清幽健胃汤治疗慢性萎缩性胃炎伴幽门螺杆菌感染患者的临床疗效及对其抗胃壁细胞抗体、内因子抗体、胃肠激素水平的影响OA

Objective To observe the clinical efficacy of Qingyou Jianwei Decoction(QJD)for patients with chronic atrophic gastritis(CAG)and Helicobacter pylori(Hp)infection and its effects on the levels of anti-parietal cell antibody(APCA),intrinsic factor antibody(IF-Ab),and gastrointestinal hormones.Methods A total of 120 patients with CAG and Hp infection who were treated at the Department of Gastroenterology,the Heilongjiang University of Chinese Medicine Affiliated Fourth Hospital from March 2022 to December 2023 were enrolled as research subjects.According to the random number table method,the subjects were divided into a control group,a combination group,and a Chinese medicine group,with 40 cases in each group.The control group was given conventional therapy,the Chinese medicine group was orally administered QJD,and the combination group received conventional therapy in combination with oral administration of QJD.After treatment for 14 consecutive days,the clinical efficacy,Hp eradication rate,and safety were observed and compared among the three groups.The traditional Chinese medicine(TCM)syndrome scores,improvement rate of gastric mucosal histopathology,levels of autoimmune antibodies(APCA and IF-Ab),and gastrointestinal hormones[gastrin-17(G-17),somatostatin(SS),and motilin(MTL)]were compared among the three groups before and after treatment.Results After treatment,the Hp eradication rate in the combination group was 89.47%(34/38),which was significantly higher than 70.27%(26/37)in the control group and 67.57%(25/37)in the Chinese medicine group(P<0.05).The scores of inflammatory activity,gastric mucosal atrophy,and intestinal metaplasia in the three groups were significantly lower after treatment than those before treatment(P<0.05).Moreover,the above scores in the combination group were significantly lower than those in the control group and the Chinese medicine group(P<0.05).The TCM syndrome scores in the three groups were significantly decreased after treatment(P<0.05).Additionally,the scores in the combination group were significantly lower than those in the control group and the Chinese medicine group(P<0.05),and the scores in the Chinese medicine group were significantly lower than those in the control group(P<0.05).After treatment,the positive rate of APCA and the level of IF-Ab in the three groups were significantly reduced compared with those before treatment(P<0.05),and they were significantly lower in the combination group than in the control group and the Chinese medicine group(P<0.05).After treatment,the G-17 levels in the three groups were significantly decreased,while the SS and MTL levels were significantly increased compared with those before treatment(P<0.05).The G-17 level in the combination group was significantly lower,whereas the SS and MTL levels were significantly higher than those in the control group and the Chinese medicine group(P<0.05).The total clinical efficacy rate in the combination group was 92.11%(35/38)after treatment,which was significantly higher than 75.68%(28/37)in the control group and 70.27%(26/37)in the Chinese medicine group(P<0.05).During the treatment period,there was no statistically significant difference in the incidence of adverse reactions among the three groups(P>0.05).Conclusion Through the compatibility of sovereign,minister,assistant,and guiding medicinals,QJD has a good synergistic effect with conventional quadruple therapy in treating CAG with Hp infection.It can effectively eradicate Hp,alleviate inflammation,improve gastric mucosal lesions,TCM syndromes,and immune indexes,and regulate gastrointestinal hormones with high safety and definite efficacy.