摘要
目的:观察加减归脾汤联合胃复春治疗脾胃虚弱型慢性萎缩性胃炎(Chronic atrophic gastritis,CAG)伴焦虑的临床疗效。探求该药的临床价值及潜在的作用机制,为临床治疗提供一种参考。方法:观察符合纳入要求的CAG伴焦虑患者,共80例,随机地分为对照组和治疗组各40例,对照组予胃复春治疗,治疗组予加减归脾汤联合胃复春,两组以8周为疗程。治疗8周后观察两组中医证候积分、中医证候疗效、汉密尔顿焦虑量表(HAMA)评分、胃镜症候评分、病理评分、血清中胃泌素17(G-17)、胃蛋白酶原I(PGI)、胃蛋白酶原I/II比值(PGR)以及安全性评价。结果:中医症候疗效:相比对照组的总有效率为75.00%,治疗组总有效率92.50%显示较对照组更佳(P<0.05)。中医症候积分:治疗8周后,两组中医证候积分均较前有所下降,对比治疗前后中医症候积分变化情况,治疗组更为明显(P<0.05)。病理积分:将炎症、萎缩、肠化、异型增生的有无,按程度分为分为无、轻、中、重四个轻重等级,记为0、1、2、3分,两组治疗后记录各项目总积分,表明两组治疗均是有效的(P<0.05),且治疗组治疗效果明显高于对照组(P<0.05)。血清G-17、PGI、PGR水平:经治疗两组患者G-17、PGI、PGR较前均上升(P<0.05),且治疗组升幅大于对照组(P<0.05)。汉密尔顿焦虑量表(HAMA)评分:治疗后两组患者焦虑量表评分均较治疗前降低(P<0.05),治疗后两组间比较,差异具有统计学意义(P<0.05)。表示治疗组较对照组更能改善焦虑。结论:加减归脾汤联合胃复春治疗脾胃虚弱型CAG伴有焦虑的患者时可以显著改善患者的中医症候、心理状态、胃黏膜状态及病理积分,有效调节血清G-17、PGI、PGR水平,对比对照组疗效更佳,且治疗安全,无不良事件发生。
Objective:To observe the clinical efficacy of modified Guipi Decoction combined with Weifuchun in the treatment of spleen and stomach weakness type chronic atrophic gastritis(CAG)accompanied by anxiety.Explore the clinical value and potential mechanism of action of this drug to provide a reference for clinical treatment.Methods:A total of 80 CAG patients with anxiety who met the inclusion requirements were observed,and they were randomly divided into a control group and a treatment group of 40 cases each.The control group was treated with Weifuchun,and the treatment group was treated with Jiajia Guipi Decoction combined with Weifuchun.The treatment course for both groups was 8 weeks.After 8 weeks of treatment,the TCM syndrome scores,TCM syndrome efficacy,Hamilton Anxiety Scale(HAMA)score,gastroscopy symptom score,pathology score,serum gastrin 17(G-17),pepsinogen I(PGI),pepsinogen I/II ratio(PGR)and safety evaluation.Results:The efficacy of TCM symptoms:compared with the control group,the total effective rate was 75.00%,and the treatment group’s total effective rate was 92.50%,which showed that it was better than the control group(P<0.05).TCM syndrome scores:After 8 weeks of treatment,the TCM syndrome scores of both groups decreased compared with before.Comparing the changes in TCM syndrome scores before and after treatment,the treatment group was more obvious(P<0.05).Pathological score:The presence or absence of inflammation,atrophy,intestinal metaplasia,and dysplasia is divided into four severity levels:none,mild,moderate,and severe,recorded as 0,1,2,and 3 points.After treatment in both groups The total points of each item were recorded,indicating that the treatments in both groups were effective(P<0.05),and the treatment effect of the treatment group was signifi-cantly higher than that of the control group(P<0.05).Serum G-17,PGI,and PGR levels:After treatment,the levels of G-17,PGI,and PGR in both groups of patients increased compared with before(P<0.05),and the increase in the treatment group was greater than that in the control group(P<0.05).Hamilton Anxiety Scale(HAMA)score:After treatment,the anxiety scale scores of the two groups of patients were lower than before treatment(P<0.05).The difference between the two groups after treatment was statistically significant(P<0.05).It means that the treatment group can improve anxiety better than the control group.Conclusion:Jiajian Guipi Decoction combined with Weifuchun can significantly improve the patients’TCM symptoms,psychological state,gastric mucosal status and pathological scores,and effectively regulate serum G-17,PGI and PGR when treating patients with spleen and stomach weakness CAG accompanied by anxiety level,compared with the control group,the efficacy is better,and the treatment is safe,with no adverse events.
作者
孙雯蔷
杨辉
刘丽丽
SUN Wenqiang;YANG Hui;LIU Lili(Anhui University of Chinese Medicine,Anhui Hefei 230038,China;The First Affiliated Hospital of Anhui University of Chinese Medicine,Anhui Hefei 230031,China)
出处
《中医药临床杂志》
2024年第4期754-758,共5页
Clinical Journal of Traditional Chinese Medicine
基金
安徽省中医药传承创新科研项目(编号:No.2020cczd02)
国家中医药管理局全国名老中医药专家传承工作室建设项目(国中医药人教函[2022]175号)。
关键词
加减归脾汤
慢性萎缩性胃炎伴焦虑
脾胃虚弱型
Jiajia Guipi Decoction
Chronic atrophic gastritis with anxiety
Spleen and stomach weakness type
