目的 探討仁青常覺聯(lián)合泮托拉唑四聯(lián)方案治療幽門螺桿菌（Hp）陽性慢性萎縮性胃炎的臨床療效。方法 選取2022年5月—2025年4月平頂山市第一人民醫(yī)院消化內(nèi)科收治的82例Hp陽性慢性萎縮性胃炎患者，按照隨機數(shù)字法分為對照組41例和治療組41例。對照組患者給予泮托拉唑標(biāo)準(zhǔn)四聯(lián)療法，泮托拉唑鈉腸溶片40 mg/次，早晚餐前30 min口服，每日2次；阿莫西林膠囊1 g/次，早晚餐前30 min口服，每日2次；克拉霉素片0.5 g/次，枸櫞酸鉍鉀片0.22 g/次，早晚餐后30 min口服，每日2次。在對照組的基礎(chǔ)上，治療組口服仁青常覺，1 g/次，每隔3天服用1次。兩組用藥2周。觀察兩組的臨床療效，比較兩組治療前后中醫(yī)癥狀積分、胃黏膜病理積分、血清炎性因子和胃腸激素水平。結(jié)果 治療后，治療組患者總有效率高于對照組（P＜0.05）。治療后，兩組胃痛痞滿積分、胃熱嘈雜積分、口干口苦積分、噯氣反酸積分均顯著降低（P＜0.05）；治療后，與對照組對比，治療組胃痛痞滿積分、胃熱嘈雜積分、口干口苦積分、噯氣反酸積分均更低（P＜0.05）。治療后，兩組胃泌素17（G-17）、胃蛋白酶原Ⅰ（PGⅠ）水平顯著升高，而胃蛋白酶原Ⅱ（PGⅡ）水平降低（P＜0.05）；治療后，與對照組對比，治療組患者G-17、PGⅠ水平均更高，PGⅡ水平更低（P＜0.05）。治療后，兩組患者胃黏膜萎縮評分、不典型增生評分、胃黏膜炎癥評分、腸上皮化生評分顯著降低（P＜0.05）；治療后，與對照組對比，治療組胃黏膜萎縮評分、不典型增生評分、胃黏膜炎癥評分、腸上皮化生評分均更低（P＜0.05）。治療后，兩組單核細(xì)胞趨化因子-1（MCP-1）、白細(xì)胞介素-1β（IL-1β）水平顯著降低，而胃促生長素（Ghrelin）、表皮生長因子（EGF）水平升高（P＜0.05）；治療后，與對照組對比，治療組MCP-1、IL-1β水平更低，且Ghrelin、EGF水平均更高（P＜0.05）。結(jié)論 仁青常覺聯(lián)合四聯(lián)療法治療Hp陽性慢性萎縮性胃炎效果良好，可較好地改善患者臨床癥狀，降低胃黏膜嚴(yán)重程度，調(diào)節(jié)血清炎性因子和胃腸激素水平。

Objective To explore the clinical effect of Renqing Changjue combined with quadruple therapy in treatment of Hp-positive chronic atrophic gastritis. Methods A total of 82 patients with Hp-positive chronic atrophic gastritis admitted to the Department of Gastroenterology of Pingdingshan First People’s Hospital from May 2022 to April 2025 were selected and divided into control group of 41 cases and treatment group of 41 cases according to random number method. Patients in control group were given pantoprazole standard quadruple therapy, Pantoprazole Sodium Enteric-coated Tablets 40 mg/time, orally 30 min before breakfast and dinner, twice daily. Amoxicillin Capsules 1 g/time, taken orally 30 min before breakfast and dinner, twice daily. Clarithromycin Tablets 0.5 g/time, Bismuth Potassium Citrate Tablets 0.22 g/time, take orally 30 min after breakfast and dinner, twice daily. Based on control group, the treatment group took Renqing Changjue orally, 1 g/time, once every 3 d. Both groups were treated with medication for two weeks. The clinical efficacy of two groups was observed, and TCM symptom scores, gastric mucosa pathological scores, serum inflammatory factors and gastrointestinal hormone in two groups were compared before and after treatment. Results After treatment, the total effective rate of patients in treatment group was higher than that in control group (P < 0.05). After treatment, the scores of stomach pain and fullness, stomach heat and noise, dry and bitter mouth, and belching and acid reflux in both groups were significantly reduced (P < 0.05). After treatment, compared with control group, the scores of stomach pain and fullness, stomach heat and noise, dry and bitter mouth, and belching and acid reflux in treatment group were all lower (P < 0.05). After treatment, the levels of G-17 and PG I in both groups significantly increased, but the level of PG II decreased (P < 0.05). After treatment, compared with control group, the levels of G-17 and PGⅠ in treatment group were higher, but the level of PGⅡ was lower (P < 0.05). After treatment, the scores of gastric mucosal atrophy, atypical hyperplasia, gastric mucosal inflammation and intestinal metaplasia in both groups were significantly decreased (P < 0.05). After treatment, compared with the control group, the scores of gastric mucosal atrophy, atypical hyperplasia, gastric mucosal inflammation and intestinal metaplasia in the treatment group were all lower (P < 0.05). After treatment, the levels of MCP-1 and IL-1β in both groups decreased significantly, but the levels of Ghrelin and EGF increased (P < 0.05). After treatment, compared with control group, the levels of MCP-1 and IL-1β in treatment group were lower, but the levels of Ghrelin and EGF were higher (P < 0.05). Conclusion Renqing Changjue combined with quadruple therapy has a good effect in treatment of Hp-positive chronic atrophic gastritis, and can effectively improve the clinical symptoms of patients, reduce the severity of gastric mucosa, and regulate the levels of serum inflammatory factors and gastrointestinal hormones.

R975

河南省醫(yī)學(xué)科技攻關(guān)計劃聯(lián)合共建項目（LHGJ20230848）