DIEU TRI

Journal of research in viet nam traditional medicine and pharmacy • No 41 2014

KET QUA BUOC DAU T A C DUNG CUA CHE TAN "HUONG SA LUC

Q U A N "

TRONG DIEU TRI VIEM DA D A Y MAN TINH CO HP (+)

Initial assessment of the effects of soluble tea "Huong sa luc quan"

in the treatment of chronic gastritis HP(+)

* Pham Van Tuyen, ** Vu Nam Benh vien Y hoc cd truyen Trung uong Tom Tat:

Muc tieu nghien ciru: (1) Ddnh gid tdc dung diiu tri cua che tan "Huang sa luc qudn " tren benh nhdn viem da ddy man tinh cd HP (+). (2) Khdo sdt tdc dung khdng mong mudn.

Phuang phdp nghien cii-u: Thie nghiem ldm sdng md, buac ddu ddnh gid tdc dung trudc sau tren 30 benh nhdn, udng thudc lien tuc trong 30 ngdy. Kit qud nghien cieu: Ti le hit dau dgt 90%, ti le diet H.Pylori dgt 43,33%, cdi thien mice do hogt ddng qua viem tren md benh hoc. Thudc khdng cd tdc dung khdng mong mudn. Kit luan: Che tan Huang sa luc qudn cd tdc dung tren benh nhdn viem dg ddy man tinh HP(+). Thudc cd hieu qud ldm sdng tdt vd khdng cd tdc dung khdng mong mudn.

Tir khoa: Viem da day man tinh, vi khuan Helicobacter Pylori, che tan Hu-ong sa luc quan.

Summary

INITIAL ASSESSMENT OF THE EFFECTS OF SOLUBLE TEA

"HUONG SA LUC QUAN" IN THE TREATMENT OF CHRONIC GASTRITIS HP(+)

Objectives: (1) To evaluate the treatment effect of soluble tea "Huong sa luc quan " in patients with chronic gastritis HP(+). (2) To assess the side effects of the remedy. Methods: open clinical trial, comparing the result before and after taking medication continuously for 30 days on 30 patients. Results: The rate of patients who had no pain is 90%, rates of H. Pylori extermination reached 43,33%. The soluble tea had anti-inflammatory effect based on histopathological examination. Side effects were not seen in clinical. Conclusions: soluble tea "Huong sa luc quan "

has good effect on patients with gastritis HP(+) without side effects.

Key words: Chronic gastritis, Helicobacter Pylori, soluble tea "Huong sa luc quan".

Dja chi lien he: Pham Van Tuyen - Benh vien Y hpc co truyen Trung uong Ngay nhan bai: 08/5/2014 Dja chi email: wellness.medicare@gmail.com Ngay phan bien: 16/5/2014 Phan bien khoa hoc: PGS.TS. Nguyen Nhugc Kim Ngay dang bao: 27/6/2014

*BS:** PGS.TS

Nghien cidi YDHCT Viet Nam So'41 - 2014

I. DAT VAN DE

Viem da day man tinh (VDDMT) la mdt trong nhirng benh ly dudng

•> F F F

tieu boa phd bien nhat, chiem ty le 35 - 45 % trong cac benh ly da day ta trang. VDDMT tuy khdng nguy hiem den tinh mang ngay lap tiic nhung anh hudng khdng nhd tdi siic khde va kha nang lao ddng cua ngudi benh do viec dieu tri cdn nhieu khd khan, de tai phat.

"Huong sa luc quan" la mdt bai

F •> F

thudc c6 phuong xuat xii tir "Y phuong tap giai" bao g6m: Dang sam, bach linh, bach truat, cam thao, ban ha che, tran bi, moc huong bac, sa nhan. Bai thu6c nay thudng dugc dung de dieu tri cac benh d dudng tieu boa nhu bdi chiing rugt kich thich, viem da day man tinh... Hien nay, bai thu6c nay da dugc benh vien YHCT trung uong san xuat dudi dang che tan dung de dieu trj cac benh da day, dai trang va budc dau da mang lai nhiing ket qua dieu tri kha tit.

