Effect of Hewei-Decoction on chronic atrophic gastritis and eradication of Helicobacter pylori.

AIM: To demonstrate the effect of Hewei-Decoction (Decoction for regulating the stomach) on chronic atrophic gastritis (CAG) and eradication of Helicobacter pylori. METHODS: Ninety patients with CAG entering the investigation were divided into six differentiation syndromes, based on their major symptoms and signs. Hewei-Decoction was taken by all the patients orally for 4 or 8 wk. The efficacy was assessed by both the composite accumulation of reduced scores of major symptoms and the eradication of H pylori. chi(2) test was used to compare the efficacy between H pylori-positive and negative cases, and to disclose the relationship between efficacy and eradication of H pylori. RESULTS: In patients with six different syndrome types, the efficacy of Hewei-Decoction was 91.67% (11/12), 92.86% (13/14), 97.22% (35/36), 87.50% (14/16), 75.00% (6/8), 75.00% (3/4) respectively. The rate of highly efficacious was 58.33% (7/12), 50.00% (7/14), 77.78% (28/36), 62.50% (10/16), 12.50% (1/8) and 25.00% (1/4), respectively. The total efficacy was 91.11% (82/90), and the rate of highly efficacious was 60.00% (54/90). The eradication rate of H pylori was 67.86% (38/56). The therapeutic effect of Hewei-Decoction was better in H pylori positive cases than that in H pylori-negative cases with the total effect of 96.43% vs 82.35% (P<0.05). In 56 H pylori positive cases, the therapeutic effect was better in H pylori eradicated cases than that in H pylori- existent cases with the total effect of 97.37% vs 72.22% (P<0.01). CONCLUSION: Hewei-Decoction is effective in most cases of all the syndrome types. The results indicate that eradication of H pylori is one of the important mechanisms for alleviation of symptoms and signs. Also, the decoction is efficacious in H pylori-negative cases.

[Endoscopic nasobiliary drainage for acute obstructive suppurative cholangitis with multiple organ failure: report of 25 cases].

OBJECTIVE: To explore the treatment of acute obstructive suppurative cholangitis (AOSC) with multiple organ failure (MOF). METHODS: Twenty-five patients with AOSC complicated by MOF underwent non-surgical comprehensive therapies, including endoscopic naso biliary drainage (ENBD), flushing and antibiotic perfusion through the naso biliary catheter. The alterations of the levels of serum total bilirubin and common bile duct diameter were measured both preoperatively and postoperatively, with retrospective analysis of the patients' clinical record. RESULTS: Of all the 25 patients, 23 underwent endoscopic retrograde cholangiopancreatography (ERCP) with successful placement of the nasobiliary catheters and bile drainage, and MOF was corrected. The cure rate of the this group of patients was 92.0%, with two cases being transferred for emergency surgical treatment. CONCLUSION: Comprehensive treatment consisting of ENBD, flushing and antibiotic perfusion through the naso biliary catheter and intravenous use of antibiotics is effective and safe for the treatment of AOSC complicated by MOF.