目的 探讨清胃止痛微丸联合二联疗法治疗伴有幽门螺杆菌（Hp）感染的消化性溃疡的临床疗效。方法 纳入2024年2～6月就诊于新乡医学院第三附属医院的合并Hp感染的消化性溃疡患者150例，随机分为对照组和治疗组，每组各75例。对照组口服富马酸伏诺拉生片，1片/次，2次/d，同时口服阿莫西林胶囊，4粒/次，3次/d。治疗组在对照组的基础上口服清胃止痛微丸，1袋/次，3次/d。两组患者均治疗14 d。观察两组患者临床疗效，比较治疗前后两组患者临床症状积分及腹痛、反酸缓解至少50%所需时间，Hp清除率，胃泌素-17、胃蛋白酶原Ⅰ（PGⅠ）和胃蛋白酶原ⅠⅠ（PGⅠⅠ）水平，及炎症因子白细胞介素-6（IL-6）、白细胞介素-17（IL-17）和肿瘤坏死因子-α（TNF-α）水平。结果 治疗后，对照组总有效率为84.00%，显著低于治疗组总有效率94.67%，两组比较差异具有统计学意义（P＜0.05）。治疗后，两组临床症状积分均显著降低（P＜0.05），且治疗组临床症状积分显著低于对照组（P＜0.05）。治疗后，治疗组腹痛及反酸症状缓解至少50%所需时间均显著低于对照组（P＜0.05）。治疗后，对照组Hp清除率为81.33%，显著低于治疗组Hp清除率93.34%（P＜0.05）。治疗后，两组两组胃泌素-17、PGⅠ、PGⅠⅠ、IL-6、IL-17和TNF-α水平均显著降低（P＜0.05），且治疗组这些因子水平均显著低于对照组（P＜0.05）。结论 清胃止痛微丸联合二联疗法治疗伴有Hp感染的消化性溃疡患者疗效显著、安全性高，能快速改善患者临床症状，主要与改善消化道黏膜屏障功能及降低机体的炎症状态有关。

Objective To investigate the clinical efficacy of Qingwei Zhitong Micro-Pills combined with dual therapy in treatment of peptic ulcer associated with Helicobacter pylori (Hp). Methods Patients (150 cases) with peptic ulcer associated with Hp in the Third Affiliated Hospital of Xinxiang Medical University from February 2024 to June 2024 were randomly divided into control and treatment group, and each group had 75 cases. Patients in the control group were po administered with Vonoprazan Fumarate Tablets, 1 tablet/time, twice daily, and they were administered with Amoxicillin Capsules at the same time, 4 grains/time, three times daily. Patients in the treatment group were po administered with Qingwei Zhitong Micro-Pills on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical evaluations were evaluated, and the clinical symptom scores and the time required for at least 50% remission of abdominal pain and acid reflux, Hp clearance rate, the levels of gastrin-17, PGⅠ and PGⅠⅠ, IL-6, IL-17 and TNF-α in two groups before and after treatment were compared. Results After treatment, the total effective rate in the control group was 84.00%, which was significantly lower than that in the treatment group (94.67%), the difference between two groups was statistically significant (P < 0.05). After treatment, the clinical symptom scores in two groups were significantly reduced (P < 0.05), and the clinical symptom scores in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the time required for abdominal pain and acid reflux symptoms to be relieved by at least 50% in the treatment group was significantly lower than that in the control group (P < 0.05). After treatment, the Hp clearance rate in the control group was 81.33%, which was significantly lower than that in the treatment group (93.34%, P < 0.05). After treatment, the levels of gastrin-17, PGⅠ, PGⅠⅠ, IL-6, IL-17 and TNF-α were significantly reduced in two groups (P < 0.05), and the levels of these factors in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusions Qingwei Zhitong Micro-Pills combined with dual therapy has a significant clinical efficacy in treatment of peptic ulcer associated with Hp infection, and can rapidly improve the clinical symptoms, which is mainly related to improving the function of digestive mucosa and reducing the inflammatory state.

R975

河南省中医药科学研究专题项目（2024ZY3088）；河南省医学教育研究项目（Wjlx2022102）；中医药传承与创新人才（210999904）