Chiing tdi tiln hanh dl tai "Danh gia tac dung ciia che tan Huong sa luc quan trong dieu tri viem da day man tinh do nhilm HP" vdi muc tieu:

1. Nhan xet bie&c ddu cua che tan trong dieu tri viem da ddy man tinh nhiem HP.

2. Khdo sdt tdc dung khong

F r

mong muon ciia thuoc.

H. C H A T LIEU, DOI T U Q N G V A

PHUONG P H A P N G H I E N C U U

2.1. Chat lieu nghien cuu

Thudc "Huong sa luc quan" do Khoa Dugc - Benh vien Y hgc co truyen Trung uong san xuat. Thu6c dugc ddng goi dang cdm tan 15g/g6i.

Cach dimg: Ngay udng 2 gdi chia 2 lan sang - chieu, udng sau an. Thdi gian dung thudc 30 ngay.

F

1.1. Doi tuong nghien cuu 2.2.1. Tieu chudn liea chgn:

Benh nhan > 18 tuoi, khdng phan biet gidi, nghe nghiep dugc chan doan xac djnh viem da day man tinh theo tieu chuan ciia Y hgc hien dai (lam sang, ngi soi, md benh hgc) thudc chiing Vi quan thdng the Ty vi hu ban theo Y hgc cd truyen. Benh nhan dugc dieu trj ngoai trii - Benh vien Y hgc cd truyen Trung uong.

2.2.2. Tieu chudn loai trie: Benh nhan bi viem da day man tinh nghi ngd ung thu, loet, cd tiln sii phau thuat, dang dung NSAIDs va steroid, phu nil cd thai va cho con bii, bd dd dieu tri...

2.3. Phuong phap nghien cun:, Can thiep, thu nghiem lam sang md,

F y

so sanh ket qua trudc va sau dieu tri.

2.4. Phuong phap tien hanh 2.4.1. Dia diem vd th&i gian nghien cieu:

* f)ia diem

Journal of research in viet nam traditional medicine and pharmacy No 41 2014 Lam sang va ngi soi: Benh vien

Y hgc cd truyen Trung uong.

- Mo benh hgc: Bg m6n giai phau benh Trudng Dai hgc Y Ha Ngi.

* Thdi gian: Tir thang 8/2013 din 05/2014.

2.4.2. Cdc bie&c tien hdnh:

- Kham lam sang -^ Ngi soi, sinh thiet, test urease, xet nghiem md benh hgc.

F

- Dung thudc nghien ciiu.

- Tham kham lam sang dugc tiln hanh vao ngay dau tien va sau dilu tri 7 ngay, 14 ngay, 21 ngay, 30 ngay.

- Xet nghiem can lam sang dugc

F \

tien hanh trudc va sau dieu tri.

F

- Thu thap ket qua va phan tich sd lieu thu dugc.

2.4.3. Chi tieu nghien ciru:

Trieu chiing lam sang: Dau thugng vi, day bung, g hoi, g chua, budn ndn.

- Can lam sang: Ngi soi, md benh hgc, urease test.

2.4.4. Tieu chudn ddnh gid ket qud

2.4.4.1. Tdc dung gidm dau tren ldm sdng

F F \

Loai tdt: Het dau sau < 1 tuan dieu tri. Kh6ng dau lai trong dgt dieu tri.

- Loai kha: Het dau sau 1 - 3 tuan dieu trj.

- Loai trung binh: Het dau sau 3 - 4 tuin dieu tri.

Loai kem: Cdn dau sau dieu tri hoac dau tang len phai ngimg hoac

t F

chuyen qua thudc khac.

2.4.4.2. Tdc dung gidm day bung tren ldm sdng:

F F -y

- Loai tdt: Het day bung sau < 1 tuan dieu tri. Khdng bi lai trong dgt dieu tn.

- Loai kha: Het day bung sau 1 - 3 tuan dieu tri.

- Loai trung binh: Het day bung sau 3 - 4 tuan dieu tri.

