In 1982, Australian scholars discovered Helicobacter pylori (Hp), a spiral-shaped bacterium with two to six flagella that settles between the submucosa and the epithelium of the gastric mucosa, actively invades the epithelial cells of the mucosa, destroys the integrity of the mucosa, and produces a variety of substances such as lipopolysaccharides, cytotoxins and a variety of enzymes, leading to inflammatory degeneration and necrosis of cells, which is the main causative factor of chronic gastritis, peptic ulcer and It is the main pathogenic factor of chronic gastritis, peptic ulcer and gastric cancer. The World Health Organization has designated Hp as a class I carcinogen, clearly indicating that Hp is an important culprit in the development of gastric cancer. In addition, HP may also cause other diseases, such as cardiovascular disease, anemia and idiopathic thrombocytopenic purpura. According to statistics, the rate of Hp infection in China is about 40%-70%, which is higher than that in developed countries, and the detection rate of Hp in patients with gastric disease is much higher than that in the general population, about 80%-90%.
So, how much do you know about Hp?
1.How is Hp spread?
The main ways of transmission of Hp are: oral-oral transmission, fecal-oral transmission, close contact transmission and medical transmission, etc. Hp infection has family aggregation, one of the family members is infected, others may also be infected, kissing between lovers and parents chewing food and feeding children can spread Hp. poor hygiene, sharing utensils and other high-risk factors for Hp infection, the key to the prevention and treatment of Hp is to pay attention to The key to Hp prevention is to pay attention to dietary hygiene, and people who often eat out have more chances to be infected.
2.How do I know if I am infected with Hp?
There are many ways to detect Hp, but there are two main methods commonly used in hospitals: the 13C urea breath test (or 14C urea breath test) and the rapid urease test, which relies on gastroscopic biopsy. Among them, the 13C urea breath test has the advantages of being non-invasive, painless, accurate and specific, and has been widely accepted by patients.
It is important to note that before testing for H. pylori, patients need to have not taken antibiotics, proton pump inhibitors (such as omeprazole, rabeprazole, pantoprazole and other razole drugs), H2 receptor blockers (such as cimetidine, ranitidine, famotidine and other titin drugs) within the last month.
3.Is it necessary to treat Hp infection?
Not all Hp-infected patients need treatment. It is best to have a gastroscopy to clarify the diagnosis and then use the medication scientifically under the guidance of a specialist. If there is no symptom and the history of gastric disease, family history of gastric cancer, long-term use of aspirin, ibuprofen, hormones and other drugs are excluded, treatment is not necessary.
4.How to cure Hp in western medicine and the current situation?
At present, western medicine mostly adopts triple therapy or quadruple therapy for Hp treatment.
Triple therapy: 1 proton pump inhibitor + 2 antibiotics, for example: omeprazole or pantoprazole + clarithromycin + amoxicillin (or metronidazole, or levofloxacin, etc.).
Quadruple therapy: i.e. 1 proton pump inhibitor + 2 antibiotics + bismuth, that is, bismuth on top of triple therapy, bismuth such as: bismuth in pectin or bismuth potassium citrate.
The course of treatment: mostly 10-14 days (note do not just stop or increase the course of treatment, which can easily lead to sterilization failure or drug resistance).
Current status: With the
With the popularization and promotion of Hp eradication treatment, the widespread use of antibiotics and poor compliance of some patients, the rate of Hp drug resistance has gradually increased. It has been reported that the eradication rate of Hp has decreased from 80-96% in the past to 60-80% at present.
Hp resistance to antibiotics is the main reason for the decrease in eradication rate.
5.When should I be reviewed to determine the success of Hp eradication?
At least 1 month after the end of treatment, the Hp test will be repeated again, and a negative test means successful sterilization.
6.What is the advantage of combining Chinese and Western medicine to cure Hp?
Hp can belong to the category of “evil qi” in Chinese medicine, as the saying goes, “where evil qi is found, its qi will be deficient”. Regarding Hp infection, most TCM scholars believe that weakness of the spleen and stomach is the root cause of the disease, while Qi stagnation, blood stasis and damp heat are the symptoms of the disease, so the treatment mostly adopts strengthening the spleen and benefiting Qi to strengthen the root, regulating Qi and blood, clearing heat and detoxifying toxins to treat the symptoms, helping to eliminate evil and treating both the symptoms and the root cause. Chinese medicine is characterized by a holistic concept and evidence-based treatment, with emphasis on individualization, and has unique advantages in the treatment of Hp. Although Chinese medicine alone has certain clinical efficacy in treating Hp, the eradication rate is not as good as the standard triple or quadruple therapy of western medicine.
Because of this, combining Chinese and Western medicine to treat Hp has received widespread attention. The advantages of combining Chinese and Western medicine complement each other, and they can play a synergistic role, combining disease identification with evidence identification. Recent studies have shown that combining Chinese and Western medicine can improve the eradication rate of Hp, reduce the side effects of Western medicine, and provide rapid relief of clinical symptoms, which is becoming the mainstream choice nowadays.