Discussion on duodenal ulcer and related Chinese patent medicine conditioning

Duodenal ulcer refers to the disorder of self-mucosal defense and digestive function under the attack of high gastric acid and pepsin, forming local inflammatory defects.

Our stomach acid is corrosive and can corrode the mucosa of stomach and duodenum. But under normal circumstances, there is a protective mucus barrier on the inner wall of stomach and duodenum. When gastric acid increases or protective mucus decreases for some reason, the defense ability of mucosal barrier is out of balance with the invasion of gastric acid and pepsin on gastroduodenal mucosa, resulting in duodenal mucosa damage and ulcer formation. Ulcer mostly occurs in the duodenal bulb, which is more common in young people. Typical clinical manifestations are periodic and rhythmic epigastric pain, mainly hunger, which is relieved after meals, often accompanied by symptoms such as abdominal distension, nausea and vomiting. With the aggravation of the disease, the ulcer deepens, which can damage submucosal blood vessels or penetrate the muscle layer, causing complications such as bleeding and perforation.

1, Helicobacter pylori (Hp): The infection rate of HP in patients with duodenal ulcer can reach over 90%.

2. Drugs: Patients who take non-steroidal anti-inflammatory drugs (NSAIDs), glucocorticoids, clopidogrel, diphosphate and sirolimus for a long time are prone to duodenal ulcer. Among them, non-steroidal anti-inflammatory drugs are the most commonly used drugs, such as ibuprofen, indomethacin and aspirin.

3. Heredity: Some patients have obvious family history and genetic susceptibility.

Ulcer granule, this prescription consists of licorice extract, cuttlebone, bletilla striata, Scutellaria baicalensis Georgi, Rhizoma Corydalis (parched with vinegar), Coicis Semen (parched with bran), Alisma orientalis and hyacinthus orientalis. Has the effects of invigorating stomach, diminishing inflammation and relieving pain. Can be used for treating gastric ulcer, duodenal ulcer, and acute and chronic gastritis.

Summary of clinical medication experience:

Li Jiang, Ye Xinbin and Wang Tingting observed the clinical efficacy of Ulcer Granule in treating gastric ulcer and its influence on serum levels of IL- 10, IL- 17, NO and TNF-α. They thought that Ulcer Granule could improve the curative effect of western medicine in treating gastric ulcer, and its mechanism was related to reducing the secretion of inflammatory mediators and improving gastric mucosal blood flow. (China Science and Technology of Traditional Chinese Medicine, 2019,26 (01):18-20). )

Usage and dosage: Take it with boiled water once 1 bag (10g), three times a day.

Ulcer capsule consists of concha arcae, Herba et Gemma Agrimoniae, Fructus Polygoni Orientalis, dried alum, eggshell, dried tangerine peel and pearl powder. Has analgesic, granulation promoting, and astringent effects. Used for epigastric pain, nausea and pantothenic acid, and gastric and duodenal ulcer.

Administration and dosage: Take orally, 2 capsules at a time, 3 times a day.

Kuiyangning tablet consists of licorice extract, cuttlebone, vitamin U, atropine sulfate, hydrochlorothiazide and procaine hydrochloride. It has the effects of relieving acid, spasmolysis, analgesia and hemostasis. For gastric and duodenal ulcers.

Administration and dosage: Take orally, 4-6 tablets at a time, 3 times a day, or as directed by the doctor.

Kuiyangling Capsule consists of Radix Notoginseng, Catechu, Bulbus Fritillariae Cirrhosae, cuttlefish bone, Radix Glycyrrhizae, Rhizoma Corydalis, Radix Astragali, Rhizoma Bletillae and Bulbus Lilii. Has the effects of benefiting qi, removing blood stasis and relieving pain. For gastric and duodenal ulcers.

Administration and dosage: Take orally, 3-5 capsules at a time, 3 times a day.

Kuiyang Powder Capsule consists of Glycyrrhiza uralensis Fisch, Bletilla striata, Rhizoma Corydalis, Alismatis Rhizoma, Os Sepiae, Coicis Semen, Scutellariae Radix and hyacinthus orientalis. It has the effects of regulating qi and stomach, inhibiting acid and relieving pain. Used for damp-heat of spleen and stomach, epigastric pain and hyperacidity; Ulcer and chronic gastritis see the above syndromes.

Administration and dosage: Take orally, 5 capsules at a time, 3 times a day.

1, in strict accordance with the doctor's advice, can't stop drug, dressing change, avoid incomplete treatment or recurrence.

2. Pay attention to monitoring adverse drug reactions and drug effects.

3. Some patients with coronary heart disease are taking Plavix (clopidogrel bisulfate tablets). If they have ulcers at the same time, they should communicate with their doctors in detail before they need PPI drugs. In the CFDA Adverse Drug Reaction Information Bulletin (No.55) issued by National Medical Products Administration, "Beware of the fracture, hypomagnesemia risk and interaction with clopidogrel of proton pump inhibitors", it is pointed out that the combination of some proton pump inhibitors with clopidogrel will reduce the antithrombotic effect of the latter and increase the incidence of coronary events or other thrombosis, especially omeprazole. However, there is still a lack of relevant high-quality clinical research in China, and more research results are needed to confirm it.

1, avoid mental stress, long-term mental stress, anxiety or emotional excitement can cause autonomic nerve dysfunction, which is not conducive to food digestion. Cheerful and optimistic, regular life, a combination of work and rest, and a relaxed and happy attitude are the keys to prevent ulcer disease.

2. Develop good living habits, take part in more physical exercises, improve physical resistance, pay attention to food hygiene, and quit smoking and drinking.

3. Avoid long-term use of non-steroidal anti-inflammatory drugs such as ibuprofen, indomethacin and aspirin.

4, pay attention to hygiene, try to implement separate meals, avoid * * * with tableware, cups, dental appliances, etc. Caused by helicobacter pylori infection.

1. Fasting irritating foods and foods that stimulate gastric acid secretion, such as strong tea, broth, coffee, raw onions, concentrated juice, raw garlic, wine, etc.

2, avoid eating too sweet food, because sweets will promote gastric acid secretion, making the condition worse.

3, avoid eating overheated food, overheated food will stimulate the ulcer surface, leading to increased pain. In severe cases, the blood vessels on the ulcer surface dilate, causing bleeding.

4, avoid eating spicy food, this kind of food will stimulate the ulcer surface and increase gastric acid secretion.

5, avoid eating too hard or too cold food, so that patients are not easy to digest, but also aggravate the condition.

6, quit smoking, because tobacco contains nicotine, which can change the pH of gastric juice, thus disrupting the normal operation of gastric pylorus, leading to the aggravation of ulcers.

7. Restrict foods containing dregs, including crude fiber, fried or fried fast food, such as dried fish, celery, bean sprouts, leeks, bacon, ham and various coarse grains. These foods are not conducive to digestion, but also accelerate the secretion of gastric juice and increase the burden on the stomach and duodenum.