Loai kem: Cdn day bung sau dieu tri hoac tang len phai ngimg hoac chuyen qua thudc khac.

2.4.4.3. Tdc dung gidm a hai, a chua tren ldm sdng:

F F

- Loai t6t: Het g hoi, g chua sau <

1 tuan dieu tri. Kh6ng bi lai trong dgt dieu tri.

- Loai kha: Het g hoi, g chua sau 1 - 3 tuan dieu trj.

Loai trung binh: Het g hoi, g chua sau 3 - 4 tuan dieu trj.

Loai kem: Cdn g hoi, g chua sau dieu trj hoac tang len phai ngung hoac chuyen qua thudc khac.

2.4.4.4. Mire do gidm viem tren noisoi

F y

- Loai t6t: Khoi, sau dieu trj niem mac da day h6ng deu, tron nhan.

Loai trung binh: Cdn viem nhe,

\ F

niem mac phu ne, xung huyet nhe - Loai kem: Khdng thay ddi so

Nghien cihi YDHCT Viet Nam So 41 2014

2.4.4.5. Mice do gidm viem tren mo benh hoc:

Chu ylu dua vao miic do boat dgng cua viem chia lam 4 miic do nhu sau:

Loai tot: Khong cdn hinh anh cua viem da day boat ddng

- Loai kha: Giam 2 miic do boat dgng ciia viem so vdi trudc dilu tri

- Loai trung binh: Giam 1 miic do boat dgng ciia viem so vdi trudc dieu tri

Loai kem: Viem khdng giam, do boat dgng ciia viem kh6ng thay d6i hoac tang len.

2.4.4.6. Mice do ldm sach HP:

Loai tit: Kh6ng cdn HP tren vi trudng, test urease (-).

- Loai kha: So lugng HP giam 2 miic tren mdt vi trudng so vdi trudc dieu trj.

Bang 1: Dac diem

- Loai trung binh: ,Sd lugng HP giam 1 miic tren mgt vi trudng so vdi trudc dieu trj.

- Loai kem: So lugng HP tren 1 vi trudng khdng thay doi hoac tang len.

2.4.4.7. Tdc dting khong mong muon cua thuoc

Khao sat sir xuit hien cac trieu chiing nhu may day dj ling, min ngiia, dau diu, buon ndn, chdng mat, dau bung, dai tien Idng...(cac trieu chirng chi xuit hien sau khi dung thudc).

2.5. Xu ly so lieu: Sd lieu dugc thu thap va xii ly bang phan mem thing ke toan hgc SPSS 16.0

III. KET QUA NGHIEN CUU:

3.1. Dac diem benh nhan nghien cuu:

tuoi, gidi, nghe nghiep:

Thong so

N

%

rr-i F\

Tong

Tuoi

<40 7 23,33

40-60 16 53,34

>60 7 23,33

Gidi Nam

15 50

Nir 15 50

>

Nghe nghiep

rr\ F F

Tn oc 21 70

Chan tay 9 30 (n= 30, 100%)

Nhan xet: Tuoi ciia nhdm nghien ciiu tir 26 den 74, trung binh la 49,8 ± 13,62.

Ti le mic benh nhdm tuoi dudi 40 la 23,33%, tir 40 din 60 tuoi la 53,34%, tir 60 tuoi trd len la 23,33%. Gidi nam va nir chilm ti le nhu nhau 50%). Hiu hit la lao

F

dgng tri 6c chiem 70%.

Journal of research in viet nam traditional medicine and pharmacy No 41 - 2014

Bang 2: Bieu hien lam sang Trieu chung LS

Dau TV Ohoi 0 chua Day bung Budn n6n

F

So lugng (n) 30 24 21 27 11

•

Ti le (%) 100

80 70 90 36,67

Nhan xet: Trong nhdm nghien ciiu trieu chiing dau thugng vj gap d 100%

X X

benh nhan, 90% benh nhan bj day bung, >70% benh nhan bj g hoi va g chua, bu6n n6n chi cd 36,67% benh nhan bi.

