湯小霞 孟仁晶 何妙芳 徐嘉輝

摘要：目的 研究益氣健脾方聯(lián)合中醫(yī)特色單元護理對兒童幽門螺旋桿菌相關性胃炎的療效作用。方法 選取廣東省第二中醫(yī)院與黃浦區(qū)永和街社區(qū)衛(wèi)生服務中心兒科門診治療的幽門螺旋桿菌相關性胃炎患兒76例，按隨機數(shù)字表法將患者分為治療組和對照組，每組各38例。對照組予奧美拉唑、阿莫西林顆粒與甲硝唑治療，治療組在對照組的基礎上給予益氣健脾方聯(lián)合中醫(yī)特色單元護理治療，2組均連續(xù)治療14 d。觀察2組患者的臨床癥狀與體征改善情況，采用中醫(yī)證候評分進行療效評價。檢測2組患兒血清白介素（IL）-6、C反應蛋白（CRP）的水平。13C呼氣試驗檢測2組患兒治療前與治療后2個月的感染水平，并隨訪2組患兒治療后2個月的癥狀復發(fā)率情況。結果 觀察組患兒總有效率為94.74%，對照組患兒總有效率為71.05%，2組總有效率比較，差異有統(tǒng)計學意義（P<0.05）。觀察組患兒胃區(qū)疼痛、腹脹不適、惡心嘔吐癥狀評分均低于對照組，差異有統(tǒng)計學意義（P<0.05）。觀察組患者治療后血清IL-6濃度水平明顯低于對照組，差異有統(tǒng)計學意義（P<0.05）。觀察組患者治療后血清CRP濃度水平明顯低于對照組，差異有統(tǒng)計學意義（P<0.05）。隨訪3個月，觀察組患兒Hp轉陰率明顯高于對照組（89.47% vs 65.79%），差異有統(tǒng)計學意義（P<0.05）。此外，觀察組患兒復發(fā)率明顯低于對照組（5.26% vs 23.68%），差異有統(tǒng)計學意義（P<0.05）。結論 益氣健脾方聯(lián)合中醫(yī)特色單元護理能夠顯著改善Hp相關性胃炎患兒的臨床癥狀，縮短病程，其作用可能與減少IL-6與CRP的分泌有關。

關鍵詞：益氣健脾方;中醫(yī)特色單元護理;幽門螺旋桿菌;胃炎

中圖分類號：R573.3 文獻標志碼：B 文章編號：1007-2349（2018）07-0029-04

Effect of Qi Supplement and Spleen Reinforcement Decoction Combined with Traditional Chinese

Medicine Nursing Unit on Children with Helicobacter Pylori Associated Gastritis

TANG Xiao-xia MENG Ren-jing HE Miao-fang XU Jia-hui3

（1.The Community Health Service Center of Yonghe Street of Huangpu District of Guangzhou City，Guangzhou 510000，China;

2. The Community Health Service Center of Xiagang Street of Huangpu District of Guangzhou City，Guangzhou 510000，China;

3. The Second Hospital of Traditional Medicine of Guangzhou Province，Guangzhou 510000，China）

【Abstract】To study the therapeutic effect of Qi Supplement and Spleen Reinforcement Decoction combined with traditional Chinese medicine（TCM）nursing unit on children with helicobacter pylori（HP）associated gastritis. Methods：76 pediatric outpatients with Helicobacter Pylori associated gastritis were included from the Second Hospital of Guangdong Province and the Community Health Service Center in Yonghe Street of Huangpu District. The patients were averagely divided into the treatment group（n=38）and the control group（n=38）according to random number table method. The control group was given with omeprazole，amoxicillin and metronidazole. And the treatment group was administered Qi Supplement and Spleen Reinforcement Decoction combined with traditional Chinese medicine nursing unit on the basis of the control group. Both of groups were treated for 14 consecutive days. The improvement of clinical symptoms and signs in the two groups were observed，and TCM syndrome scores system was used to evaluate the efficacy. In addition，interleukin（IL）-6 and C-reactive protein（CRP）levels in serum were measured. The 13C breath test was also used to test infection status before and after the treatment（2 months later）and the patients were followed up for their recurrence rate in 2 months. Results：The total effective rate was 94.74% in the treatment group and 71.05% in the control group with significant difference（P<0.05）. The scores of gastric pain，abdominal distension，nausea and vomiting in the treatment group were lower than those in the control group with significant difference（P<0.05）. The serum IL-6 and CRP level in the treatment group were significantly lower than that in the control group with significant difference（P<0.05）. After 3 months of follow-up，the negative conversion rate of HP in the treatment group was significantly higher than that in the control group（89.47% vs 65.79%，P<0.05）. In addition，the recurrence rate in the treatment group was significantly lower than that in the control group（5.26% vs 23.68% P<0.05）. Conclusion：The combination of Qi Supplement and Spleen Reinforcement Decoction and TCM nursing unit can significantly improve the clinical symptoms and shorten the duration of the disease in children with HP-associated gastritis，possibly related to the decrease of IL-6 and CRP secretion.