Banxiaxiexin Decoction Combined With Vonoprazan-Amoxicillin Dual Therapy in H. Pylori Eradication

Nanjing First Hospital, Nanjing Medical University104 enrolled

Overview

Vonoprazan and high-dose amoxicillin dual therapy was used as a control group to evaluate the clinical efficiency and safety of Banxiaxiexin decoction combined with vonoprazan and high-dose amoxicillin dual therapy in the treatment of helicobacter pylori infection complicated with functional dyspepsia,through a randomized controlled trail.

Helicobacter pylori（H.pylori）is a gastric pathogen, related to various gastrointestinal disorders. It's now a consensus of experts that H.pylori infection should be treated once it is recognized. Vonoprazan and high-dose amoxicillin dual therapy is a potential H.pylori eradication regimen. It provides a satisfactory eradication rate of 90%. Nevertheless,it has certain limitations, including a series of problems such as low eradication rate and more side effects of eradication in recurrent patients. The main side effects of the dual therapy for eradication are related symptoms of gastric motility deficiency and indigestion, such as bloating, abdominal pain, belching, acid reflux, etc. Combining traditional Chinese medicine may be one of the effective ways to solve the above problems.This study aims to compare the efficacy of Banxiaxiexin decoction combined with vonoprazan and high-dose amoxicillin dual therapy,with that of vonoprazan and high-dose amoxicillin dual therapy.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

104

Conditions

Helicobacter Pylori Infection

Interventions

VonoprazanDRUG

20 mg tablet twice daily

AmoxicillinDRUG

1 g tablet three times daily

Banxiaxiexin decoctionDRUG

100 ml liquid-medicine twice daily

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Age 18-65 years old 2. Patients with H.pylori infection 3. Diagnosed as functional dyspepsia 4. Meet the diagnostic criteria of H. pylori cold-heat syndrome in traditional Chinese medicine. 5. Patients who have not received H. pylori eradication treatment before, or who have failed eradication in the early stage but have not received eradication treatment within six months. 6. Volunteer to participate in this experiment and sign the informed consent. Exclusion Criteria: 1. Allergy to research drugs (penicillin allergy, etc.) 2. Patients with gastric and duodenal ulcer, pyloric obstruction, esophageal and gastric varices, gastrorrhagia, gastrointestinal mucosa with dysplasia, gastric malignant tumor and other gastrointestinal diseases. 3. Patients with severe heart, brain, liver, kidney, hematopoietic system and connective tissue diseases 4. Patients who have received H. pylori eradication treatment within six months. 5. Antibiotics and bismuth were used 4 weeks before the start of study treatment, and histamine H2 receptor antagonist or PPI was used 2 weeks before the start of study treatment. 6. Use adrenocortical hormone, non-steroidal anti-inflammatory drugs or anticoagulants. 7. History of esophageal or gastric surgery 8. Pregnant and lactating women

Locations (1)

Nanjing First Hospitai

Nanjing, Jiangsu, China

Outcomes

Primary Outcomes

Helicobacter pylori eradication rate

Eradication of H. pylori is assessed by a 13C-urea breath test (13C-UBT) performed 4 weeks after completion of eradication therapy (at week 6). A negative 13C-UBT result indicates successful eradication.

Time frame: At 4 weeks post-treatment (week 6)

Secondary Outcomes

Dyspeptic symptom score

Dyspeptic symptoms (epigastric pain, epigastric burning, postprandial fullness, early satiation) are assessed using a 4-point Likert scale for both frequency and severity. Frequency is graded as 0 (none), 1 (1-2 days/week for pain/burning; 3 days/week for fullness/satiation), 2 (3-4 days/week for pain/burning; 4-5 days/week for fullness/satiation), or 3 (≥5 days/week for pain/burning; 6-7 days/week for fullness/satiation). Severity is graded as 0 (none), 1 (mild, does not affect daily activities), 2 (moderate, can be tolerated but partially affects daily activities), or 3 (severe, difficult to tolerate and significantly affects daily activities). The total symptom score is calculated as the sum of (frequency score × severity score) for each symptom, with a possible range from 0 to 36. Higher scores indicate worse dyspeptic symptoms.

Time frame: Baseline (week 0), immediately after 2-week treatment (week 2), and at follow-up (week 6)

Incidence of adverse events

Adverse events occurring during the treatment period are recorded via telephone follow-up. The incidence and type of adverse events are documented.

Time frame: During the 2-week treatment period (days 1-14)

Medication adherence rate

Medication adherence is evaluated using the medication possession ratio (MPR). MPR is calculated as (actual number of doses taken / expected number of doses) × 100%. Good adherence is defined as MPR ≥80%; poor adherence as MPR \<80%.

Time frame: During the 2-week treatment period (days 1-14)

Tongue coating microbiota composition

Data from ClinicalTrials.gov

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