^^^^^-^^ Muc do So l u o n g ^ ^ ^ - ^ ^ ^

n

%

Tdng

Bang 3: Tdn thuong viem tren ngi soi Ton thuong

Trgt phang 21 70

Trgt ndi 3 10

Xung huyet 6 20 (n=30, 100%)

Muc do Nhe

9 30

Vira 15 50

Nang 6 20 (n=30, 100%) Nhan xet: Nhdm nghien ciiu cd nhieu benh nhan bj viem trgt phang nhat la

F F F t

70%, tiep den viem xung huyet 20%, cdn viem trgt ndi la 10%. Viem miic do nhe chilm ti le 30%, muc do vua 50% va miic do nang la 20%.

Bang 4: Ton thuong viem tren mo benh hoc Muc do hoat dgng cua viem

Khdng HD HDnhe HD vira HD manh

•7

Tong

F

So lugng (n) 13

8 4 5 30

Ti le (%) 43,33 26,67 13,33 16,67 100

Nhan xet: Tren md benh hgc, cd den 43,33% benh nhan viem khdng boat dgng, 26,67%) viem hoat dgng nhe, 16,61% viem boat dgng manh va 13,33% viem boat dgng vua.

Bang 5: Muc do nhiem HP tren mo benh hoc

^-^—-J^Iucdo nhiem HP

Trudc dieu tri —--^-__

n

%

HP(+) 19

63,33

HP (++) 3

10

HP (+++) 8

26,67

Tong 30

100 Nhan xet: Miic do nhiem HP (+) la 63,33%, HP (++) chiem 10%, HP (+++)

Nghien cdu YDHCT Viet Nam So 41 - 2014

3.2. Ket qua dieu tri

F

3.2.1. Ket qud tren lam sdng

Bang 6: Tac dung giam dau

N. F

\ ^ e t qua

F ^ s ^

So lugng\^

n

%

Tot (Hit dau sau

<1 tudn) 6 20

Kha

F

(Hit dau sau 2-3 tudri)

17 56,67

T.binh (Hit dau sau

X

3-4 tudn) 4 13,33

Kem (Cdn dau sau d.tri)

3 10

Tong 30 100 Nhan xet: Sau 30 ngay dieu trj, ti le het dau tren lam sang dat 90% trong do ti le loai kha tdt la 76,67%, trung binh chiem 13,33%.

Bang 7: Tac dung giam cac trieu chung lam sang khac

~~-~-~-___^ Ket qua Trieu chung^ ~~^-~—-____

Day bung Ohoi 0 chua Budn n6n, n6n

n

%

n

%

n

%

n

%

Tot 14 51,85

6 25

12 57,14

9 81,82

Kha 11 40,74

14 58,33

9 42,86

2 18,18

Trung binh 2 7,41

3 12,5

0 0 0 0

Kem 0 0 1 4,17

0 0 0 0

Tong 27 100%

24 100%

21 100%

11 100%

Nhan xet: Sau 30 ngay dieu trj, ti le kha t6t cua cac trieu chirng lam sang lin lugt la: Diy bung chilm 92,59%, g hoi chilm 83,33%, g chua 100%, buon n6n

100%.

F

3.2.2. Ket qud tren mo benh hoc

Bang 8: Tinh trang hoat dong cua viem

^^~~~~~~-Tinh trang viem

T h o i g i a n ^^~~~~~~~~--.,,,^^

T r u d c D T S a u D T

n

%

n

%

Khong HD

13 43,33

20 66,67

HD nhe 8 •

26,67 8 26,67

HD vira 4 13,33

2 6,66

HD manh

5 16,67

0 0

Tong

30 100

30 100

P trudc sau

<0,05

Nhan xet: Sau dieu trj, mire do hoat dgng ciia viem cd cai thien, mire khdng boat d6ng tang tir 43,33% len 66,67%, boat dgng vira giam tir 13,33% xuong 6,66%, kh6ng cdn benh nhan cd viem boat ddng manh. Sir khac biet nay cd y nghia th6ng ke vdi p<0,05.

