健脾益胃汤治疗慢性萎缩性胃炎的随机对照研究
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摘要
目的:观察自拟健脾益胃汤治疗慢性萎缩性胃炎的临床效果。方法:选取2017年6月至2018年6月在本院治疗的慢性萎缩性胃炎患者90例,随机分为观察组和对照组,每组45例。对照组给予养胃舒胶囊治疗,观察组给予自拟健脾益胃汤治疗。观察两组患者治疗后临床疗效、幽门螺杆菌(helicobacter pylori,Hp)根除效果以及治疗前后中医证候积分、胃黏膜病理评分、血清炎性因子[肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-1β(interleukin-1β,IL-1β)、白细胞介素-8 (interleukin-8,IL-8)]水平变化情况。结果:观察组有效率97. 78%,Hp转阴率为90. 32%,对照组有效率82. 22%,Hp转阴率为70. 00%,观察组有效率、Hp转阴率高于对照组,差异有统计学意义(P <0. 05);观察组治疗后中医证候积分低于对照组,差异有统计学意义(P <0. 05);观察组治疗后胃黏膜萎缩、肠化生、异型增生评分均低于对照组,差异有统计学意义(P <0. 05);观察组治疗后TNF-α、IL-1β、IL-8水平均低于对照组,差异有统计学意义(P <0. 05)。结论:自拟健脾益胃汤治疗慢性萎缩性胃炎疗效显著,可明显改善患者炎症和胃黏膜状态。
Objective: To observe the clinical curative effect of Spleen-Invigorating and Stomach-Nourishing Decoction on chronic atrophic gastritis. Methods: Ninety patients with chronic atrophic gastritis treated in our hospital from June 2017 to June 2018 were randomly divided into the observation group and the control group,with 45 cases in each group. The control group was treated with Yangweishu Capsules( YSSC),while the observation group was treated with Self-Made Spleen-Invigorating and Stomach-Nourishing Decoction. The clinical efficacies,eradication effects of Helicobacter pylori( Hp) and changes of TCM syndrome score,gastric mucosal pathological score,serum inflammatory factors levels [tumor necrosis factor-α( TNF-α),interleukin-1β( IL-1β),interleukin-8( IL-8) ] before and after the treatment were observed. Results: The effective rate of the observation group was97. 78%,the negative rate of Hp was 90. 32%,the effective rate of the control group was 82. 22%,and the negative rate of Hp was 70. 00%. The effective rate and the negative rate of Hp of the observation group were higher than those of the control group,and all the differences were statistically significant( P < 0. 05). The scores of TCM syndromes in the observation group were lower than those in the control group,and the difference was statistically significant( P < 0. 05). The scores of gastric atrophy,intestinal metaplasia and dysplasia in the observation group were lower than those in the control group and all the differences were statistically significant( P < 0. 05). The levels of TNF-α,IL-1βand IL-8 in the observation group were lower than those in the control group and all the differences were statistically significant( P < 0. 05). Conclusion: Self-Made Spleen-Invigorating and StomachNourishing Decoction has a remarkable efficacy on chronic atrophic gastritis,can significantly improve the inflammation and gastric mucosal status of patients.
Objective: To observe the clinical curative effect of Spleen-Invigorating and Stomach-Nourishing Decoction on chronic atrophic gastritis. Methods: Ninety patients with chronic atrophic gastritis treated in our hospital from June 2017 to June 2018 were randomly divided into the observation group and the control group,with 45 cases in each group. The control group was treated with Yangweishu Capsules( YSSC),while the observation group was treated with Self-Made Spleen-Invigorating and Stomach-Nourishing Decoction. The clinical efficacies,eradication effects of Helicobacter pylori( Hp) and changes of TCM syndrome score,gastric mucosal pathological score,serum inflammatory factors levels [tumor necrosis factor-α( TNF-α),interleukin-1β( IL-1β),interleukin-8( IL-8) ] before and after the treatment were observed. Results: The effective rate of the observation group was97. 78%,the negative rate of Hp was 90. 32%,the effective rate of the control group was 82. 22%,and the negative rate of Hp was 70. 00%. The effective rate and the negative rate of Hp of the observation group were higher than those of the control group,and all the differences were statistically significant( P < 0. 05). The scores of TCM syndromes in the observation group were lower than those in the control group,and the difference was statistically significant( P < 0. 05). The scores of gastric atrophy,intestinal metaplasia and dysplasia in the observation group were lower than those in the control group and all the differences were statistically significant( P < 0. 05). The levels of TNF-α,IL-1βand IL-8 in the observation group were lower than those in the control group and all the differences were statistically significant( P < 0. 05). Conclusion: Self-Made Spleen-Invigorating and StomachNourishing Decoction has a remarkable efficacy on chronic atrophic gastritis,can significantly improve the inflammation and gastric mucosal status of patients.
引文
[1]赵润元,刘小发.慢性萎缩性胃炎伴胃黏膜肠上皮化生的中西医诊疗进展[J].河北中医,2018,40(6):942-946.
[2]姜小艳,李京伟,张竞超,等.萎缩性胃炎致病机制研究概况及中医药实验研究进展[J].中国中西医结合消化杂志,2018,26(12):1049-1052.
