芪参益胃汤治疗慢性萎缩性胃炎伴胃癌前病变疗效及其机制探讨  

Curative effect and the mechanism of Qishenyiwei Decotion on chronic atrophic gastritis with precancerous lesions of gastric cancer

作　　者：石维娜[1] 白学娟 郝杰[1] 石新涛[1] 

机构地区：[1]河北省中医院脾胃病3科,石家庄050011 [2]河北省优抚医院消化内科,石家庄050000

出　　处：《中药药理与临床》2017年第2期176-179,共4页Pharmacology and Clinics of Chinese Materia Medica

基　　金：河北省中医药管理局科研计划项目(2015111)

摘　　要：目的:观察芪参益胃汤治疗慢性萎缩性胃炎伴胃癌前病变临床疗效,并初步探讨其治疗机制。方法:选择河北省中医院脾胃科门诊2014年1月至2016年1月收治的萎缩性胃炎伴胃癌前病变患者170例,按照数字随机表法分为2组,每组85例,治疗组给予中药组方芪参益胃汤口服,对照组给予对照组给予胃复春片口服,两组均连续治疗24周,比较两组治疗前后中医证候评分、病理积分和血清白细胞介素(IL)-2、IL-4、IL-6和干扰素-γ(INF-γ)水平,并比较两组治疗中有效率。结果:治疗后治疗组胃脘痛[(0.58±0.21)分比(1.06±0.37)分]、痞满[(0.84±0.36)分比(1.49±0.81)分]、纳呆[(0.68±0.22)分比(0.92±0.45)分]积分低于对照组(P<0.01),炎症[(0.79±0.32)分比(1.08±0.45)分]、萎缩[(0.94±0.41)分比(1.26±0.54)分]、肠化生[(0.75±0.34)分比(1.22±0.53)分]、异型增生[(0.65±0.26)分比(0.79±0.30)分]积分均明显低于对照组,血清IL-2[(9.44±1.74)pg/ml比(5.81±1.49)pg/ml]、INF-γ[(20.48±5.17)pg/ml比(15.78±5.44)pg/ml]水平明显高于对照组,IL-4[(6.04±1.51)pg/ml比(8.23±1.95)pg/ml]、IL-6[(59.64±12.77)pg/ml比(76.38±12.80)pg/ml]水平明显低于对照组,治疗总有效率高于对照组(95.18%比81.71%)。结论:芪参益胃汤可有效改善症状,缓解胃黏膜炎症,阻断和逆转肠上皮化生、异型增生,治疗萎缩性胃炎伴胃癌前病变疗效显著,其机制可能与调节Th1/Th2免疫失衡有关。Objective： To observe the curative effect of Qishenyiwei decotion on chronic atrophic gastritis （CAG）with precancerous lesions of gas- tt-ic cancer（PLGC）and to discuss the preliminary mechanism. Methods ：170 patients with CAG combined with PLGC admitted to outpatient service of spleen and stomach department of traditional Chinese hospital in hebei province from January, 2014 to January, 2016, all the pa- tients were divided into two groups according to the digital random table method, with 85 cases in each group, patients in the treatment group were orally given traditional Chinese medicine Qishenyiwei decotion, while those in the control group were given Weifuchen pills. After 24 weeks＇treatment, TCM syndrome score, pathological score, levels of serum interleukin （IL） - 2, IL - 4, IL - 6 - and interferon gamma （ INF - gamma） in two groups were compared before and after treatment. And effective rates of the two groups were compared. Results： Epigastric pain [ （0.58 ± 0. 21 ） vs （ 1.06 ± 0. 37 ） ], abdominal fullness [ （0.84 ± O. 36 ） vs （ 1.49 ± 0. 81 ） ], anorexia andtotal [ （ 0. 68 ±0. 22 ） vs （ 0. 92± 0. 45 ） ] score in the treatment group after treatment were lower than those in the control group （ P 〈 0. 01 ）. Scores of inflammation [ （0.79± 0.32） vs （ 1.08 ± 0.45 ） ], atrophy [ （0.94 ± 0.41 ） vs （ 1.26 ± 0.54） ], intestinal metaplasia [ （ 0.75 ± 0.34） vs （ 1.22 ± 0.53 ） ] and hy- perplasia integration [ （ 0.65 ± 0.26 ） vs （ 0.79 ± 0.30 ） ] in the treatment group were lower than those in the control group （ P 〈 0.01 ）, lev- els of serum IL - 2 [ （ 9.44 ± 1.74 ） pg/ml vs （ 5.81 ± 1.49 ） pg/ml ] and INF-γ [ （ 20.48 ± 5.17 ） pg/ml vs （ 15.78 ± 5.44 ） pg/ml ] in the treatment group were higher than those in the control group （ P 〈 0.01 ）, levels of IL - 4 [ （ 6.04 ± 1.51 ） pg/ml vs （ 8.23 ± 1.95 ） pg/ml ], IL - 6 [ （59.64 ± 12.77 ） pg/ml vs （76.38 ± 12.80） pg/ml

关 键 词：芪参益胃汤 萎缩性胃炎 癌前病变 

分 类 号：R259[医药卫生—中西医结合]