Journal of research in viet nam traditional medicine and pharmacy No 41 - 2014

Bang 9: Muc do lam sach HP tren mo benh hoc --JCetjma mo benh hoc

Thdi gian ^ ^ — . ^ ^ ^ Trudc DT

S a u D T

n

%

n

%

HP

(-)

0 0 13 43,33

HP (+) 19 63,33

15 50

HP 3 10

2 6,67

HP (+++)

8 26,67

0 0

T6ng 30 100

30 100

P trirdc sau

>0,05

X

Nhan xet: Sau dieu trj, miic do nhiem HP tren m6 benh hgc cd cai thien, cu the: cd 43,33%) benh nhan

X

trd ve am tinh, 37,5%) benh nhan giam 2 mire, 36,36%) benh nhan giam

1 miic, Tuy nhien su khac biet nay

F

chua cd y nghia thdng ke vdi p>0,05.

3.3. Tac dung khong mong muon cua thuoc: Buoc dau trong sd 30 benh nhan dieu trj chua phat hien

F ^

trudng hgp nao xuat hien cac trieu chiing nhu: Man ngiia, dau dau, dau bung tang len, met mdi...

IV. BAN LUAN:

4.1. Dac dilm benh nhan nghien cuu:

Tudi trung binh nhdm benh nhan

X

nghien cuu ciia chiing tdi nam trong Ilia tudi lao dgng (49,8 tuoi), tuong tu nhu cac nghien curu trudc day d trong nude. 6 Phap, theo Potet F- (1993) tudi trung binh ciia benh nhan VDDMT cao hon (53 tudi) [1]. Lua

t F

nghien ciiu tir 20-59 tudi chiem 80%, phu hgp vdi mdt sd nghien ciiu nhu Nguyen Quang Chung va cong sir trong mgt nghien cuu tren 412 benh nhan VDDMT liia tuli tir 20-59 chilm 89,32% [2].

Dau bung vung thugng vj la trieu chiing thudng gap nhat tren lam sang

F

ciia benh chiem 100% (bang 2). Ti le nay tuong duong cac nghien ciiu trudc day nhu: Nguyen Van Toan la

100%[3], Dang Kim Oanh va Nguyen Khanh Trach la 97,2 % [4]. Trong nghien cuu nay, dau vung thugng vj thudng di kem vdi cac trieu chiing khac: Day bung chiem 90%, g hoi 80%, g chua 70%, buon ndn 36,67%

(bang 2).

Vl hinh thai tdn thuong viem tren ngi soi, viem trgt phang la t6n

F F

thuong hay gap nhat chiem 70%

(bang 3), tilp din la xung huyet chilm 20% ya trgt nli chilm 10%.

Nghien cim YDHCT Viet Nam So 41 - 2014

•> F F F F

vira ph6 bien nhat chiem 50%, tiep den miic do nhe 30%) va miic do nang chiem 20%.

Ve t6n thuong viem tren m6 benh hgc, viem boat dgng chiem 56,67%

bao gom 3 miic hoat dgng la nhe, vira va manh (bang 4). Ti le nay thap hon mgt s6 nghien ciru, nghien ciiu ciia Lai Thanh Hien la 95%) [5], nghien ciiu ciia Nguyen Quang Chung va cong sir (1997) la 80,35%. Miic do nhiem HP lien quan mat thilt vdi miic do boat dgng cua viem. Miic do nhiem HP cua nghien ciiu chiing t6i lin lugt nhu sau: HP(+) chilm 63,33%, HP (+++) chilm 26,67%.

Khac vdi mdt sd nghien ciiu khac nhu: Le Trung Thg va cdng sir, ti le HP(+) la 36,05%, HP(+++) la 25,58%.

4.2. Ket qua nghien cuu:

4.2.1. Tdc dung gidm dau:

Dau thugng vj la trieu chiing thudng gap, lam anh hudng din kha nang lao ddng va chit,lugng cugc song ciia ngudi benh. Thudc lam giam dau tdt se giup siic khde ngudi benh mau hue bdi.