[3]周滔,危北海,陈誩,等.消化病中西医结合研究的热点与进展[J].中国中西医结合消化杂志,2017,25(8):635-637.
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[10]张华颖,黄鑫宇,薛会光,等.慢性萎缩性胃炎发生胃癌的危险因素:一项长期随访研究[J].世界华人消化杂志,2018,26(31):1812-1817.
[11]魏冬琴,蒋士生.慢性萎缩性胃炎中医辨证论治研究进展[J].湖南中医杂志,2018,34(12):155-157.
[12]施文杰,王艳,袁成业,等.慢性萎缩性胃炎中医证型与胃黏膜象相关性研究[J].云南中医学院学报,2018,41(3):61-64.
[13]刘洋,黄鹤,周毅,等.慢性萎缩性胃炎近十年中医文献浅析[J].中国中西医结合消化杂志,2018,26(10):868-870.
[14]朱亚楠.慢性萎缩性胃炎患者的中医证候与病理变化及幽门螺杆菌感染的相关性研究[J].现代中西医结合杂志,2018,27(36):4068-4071.
[15]刘伟锋,蒋玉萍,龙凤艳,等.健脾益胃方治疗脾胃虚弱型慢性萎缩性胃炎疗效观察[J].光明中医,2015,30(11):2334-2335.
[16]周静,徐惠明,陈小芳,等.健脾益胃化瘀方治疗萎缩性胃炎伴低级别上皮内瘤变的临床研究[J].实用临床医药杂志,2018,22(24):37-40.
[17]石芳,王志坤,刘启泉,等.基于中医传承辅助系统挖掘刘启泉治疗慢性萎缩性胃炎伴肠上皮化生用药规律[J].河南中医,2018,38(4):633-637.
[18]罗仕娟,王静,黄穗平.“肝主疏泄、脾主运化”与慢性萎缩性胃炎中医发病机制探讨[J].辽宁中医药大学学报,2014,16(12):145-147.
[19]徐明,陈睿,李颖,等.陈秀华综合疗法治疗慢性萎缩性胃炎经验探析[J].现代中西医结合杂志,2018,27(34):3803-3807.
[2]姜小艳,李京伟,张竞超,等.萎缩性胃炎致病机制研究概况及中医药实验研究进展[J].中国中西医结合消化杂志,2018,26(12):1049-1052.
[3]周滔,危北海,陈誩,等.消化病中西医结合研究的热点与进展[J].中国中西医结合消化杂志,2017,25(8):635-637.
[4]于皆平,沈志祥,罗和生.实用消化病学[M]. 3版.北京:科学出版社,2017:369-370.
[5]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:159.
[6]梁立敏.赵绍华治疗慢性萎缩性胃炎经验[J].河南中医,2017,37(11):1908-1910.
[7]国家中医药管理局.中医病证诊断疗效标准(2012版)[M].北京:中国医药科技出版社,2012:57.
[8]刘枭,刘涛,王灿晖.王灿晖教授治疗慢性萎缩性胃炎的经验[J].浙江中医药大学学报,2016,40(3):196-199.
[9]陈莹莹,鲁晏武,刘涛,等.王灿晖辨治慢性萎缩性胃炎临床经验撷菁[J].中华中医药杂志,2017,32(10):4497-4499.
[10]张华颖,黄鑫宇,薛会光,等.慢性萎缩性胃炎发生胃癌的危险因素:一项长期随访研究[J].世界华人消化杂志,2018,26(31):1812-1817.
[11]魏冬琴,蒋士生.慢性萎缩性胃炎中医辨证论治研究进展[J].湖南中医杂志,2018,34(12):155-157.
[12]施文杰,王艳,袁成业,等.慢性萎缩性胃炎中医证型与胃黏膜象相关性研究[J].云南中医学院学报,2018,41(3):61-64.
[13]刘洋,黄鹤,周毅,等.慢性萎缩性胃炎近十年中医文献浅析[J].中国中西医结合消化杂志,2018,26(10):868-870.
[14]朱亚楠.慢性萎缩性胃炎患者的中医证候与病理变化及幽门螺杆菌感染的相关性研究[J].现代中西医结合杂志,2018,27(36):4068-4071.
[15]刘伟锋,蒋玉萍,龙凤艳,等.健脾益胃方治疗脾胃虚弱型慢性萎缩性胃炎疗效观察[J].光明中医,2015,30(11):2334-2335.
[16]周静,徐惠明,陈小芳,等.健脾益胃化瘀方治疗萎缩性胃炎伴低级别上皮内瘤变的临床研究[J].实用临床医药杂志,2018,22(24):37-40.
[17]石芳,王志坤,刘启泉,等.基于中医传承辅助系统挖掘刘启泉治疗慢性萎缩性胃炎伴肠上皮化生用药规律[J].河南中医,2018,38(4):633-637.
[18]罗仕娟,王静,黄穗平.“肝主疏泄、脾主运化”与慢性萎缩性胃炎中医发病机制探讨[J].辽宁中医药大学学报,2014,16(12):145-147.
[19]徐明,陈睿,李颖,等.陈秀华综合疗法治疗慢性萎缩性胃炎经验探析[J].现代中西医结合杂志,2018,27(34):3803-3807.