌前病变前瞻性自动监测随访软件对2组患者进行随访,观测其胃癌发病率并进行分析。结果观察组治疗总有效率为89.19%,高于对照组的79.73%(P<0.05);2组血清G-17、TRX-1水平较治疗前均降低,且观察组优于对照组(P<0.05)。使用胃癌癌前病变随访软件对2组进行监控,观察组的在随访期间一、二级预警人数少于对照组,而三、四级预警人数多于对照组(P<0.05)。观察组再感染Hp率为6.76%,胃癌发病率为2.70%;对照组再感染Hp率为17.57%,胃癌发病率为6.76%,观察组优于对照组(P<0.05)。结论半夏泻心汤结合三联疗法治疗Hp阳性胃癌前病变患者,可有效改善患者的临床症状,降低Hp再感染率,有助于Hp的进一步根治,降低胃癌发病风险,值得推广借鉴。
Objective To observe the clinical efficacy of Banxiaxiexin Decoction combined with western medicine triple anti-Hp regimen in the treatment of patients with Helicobacter pylori (Hp) -positive gastric precancerous lesions and its effect on gastric cancer prevalence and its mechanism. Methods A total of 148 patients with gastric precancerous lesions who visited the Department of Gastroenterology were randomly divided into observation group and control group with 74 cases in each group. The control group treated with anti-Hp triple therapy, the observation group to Banxiaxiexin Decoction oral treatment. The levels of serum G-17 and serum thioredoxin-1 (TRX-1) in two groups of patients before and after treatment were measured respectively. The therapeutic efficiency of the two groups was analyzed. Using prospective automatic monitoring and follow-up software for gastric precancerous lesions independently developed 2 Patients were followed up to observe the incidence of gastric cancer and analyzed. Results The total effective rate of observation group was 89.19%, which was higher than that of control group (79.73%, P <0.05). The levels of serum G-17 and TRX-1 in two groups were lower than those before treatment <0.05). The two groups were monitored by using the software of gastric precancerous lesions follow-up. The number of the first and second warnings in the observation group during the follow-up period was less than that of the control group, while the third and fourth warnings were more than the control group (P <0.05). In the observation group, the reinfection rate of Hp was 6.76% and the incidence of gastric cancer was 2.70%. The re-infected Hp rate was 17.57% in the control group and 6.76% in the gastric cancer group. The observation group was superior to the control group (P <0.05). Conclusion Banxiaxiexin Decoction combined with triple therapy for Hp positive patients with gastric precancerous lesions can effectively improve the clinical symptoms and reduce the re-infection rate of Hp, contribute to the further cure of Hp, reduce the risk of gastric cancer, it is worth promoting reference.