Tren lam sang, chiing tdi nhan

F

thay che tan Huong sa luc quan cd

tac dtmg giam dau tot, hiu hit cac trudng hg^) hit dau sau dilu trj. Ti le hit dau la 27/30 (chilm 90%), loai kha tot chilm 76,67% (bang 6). Ti le

^ X F

het dau sau dieu trj ciia mdt sd nghien

X

ciiu: Lai Thanh Hien va cdng su nam 2001 la 81,2%; Khuong Tue Khanh va cdng su nam 2004 la 98,6%.

4.2.2. Tdc dung gidm viem tren mo benh hgc:

Trong nghien ciiu ciia chiing t6i, che tan Huong sa luc quan c6 tac dung cai thien miic do boat dgng viem d niem mac da day: Miic viem khdng boat ddng tang tir 43,33% len 66,67%, khdng cdn benh nhan co viem boat ddng manh (bang 8).

4.2.3. Tdc diJLng ldm sach HP:

Ti le lam sach HP ciia che tan Huong sa luc quan la 43,33% (bang 9). Ti le nay cao hon nghien ciiu ciia Lai Thanh Hiln vl thuoc Weitai 999 nam 2001 dat 34,5% va kha tuong

X

d6ng vdi nghien cuu ciia Vii Nam (1995) vl kha nang diet HP khi dung che day don thuin dat 42,5%.

4.3. Tac dung khong mong muon: Tren 30 benh nhan nghien cim, chiing tdi chua thiy xuit hien tac dung khdng mong muon nao ciia

Journal of research in viet nam traditional medicine and pharmacy No 41 - 2014

F ^

thudc tren lam sang nhu: Man ngiia, may day, hoa mit chdng mat, buIn n6n va n6n, dai tien long...Day la bieu hien ve tinh an toan ciia thuoc khi diing tren lam sang.

V. KET LUAN:

Budc dau danh gia tac dung dieu trj 30 benh nhan viem da day man tinh cd H.Pylory bang chh tan

"Huong sa luc quan", trong thdi gian 30 ngay lien tuc, chiing tdi cd mgt so nhan xet sau:

5.1. Che tan "Huong sa luc quan" cd tac dung tren benh nhan viem da day man tinh cd HP(+):

- Che tan "Huong sa luc quan" cd hieu qua tdt tren lam sang. Hieu qua cai thien cac trieu chiing tren lam sang dat tren 90%. Ti le hit dau sau 4 tuan dieu trj la 90%

Ti le diet H.Pylory dat 43,33%.

Cai thien tinh trang viem man tinh, viem boat ddng manh.

5.2. Tac dung phu ciia che tan Huong sa luc quan:

Che tan "Huong sa luc quan" an toan khi dieu trj viem da day man tinh cd HP(+). Thu6c kh6ng gay tac dung phu tren lam sang.

TAI LIEU THAM KHAO 1. Potet F. et al (1993), '.'Chronic

gastritis - Prevalence in the French population", Gastroenterol Clin Biol,

17, 103-108.

2. Nguyen Quang Chung, Ta long, Trinh Tuan Dung (1997),

"Dac diem lam sang, noi soi va mo benh hoc cua viem da day man tinh", Noi khoa, 1, 58-63.

3. Nguyen Van Toan (2001),

\ F

Nghien ciru tdc ditng dieu tri phoi

F 9 X

hap thuoc y hoc co truyen BNC trong viem da day man tinh co

Helicobacter Pylori, Luan van tdt nghiep thac sy, Dai hoc Y Ha Noi.

4. Dang Kim Oanh, Nguyen Khanh Trach (1996), "Benh da day man tinh: Hinh thai lam sang, hinh anh noi soi va mo benh hoc"

Noi khoa,l>,29-7>2.

5. Lai Thanh Hien (2001), Nghien cim tdc diing dieu tri viem

F ,

da ddy man tinh cua thuoc Weitai

F

999, Luan van tot nghiep bac st noi trii benh vien, Dai hoc Y Ha Noi.