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Abstract
A peptic ulcer disease is common worldwide. The overall lifetime prevalence is about 12% for men and 9% for women. It is an ulcer of an area of the gastrointestinal tract that is usually acidic and thus extremely painful. As much as 80% of ulcers are associated with Helicobacter pylori, a spiral shaped bacterium that lives in the acidic environment of the stomach. Ulcers can also be caused or worsened by drugs such as Aspirin and other NSAIDs (Atherton and Spiller, 2007 ).Researchers continue to look at stress as a possible cause, or at least a complication in the development of ulcers. A study of peptic ulcer patients showed that chronic stress was strongly associated with an increased risk of peptic ulcer, and a combination of chronic stress and irregular mealtimes was a significant risk factor (Forbes et al., 2006). Younger patients with ulcer-like symptoms are often treated with antacids or H2 antagonists before EGD is undertaken. Bismuth compounds may actually reduce or even clear organisms. Patients who are taking nonsteroidal anti-inflammatory (NSAIDs) may also be prescribed a prostaglandin in order to help prevent peptic ulcers, which may be a side-effect of the NSAIDs. When H. pylori infection is present, the most effective treatments are combinations of 2 antibiotics and 1 proton pump inhibitor (PPI). In complicated ulcer, 3 antibiotics may be used together with a PPI (Carbtree et al., 2008).The patient study was to determine the effect of combining herbal therapy (licorice root) with conventional therapy on the healing process of peptic ulcer.Research design: An experimental research design was adopted to fulfill the aim of the study to determining the effect of combining herbal therapy with conventional therapy on the healing process of peptic ulcer Research Setting: The study was conducted in General Medicine Out patient’s and in Tropical Medicine Department, at Menoufiya University, Hospital. The researcher selected this department because it is representative to sample selection. Data collection was extended from May 2007 to the end of Aug. 2007.Subjects: The study subjects comprised of 60 adult patients newly diagnosed with peptic ulcer were selected and divided alternatively into two equal groups. Study group (I) was received conventional therapy as anti acid ”H2 blocker” and proton pump inhibitor and maintain taking daily-prescribed dose of licorice root and follow therapeutic regimen relating to (diet, exercise, rest and sleep). Control group (II) was received conventional therapy as anti acid”H2 blocker” and proton pump inhibitor and follow therapeutic regimen relating to (diet, exercise, rest and sleep).Inclusion criteria: 1- Adult patients of both sexes. 2- Newly diagnosed with peptic ulcer, with no complications Free from any associated disorder as moderate to severe hypertension, renal failure , heart disease and diabetes mellitus. 4- Both groups were matched as much as possible regarding to age, sex and site of ulcer. 5- Women’s use oral contraceptive pills were excluded from the study. 6- Willing to participate in the study. Research Variables: The independent variable is intake of licorice root, while the dependent variable is the healing process of peptic ulcer. Research Hypothesis: The following research hypotheses were formulated to achieve the aim of the study. 1. Subjects who receive licorice root with conventional therapy ”study group” will report a relieve of symptoms than the ”controlgroup”.2. Subjects who receive licorice root with conventional therapy ”study group” will report a rapid peptic ulcer healing than. subjects who didn’t receive the herbal therapy ”control group”. 3. Subjects who didn’t receive licorice root ”control group” will show peptic ulcer complications than the ”study group”.The study was conducted in General Medicine Out patient’s and in Tropical Medicine Department, at Menoufiya University, Hospital. at Shebin El-Kom. The researcher selected this department because it is dealing with patients had peptic ulcers. Data collection was extended in the period from the May 2007 to the end of Aug. 2007.Tools of the study: To achieve the aim of the study and to collect the necessary data, the investigator used four tools based on review of related literature. All tools translated into Arabic The following tools were used: Tool I: Peptic ulcer Physical Assessment Sheet. Too II: Visual analogue pain scale. Tool III: Nutritional assessment sheet.Tool IV: Evaluation Sheet. Tool I: Peptic ulcer Physical Assessment Sheet It was developed by the investigator to assess patient’s physical conditions. It included five parts: Sociodemographic data, Medical History, patient signs and symptoms and local examination investigation (lab analysis and Upper Gastrointestinal Endoscope) Tool II: Visual analogue pain scale: A scale was developed by Smeltzer, and Bare, (2004) and translated by the researcher into Arabic to provide a simple way to record subjective estimates of pain intensity. Tool III: Nutritional assessment sheet: It was adopted by the investigator after reviewing of the related literature for assessment of the nutritional status of the patients (Peggy and Stanfield, 1997 & Dudek and Suzan, 1987). It included three parts. seven days Dietary recall, Anthropometric measurements and Physical indicator of nutritional status. IV) Tool four: Evaluation Sheet (Appendix V)It was designed by the investigator to assess patient s compliance to therapeutic regimen as treatment, diet and pattern of life as well as their health beliefs. It was in Arabic and comprised of three parts. patient s compliance to therapeutic regimen, patient s compliance to medical treatment and Upper GIT endoscope. II-Methods 1. Written approval : Prior to data collection, a written permission from the faculty of nursing to the responsible authorities of hospital as (hospital director and the head of the unit). After explaining the importance of the study and its purpose (the hospital chief executive grand an approval for the study). 2. Tools development:-Tool (I and IV) was developed by the researcher after extensive review of related literature, tool (II) was developed by Smeltzer, and Bare, (2004) and tool(III) was developed by (Peggy and Stanfield, 1997& Dudek and Suzan, 1987). All tools was translated into Arabic. All tools were tested for its content validity by three experts in the field of medical and medical surgical nursing, Faculty.