中西医结合治疗消化性溃疡并H.yilori感染的效果分析

目的：研究消化性溃疡并幽门螺杆菌(H3pylori )感染初治失败患者血浆网膜素-1 (Omentin-1)水平的变化及中西医结合干预治疗的效果。方法：选择2011 年9 月～2015 年9 月在我院进行诊治的消化性溃疡患者82 例观察组，采用阿莫西林，奥美拉唑、拉霉素和清幽口服液等中西医结合治疗，并选择20 例健康体检者为对照组。采用ELISA 法检测血浆Omentin-1 水平，分析血浆Omentin-1 水平与一氧化氮（NO）、白细胞介素-2（IL-2）、内皮素-1(ET-1)、肿瘤坏死因子alpha（TNF-alpha）的关系。观察中西医结合治疗前后病例组血浆Omentin-1 水平的变化并评价根除的疗效及安全性。结果：进行中西医结合治疗后， H.pylori根除率达88.6%；有34 例溃疡痊愈，22 例显效，33 例有效，3 例无效，愈合率为68.29% (56 /82)，有效率为96.34% (79/82)；观察组血浆Omentin-1 水平为(18.15 ± 3.96) ng/mL，明显低于对照组的(23.12 ± 6.03) ng /mL(P<0.05)；与对照组相比，观察组的NO、IL-2 水平明显降低(P<0.05)，ET-1，TNF-alpha和IL-6 水平明显升高(P<0.05)；与治疗前相比，经中西医结合治疗后NO、IL-2 水平明显降低(P<0.05)，ET-1，TNF-琢和IL-6 水平明显升高(P<0.05)；观察组血浆Omentin-1 与IL-2、NO 呈明显正相关( r = 0.412，P<0.05 和r =0.382，P<0.05)，与IL-6 和TNF-琢呈明显负相关( r =-0.246，P<0.05 和r = -0.258，P<0.05)。结论：中西医结合治疗能升高血浆Omentin-1 水平，有效提高溃疡愈合率及H.pylori根除率，抑制炎性因子的分泌，增强内源性NO保护作用和机体免疫功能。

Effect of Integrated Traditional Chinese and Western Medicine on PepticUlcer and H.yilor Infection

Objective:To study the change of serum Omentin-1 level and effect of integrated traditional Chinese and Westernmedicine on peptic ulcer and H.pyloriinfection treated first failure.Methods:82 cases of patients with peptic ulcer who were treated withamoxicillin, omeprazole, azithromycin combined with Qingyou oral solution in our hospital from September 2011 to September 2015were selected as objects, and 20 cases of healthy people were selected as control group. Using ELISA method to detect the plasma levelsof Omentin-1, the relationship between plasma levels of Omentin-1 and nitric oxide(NO), interleukin-2(IL-2), endothelin-1(ET-1), tumornecrosis factor alpha (TNF-alpha) were analyzed. The change of plasma levels of Omentin-1, the efficacy and safety of integrated traditionalChinese and Western medicine were observed.Results:After traditional Chinese and western medicine treatment, H.pylori eradicationrate was 88.6%, 34 cases recovered, 22 cases effective, 33 cases valid, 3 cases ineffective, the healing rate was 68.29% (56/82), and theeffective rate was 96.34% (79/82); theplasma level of Omentin-1in observation group was (18.15 ± 3.96) ng/mL, significantly lowerthan the control group (23.12 ± 6.03) ng /mL (P<0.05); compared with control group, the NO, IL-2 level of observation group wasobviously lower (P < 0.05), ET-1, TNF-alpha and IL-6 level wasincreased significantly (P<0.05); compared with before treatment, aftercombined Chinese and western medicine treatment, NO, IL-2 level was significantly decreased (P <0.05), and the ET-1, TNF-alpha and IL-6level was increased significantly (P < 0.05); the Omentin-1 level was significantly positively correlated with IL-2, NO (r = 0.412, P < 0.05and r = 0.382, P < 0.05), and negatively correlated with IL-6 and TNF-alpha (r = 0.246, P <0.05 and r = 0.258, P < 0.05).Conclusion:Theintegrated traditional Chinese and Western medicine can increase the plasma levels of Omentin-1 in patients with peptic ulcer and h.pylori infection, effectively improve the ulcer healing rate and H.pylori eradication rate, inhibit the secretion of inflammatory cytokines,enhance endogenous NO protection and the body''s immune function.