| Background:In the early 1980s,two academics in the Royal Perth Hospital in Australia definitively identified the Helicobacter pylori(Hp).It was cultured from gastric biopsy specimens from patients with gastric inflammation and peptic ulcer.Hp is closely related to various diseases of the human body,and is an independent pathogenic factor of gastric cancer.With the deepening of scientific research,the eradication scheme of Hp is gradually perfected and developed.However,in recent years,due to antibiotic resistance and other reasons,the eradication rate has decreased,and the elderly population is particularly problematic in this regard.As the infection rate of Hp tends to increase with age,the elderly population not only has a high infection rate,but also has a higher probability of antibiotic resistance and adverse reactions due to the use of antibiotics and the decline of various functions of the body.As a result,the eradication rate in the elderly population is low.Therefore,how to improve the eradication rate of the elderly under the premise of ensuring the safety of medication is an urgent problem to be solved.The instructor combined the previous clinical observations to creatively replace an antibiotic with Jinghua weikang Jiaowan to form a Jinghua weikang Jiaowan combined with a single antibiotic solution,which can not only reduce the types of antibiotics,but also improve the eradication rate on the basis of ensuring the safety of medication.Therefore,it has important research value to carry out clinical efficacy research of applying this scheme to the elderly population.Objective:By investigating the demographic data,dietary habits,personality characteristics,and the relationship between TCM syndromes and Hp infections in elderly Hp-infected populations,we can better understand the characteristics of Hp infections in the elderly and provide prevention and control of Hp infections in terms of emotion,diet conditioning,and TCM syndrome differentiation and treatment.By comparing Jinghua weikang Jiaowan combined with a single antibiotic regimen(referred to as "single antibiotic regimen")with a traditional quadruple regimen,the efficacy and safety of the former were explored to provide a safe and effective Hp eradication regimen for the elderly.Methods:A comparative study design of observational efficacy was used.The patients with Hp infection over 60 years old in the Department of Gastroenterology,Dongzhimen Hospital,Beijing University of Chinese Medicine were enrolled as the study objects,including 33 cases in the observation group and 27 cases in the control group.The observation group used the single antibiotic regimen of rabeprazole sodium enteric-coated capsules+amoxicillin dispersible tablets+Jinghua weikang Jiaowan+colloidal bismuth pectin capsules;the control group used the traditional quadruple regimen of rabeprazole sodium enteric-coated capsules+amoxicillin dispersible tablets+clarithromycin dispersible tablets+colloidal bismuth pectin capsules,the course of treatment in both groups was 2 weeks.General information,TCM syndrome types before treatment,13C urea breath test results before treatment and 4-8 weeks after treatment were collected through questionnaire survey and recorded symptom scores and adverse reactions during medication.Results:(1)The distribution of TCM syndromes in 60 elderly patients with H.pylori infection was the most common type of liver-stomach disharmony,accounting for 36.7%.followed by spleen-stomach damp-heat syndrome,accounting for 33.3%,spleen-stomach weakness syndrome,stomach-Yin deficiency syndrome,and stomach collateral stasis syndrome each accounted for 15.0%,8.3%,and 6.7%.The eradication rate of Hp infection in the two groups was in the order of the different syndrome types,with the syndrome of stomach collateral stasis syndrome and stomach-Yin deficiency syndrome being the highest,followed by the syndrome of liver-stomach disharmony and spleen-stomach weakness,the eradication rate of spleen-stomach damp-heat syndrome was the lowest.The observation group was generally higher than the control group.(2)After 2 weeks of eradication of 60 elderly patients with H.pylori infection,the eradication rate in the observation group was 84.85%,and the eradication rate in the control group was 81.48%.(3)The symptoms of elderly patients with Hp infection were significantly improved in the two groups,but the observation group was significantly better than the control group.The difference between the two groups was statistically significant(P<0.05).(4)The Hp eradication rate of Jinghua weikang Jiaowan combined with a single antibiotic regimen was not significantly associated with age,gender,marriage,height,weight,smoking,alcohol consumption,education level,tableware,dining out and TCM syndrome type,etc.(P>0.05).(5)A total of 4 cases in the two groups showed adverse reactions during the treatment period,including 3 cases in the control group and 1 cases in the observation group,showing that the safety of the observation group is better than that of the control group.Conclusion:Jinghua weikang Jiaowan combined with a single antibiotic regimen can not only improve the eradication rate of elderly patients with Hp infection,but also effectively improve clinical symptoms and improve compliance of elderly patients with Hp infection.It is safer than standard quadruple therapy and is worthy of in-depth research and promotion. |
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