摘要
目的:基于络病理论观察加味香砂六君子汤联合四联法治疗脾虚湿盛证慢性萎缩性胃炎的临床效果,探讨其部分作用机制,为后期临床治疗提供参考。方法:采用单纯随机抽样法,将112例患者分为对照组、观察组,各56例。对照组患者给予四联疗法联合安慰剂治疗,观察组给予加味香砂六君子汤联合四联疗法,连续治疗4周。评估两组患者治疗前后的中医证候积分、PRO生存质量评分、汉密尔顿(HAMA)焦虑状态评分、内镜评分、胃黏膜病理评分以及测定生长激素(GH)、胃泌素(G-17)、胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、免疫炎性状态(IL-6、CRP、TNF-α)含量,并记录临床有效率、Hp根除率及不良反应发生率。结果:治疗后,观察组临床总有效率96.4%,对照组82.2%(χ^(2)=12.34,P<0.05);Hp根除率观察组98.3%,对照组85.7%(χ^(2)=5.92,P<0.05);不良反应发生率观察组5.2%,对照组12.3%(χ^(2)=1.111,P>0.05)。两组患者治疗后中医证候积分、PRO生存质量评分、汉密尔顿(HAMA)焦虑状态评分、内镜评分、胃黏膜病理评分以及PGⅡ、IL-6、TNF-α、CRP表达水平均低于对照组,G-17、GH、PGⅠ、PGR表达水平高于对照组(P<0.05)。结论:加味香砂六君子汤联合四联法治疗慢性萎缩性胃炎在缓解中医证候积分、PRO生存质量评分、汉密尔顿(HAMA)焦虑状态评分、内镜评分、胃黏膜病理评分以及临床有效率、Hp根除率、不良反应发生率等方面具有积极的临床效果,其机制可能与调节PGⅠ、PGⅡ、G-17、GH和IL-6、TNF-α、CRP表达,减轻胃黏膜炎性损伤、保护胃黏膜有关。
Objective:Based on the theory of collateral disease,observe the clinical effect of Modified Xiangsha Liujunzi Decoction combined with quadruple therapy in the treatment of chronic atrophic gastritis with spleen deficiency and dampness syndrome,explore its partial mechanism of action,and provide reference for later clinical treatment.Methods:Using simple random sampling method,112 patients were divided into control group and observation group,with 56 cases in each group.The patients in the control group were given quadruple therapy combined with placebo,and the observation group was given flavored Xiangsha Liujunzi Decoction combined with quadruple therapy for 4 consecutive weeks.The TCM syndrome scores,PRO quality of life score,Hamilton(HAMA)anxiety state score,endoscopic score,gastric mucosal pathology score,and growth hormone(GH),gastrin(G-17),and The contents of pepsinogenⅠ(PGⅠ),pepsinogenⅡ(PGⅡ),and immune inflammatory status(IL-6,CRP,TNF-α)were recorded,and the clinical effective rate,Hpylori eradication rate,and incidence of adverse reactions were recorded.Results:After treatment,the total clinical effective rate in the observation group was 96.4%,and that in the control group was 82.2%(χ^(2)=12.34,P<0.05);the Hp eradication rate in the observation group was 98.3%,and that in the control group was 85.7%(χ^(2)=5.92,P<0.05);The incidence rate of adverse reactions was 5.2%and 12.3%in the control group(χ^(2)=1.111,P<0.05).After treatment,the TCM symptom scores,PRO quality of life score,Hamilton(HAMA)anxiety state score,endoscopic score,gastric mucosal pathology score,and PGⅡ,IL-6,TNF-α,and CRP expression levels of the two groups were lower than those of the control group,the expression levels of G-17,GH,PGⅠand PGR were higher than those in the control group(P<0.05).Conclusion:Modified Xiangsha Liujunzi Decoction combined with quadruple therapy in the treatment of chronic atrophic gastritis can effectively alleviate the traditional Chinese medicine syndrome score,PRO quality of life score,Hamilton(HAMA)anxiety state score,endoscopic score,gastric mucosal pathology score,and clinical effectiveness.It has positive clinical effects in terms of,Hp eradication rate,and incidence of adverse reactions.Its mechanism may be related to regulating the expression of PGⅠ,PGⅡ,G-17,GH and IL-6,TNF-α,and CRP,and reducing inflammatory damage of gastric mucosa,related to the protection of gastric mucosa.
作者
宁曹
庞浇安
叶桂源
谭熙
刘春丽
文丽君
Ning Cao;Pang Jiaoan;Ye Guiyuan;Tan Xi;Liu Chunli;Wen Lijun(Sainz New School of Medicine,Guangxi University of Chinese Medicine,Nanning 530200,China;The First Hospital Affiliated to Guangxi University of Chinese Medicine,Nanning 530200,China;Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine,Nanning 530200,China;General Hospital of the Southern Theater Command of the Chinese People Liberation Army,Guangzhou 510000,China;Binyang County Traditional Chinese Medicine Hospital,Binyang 530400,China)
出处
《亚太传统医药》
2024年第5期80-86,共7页
Asia-Pacific Traditional Medicine
基金
广西中医药适宜技术开发与推广项目(GZSY2024094)
广西高校中青年教师科研基础能力项目(2022KY1668)
广西中医药大学校级科研项目(2023MS022)
广西中医药大学研究生教育创新计划项目(YCSY2023035)。
关键词
慢性萎缩性胃炎
加味香砂六君子汤
络病理论
Chronic Atrophic Gastritis
Flavored Xiangsha Liujunzi Decoction
Collateral Disease Theory
