| ObjectiveTo explore the relationship betweenthe eradication of Helicobacter pylori(Helicobacter pylori,Hp)and traditional chinese medicine(TCM)syndromes and to analyze the related factors affecting the eradication of Hp.Methodwe designed a questionnaire about Hp eradication rate,TCM syndrome information and related factors to collect four TCM diagnostic data for patients with helicobacter pylori associated gastritis,and used epidemiological and statistical methods to stratify and cross-sectionally register TCM syndromes,and followed up the results of the review.From helicobacter pylori associated gastritis(chronic gastritis,peptic ulcer and reflux esophagitis;etc.),TCM syndromes,cold and heat deficiency syndrome,endoscopic mucosal performance,treatment frequency,course of treatment,treatment compliance and other aspects to analyze,in order to summarize the factors that affect the eradication rate of Hp.Results1 Clinical dataA total of 311 patients were enrolled.Among them,9 patients were lost due to reservation of vacant telephone number or fake call,and7 were cases not reviewed,so they were removed from the the study.295 were followed up,therefore excluding cases accounted for 5%of the total.155 cases were completed gastroscopy before treatment and 91 cases were endoscopy histopathological examination.2 Analysis of factors influencing the eradication of Hp2.1 General condition:There was no significant correlation between Hp eradication and sex,age,smoking,drinking,family Hp infection(P>0.05).2.2 TCM syndrome differentiation:Hp eradication in the distribution of syndromes was:spleen-stomach damp-heat syndrome(8 5.1%)>stagnated heat in liver and stomach syndrome(80.6%)>liver depression and qi stagnation(79.6%)>stomach collaterals stasis syndrome(65.2%)>deficiency cold of spleen and stomach syndrome(62.1%)>insufficiency of stomach-Yin syndrome(42.9%),and the difference was statistically significant(P=0.015).It shows that the eradication of Hp is different in the distribution of TCM syndromes.Among them,there was no difference between the groups of liver depression and qi stagnation,stagnated heat in liver and stomach syndrome,spleen-stomach damp-heat syndrome(P>0.05).Liver depression and qi stagnation is better than deficiency cold of spleen and stomach syndrome,insufficiency of stomach-Yin syndrome(P<0.05).The spleen-stomach damp-heat syndrome was better than the stomach collaterals stasis syndrome,deficiency cold of spleen and stomach syndrome,insufficiency of stomach-Yin syndrome(P<0.05).There was no significant difference between insufficiency of stomach-Yin syndrome and deficiency cold of spleen and stomach syndrome(P>0.05).2.3 Cold or heat syndrome:According to the syndrome of cold and heat,Hp eradication were as follows:heat syndrome(83.2%)>cold-heat complex syndrome(74.2%)>cold syndrome(62.9%).It shows that there were significant differences between cold and heat syndrome(Pearson?2=7.408,P=0.025).Two pairs of chi-square test showed that the heat syndrome of eradication rate was significantly higher than that of the cold syndrome(Pearson?2=7.173,P=0.007<P= 0.016).However,there was no significant difference between cold-heat complex syndrome and cold syndrome(Pearson?2=0.974,P=0.324),and heat syndrome(Pearson?2=1.397,P=0.237).2.4 Excess and deficiency syndromes:According to the syndrome of excess and deficiency syndromes,Hp eradication were as follows:excess syndrome(88.7%)>the excessive and the deficiency syndrome(70.4%)>the deficiency syndrome(55.0%).The difference was statistically significant(P=0.000).It sgggested that the eradication of Hp was different in the excess and deficiency syndrome.Among them,the eradication rate of excess syndrome was significantly higher than the deficiency syndrome(P=0.000),and group insufficiency and excess syndrome(P=0.000),while there was no significant difference between the deficiency syndrome and the excessive and the deficiency syndrome(P>0.05).2.5 Therapeutic regimen:The eradication rate of Hp is related to thetherapeutic regimen.In the commonly used treatment methods,the trend of Hp eradication rate werequadruple therapy(79.8%)>triple therapy(55.6%),triple combined Chinese patent medicine(81.8%)>triple therapy(55.6%),quadruple therapy(79.8%)>quadruple plus Chinese patent medicine(71.4%),which were no significant difference(P>0.05).In the quadruple regimen,furazolidone-containing regimen and amoxicillin-containing regimen showed a trend of better eradication rate,while clarithromycin-containing regimen had lower eradication rate tendency.There were no significant difference(P>0.05).In the first treatment,the eradication rates of the quadruple therapy were different,the specific eradication situation were as follows:furazolidone-containing quadruple(100%)>amoxicillin and tinidazole quadruple(85.7%)>amoxicillin and clarithromycin quadruple(84.3%)>Amoxicillin and levofloxacin quadruple(78.9%)>Clarithromycin and cefuroxime axetil tablets quadruple(70%)>Clarithromycin and tinidazole quadruple(69.2%),however it were not statistically different(P>0.05).In the retreatment,the eradication rate of furazolidone quadruplex was 84.0%,which was significantly higher than that of the other quadruple furazolidone(P=0.023).2.6 Treatment times:The primary eradication was successful in 199 cases(83%),the second eradication in 21 cases(9.2%),the third eradication in 7 cases(3.1%),and the fourth eradication in 19 cases(4.8%).The specific eradication rate were:the first time(81.5%)>the third time(70.0%)>the second time(63.6%)>the fourth time and above(57.9%),the difference was statistically significant(likelihood ratio=9.442,P =0.024).233 cases successed in the primary treatment,and 62 cases failed course of first-line therapy.The initial treatment of eradication rate was 81.5%,which is higher than the retreatment eradication rate of 62.9%.The difference was significant(P=:0.002).While the treatment of the second time,the third time,the fourth time and above were no difference(P>0.05).2.7 Course of treatment:Hp eradication rate in course of treatment was 12 days(90.9%)>10 days(82.6%)>14 days(78.3%),but no significant difference was found by chi-square test(P>0.05).2.8 Treatment compliance:A total of 288 patients(97.6%)took the prescribed full course of medication,while 7 patients(2.4%)took less than one course of medication.One patient discontinued taking medication and 6 patients discontinued treatment.The overall compliance of the patients was better.Hp eradication rate in patients who have completed the course of treatment(79.2%)was significantly higher than that of the insufficient course of treatment or intermittent medication(14.3%)(P=0.000).This indicates that there was a significant correlation between treatment adherence and eradication rate.2.9 The gastric mucosa performance under gastroscopy:There was no correlation between Hp eradication rate and reflux esophagitis,and reflux esophagitis A or B level,and pepticulce,and Barrett's esophagus,and gastric mucosa which has erythema,congestion and edema,erosion,white,bile reflux,polyps.But it positively correlated with hiatus hernia.2.10 Gastroscopy pathological examination:There was no significant correlation between Hp eradication and gastric mucosal active inflammation,chronic inflammation and inflammation grade.There was no significant correlation between Hp eradication and gastric mucosal atrophy,intestinal metaplasia and dysplasia(P>0.05).ConclusionHp eradication in the distribution of TCM syndromes had significant differences,the eradication effect of spleen-stomach damp-heat syndrome,stagnated heat in liver and stomach syndrome and liver depression and qi stagnation were significant.Deficiency cold of spleen and stomach syndrome and insufficiency of stomach-Yin syndrome were more common in the deficiency treatment of Hp eradication.Heat syndrome is easier to eradicate than cold syndrome,and excess syndrome is easier to eradicate than deficiency syndrome.The primary treatment of Hp eradication rate was significantly higher than the retreatment. |
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