观察连花清幽饮联合针刺治疗幽门螺杆菌（Hp）感染慢性萎缩性胃炎（CAG）的临床疗效及对胃肠功能的影响。 【方法】将98例肝胃郁热型Hp感染CAG患者随机分为研究组和对照组，每组各49例。对照组给予抗Hp标准四联疗法治 疗，研究组在对照组的基础上给予连花清幽饮联合针刺治疗，疗程为12周。观察2组患者治疗前后病理组织学评分[包括胃 黏膜萎缩、肠上皮化生、炎性反应、活动性、Hp感染]、胃肠功能指标[包括血清胃泌素、胃动素、血管活性肠肽（VIP）、生 长抑素]及胃蛋白酶原（PG）Ⅰ、PGⅡ水平的变化情况，并比较2组患者的临床疗效及Hp转阴情况。【结果】（1）疗效方面，治 疗12周后，研究组的总有效率为95.92%（47/49），对照组为73.47%（36/49），组间比较（χ2检验），研究组的疗效明显优于对 照组（P＜0.01）。（2）病理组织学评分方面，治疗后，2组患者的胃黏膜萎缩、肠上皮化生、炎性反应、活动性、Hp感染等各 项病理组织学评分均较治疗前下降（P＜0.05），且研究组的下降幅度均明显优于对照组（P＜0.01）。（3）胃肠功能指标方面，治 疗后，2组患者的血清胃泌素、胃动素、生长抑素水平均较治疗前升高（P＜0.05），血清VIP水平均较治疗前下降（P＜ 0.05），且研究组对血清胃泌素、胃动素、生长抑素水平的升高幅度及对血清VIP水平的下降幅度均明显优于对照组（P＜ 0.01）。（4）胃蛋白酶原方面，治疗后，2组患者的血清PGⅠ、PGⅡ水平均较治疗前升高（P＜0.05），且研究组的升高幅度均明 显优于对照组（P＜0.01）。（5）Hp转阴率方面，研究组的Hp转阴率为95.92%（47/49），明显高于对照组的79.59%（39/49），差 异有统计学意义（χ2 = 6.078，P = 0.014）。【结论】连花清幽饮联合针刺治疗肝胃郁热型Hp感染CAG患者，能有效提高临床疗效和Hp转阴率，改善病理组织学评分和胃肠功能，并能有效调节血清PGⅠ、PGⅡ水平。

To investigate the clinical efficacy of Lianhua Qingyou Decoction combined with acupuncture in the treatment of Helicobacter pylori（Hp）-infected chronic atrophic gastritis（CAG）， and to observe the effect on gastrointestinal function. Methods Ninety- eight patients with Hp- infected CAG of heat stagnation in the liver and stomach type were randomly divided into a study group and a control group， with 49 patients in each group. The control group was treated with standard anti-Hp quadruple therapy，and the study group was treated with Lianhua Qingyou Decoction combined with acupuncture on the basis of treatment for the control group. The treatment course for the two groups covered 12 weeks. Before and after the treatment，the two groups were observed in the scores of pathohistological changes in the gastric mucosal atrophy，intestinal epithelial hyperplasia， inflammatory response， activity and Hp infection， gastrointestinal function indicators of serum gastrin，motilin，vasoactive intestinal peptide（VIP），and somatostatin，and the levels of pepsinogens of PGⅠ and PGⅡ. After treatment，the clinical efficacy and Hp negative-conversion rate in the two groups were compared. Results（1）After 12 weeks of treatment，the total effective rate in the study group was 95.92%（47/49）and that in the control group was 73.47%（36/49），and the intergroup comparison（by chi-square test）showed that the therapeutic efficacy of the study group was significantly superior to that of the control group（P＜0.01）.（2）After treatment， the scores of pathohistological changes in the gastric mucosal atrophy， intestinal epithelial hyperplasia，inflammatory response，activity and Hp infection in the two groups were decreased compared with those before treatment（P＜0.05）， and the decrease in the study group was significantly superior to that in the control group（P＜0.01）.（3）After treatment，the serum levels of gastrointestinal function indicators of gastrin， motilin and somatostatin in the two groups were all higher than those before treatment（P＜0.05），and the serum VIP level was lower than that before treatment（P＜0.05）. The increase in the serum gastrin， motilin and somatostatin levels and the decrease in the serum VIP level of the study group were significantly superior to those of the control group（P＜0.01）.（4）After treatment， the serum pepsinogen levels of PGⅠ and PGⅡ in the two groups were higher than those before treatment（P＜0.05），and the increase in the study group was significantly superior to that in the control group（P＜0.01）.（5）The Hp negative-conversion rate of the study group was 95.92% （47/49），which was significantly higher than that of the control group（79.59%，39/49）and the difference was statistically significant（χ2 = 6.078，P = 0.014）. Conclusion For the treatment of patients with Hp-infected CAG of heat stagnation in the liver and stomach type， Lianhua Qingyou Decoction combined with acupuncture can effectively enhance the clinical efficacy and Hp negative-conversion rate，improve the pathohistological scores and gastrointestinal function，and regulate the serum PGⅠ and PGⅡ levels.

R259.733

首都卫生发展科研专项资助项目（编号：2020-2-4152）