| Objective:Meta-analysis revealed the relationship between Helicobacter pylori and TCM syndromes,and the treatment scheme of Helicobacter pylori-related gastritis of damp-heat type in spleen and stomach.Through a randomized controlled trial,we observed the changes of TCM syndrome score,symptom improvement,eradication rate and recurrence rate of patients with chronic gastritis associated with Helicobacter pylori of damp-heat type in spleen and stomach treated by Lianpuyin combined with quadruple therapy,and evaluated the effectiveness and safety of Lianpuyin combined with quadruple therapy in treating chronic gastritis associated with Helicobacter pylori of damp-heat type in spleen and stomach,and provided theoretical basis for TCM treatment of Helicobacter pylori.Methods:Firstly,this study found the relationship between Helicobacter pylori infection and TCM syndrome types through Meta-analysis,and found that the syndrome type with the highest proportion was spleen-stomach damp-heat type;Meta-analysis was used to study the treatment scheme of Helicobacter pylori infection with damp-heat in spleen and stomach.Finally,a randomized controlled trial was conducted from June 2020 to December 2021,and80 patients with chronic gastritis associated with Helicobacter pylori of damp-heat type in the spleen and stomach were treated in the outpatient department or ward of the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine.The control group was treated with oral quadruple therapy,while the experimental group was treated with oral Lianpuyin combined with quadruple therapy.The two groups were treated for 14 days,and the long-term curative effect was observed after 4 weeks and 3 months of drug withdrawal.Through objective data,the long-term curative effect was observed.Results:(1)Meta-analysis of the correlation between Hp infection and TCM syndromes shows that damp-heat type of spleen and stomach is the most common syndrome type of Helicobacter pylori,and Hp gastritis is the most common among digestive diseases related to Helicobacter pylori.(2)Meta-analysis of therapeutic schemes of Hp gastritis with damp-heat in spleen and stomach shows that the curative effect of traditional Chinese medicine combined with triple or quadruple therapy is better than that of the corresponding triple or quadruple therapy,and the traditional Chinese medicine treatment focuses on strengthening spleen and invigorating qi,clearing heat and eliminating dampness,with definite curative effect.Commonly used single traditional Chinese medicines,such as Coptis chinensis,Magnolia officinalis,Atractylodes macrocephala,Pinellia ternata,Honeysuckle,Scutellaria baicalensis Georgi,Poria cocos,Pericarpium Citri Tangerinae,Codonopsis pilosula,Fructus Aurantii and Glycyrrhrizae Radix,are frequently used.(3)80 cases were included in this clinical trial.During the study period,1 case in the control group was excluded because the patient stopped taking the medicine by himself,and 1case in the experimental group was excluded because the patient did not take the medicine according to the prescribed course of treatment.Finally,78 cases were included in the statistical analysis,39 cases in the control group and 39 cases in the experimental group.After statistical examination,there was no statistical difference in age,gender and TCM symptom scores before cure between the two groups(P>0.05),which was similar.(4)TCM curative effect: After treatment,the total effective rate of both groups was100%;Clinical cure rate: 25.6% in the experimental group was higher than 5.1% in the control group;Remarkable efficiency: 66.7% in the experimental group was higher than41.0% in the control group.The curative effect of the experimental group was much better than that of the control group(P<0.05).(5)TCM symptom scores after withdrawal:(1)Total scores: After treatment,the total scores of both groups were lower than before(P < 0.5);Compared with the control group,the treatment effect of the experimental group was better than that of the control group(P<0.05).(2)Single symptom score: the experimental group was better than the control group in improving fullness,xerostomia,thirst and anorexia(P < 0.05);However,the curative effect in improving epigastric pain,bitter taste,nausea and vomiting,and yellow urine is equivalent to that of the control group(P>0.05).(6)After 4 weeks of withdrawal,TCM symptom scores:(1)Total scores: After treatment,the total scores of both groups were lower than before(P < 0.5);Compared with the control group,the treatment effect of the experimental group was better than that of the control group(P<0.05).(2)Single symptom score: the experimental group was better than the control group in improving fullness,xerostomia,thirst and anorexia(P < 0.05);However,the curative effect in improving epigastric pain,bitter taste,nausea and vomiting,and yellow urine is equivalent to that of the control group(P>0.05).(7)After 3 months of withdrawal,TCM symptom scores:(1)Total scores: After treatment,the total scores of both groups were lower than before(P < 0.5);Compared with the control group,the treatment effect of the experimental group was better than that of the control group(P<0.05).(2)Single symptom score: the experimental group was better than the control group in improving fullness,xerostomia,thirst and anorexia(P < 0.05);However,the curative effect in improving epigastric pain,bitter taste,nausea and vomiting,and yellow urine is equivalent to that of the control group(P>0.05).(8)Eradication rate: After treatment,the eradication rates of experimental group and control group were 89.7% and 87.2% respectively(P>0.05).(9)Recurrence rate: After treatment,the recurrence rates of the experimental group and the control group were 11.4% and 20.6% respectively(P>0.05).(10)Safety: No adverse reactions occurred in the patients in the experimental group.In the control group,3 patients suffered from epigastric pain worse than before,and 2 patients suffered from nausea and vomiting.The difference was not statistically significant(P>0.05),indicating that both groups of drugs have certain safety in treating this disease.Conclusion:(1)Among the TCM syndromes of Helicobacter pylori infection,damp-heat type of spleen and stomach accounts for the highest proportion,and Hp gastritis is the most common among digestive diseases related to Helicobacter pylori.(2)Traditional Chinese medicine treatment of Helicobacter pylori infection with damp-heat in spleen and stomach mainly focuses on invigorating spleen and qi,clearing away heat and eliminating dampness.The experimental scheme mostly adopts traditional Chinese medicine combined with triple or quadruple therapy,and the curative effect is definite.Among the commonly used traditional Chinese medicines,coptis chinensis,magnolia officinalis,atractylodes macrocephala,Pinellia ternata,honeysuckle,scutellaria baicalensis,poria cocos,dried tangerine peel,codonopsis pilosula,bitter orange and liquorice have a high usage rate.(3)Lianpuyin combined with quadruple therapy can obviously improve clinical symptoms,clinical curative effect and patient compliance,especially for fullness,dry mouth,thirst and anorexia.It can increase the eradication rate,reduce the recurrence rate,and has good safety. |
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