参芪益胃汤治疗脾胃虚寒型萎缩性胃炎的临床疗效及对TXB_2和6-Keto-PGF1α的影响  

Shenqi Yiwei decoction for treatment of atrophic gastritis of spleen-stomach deficiency cold type: Clinical efficacy and influence on TXB_2 and 6-keto-PGF1α

作　　者：沈晨靓 王圳 

机构地区：[1]浙江中医药大学附属第三医院(浙江省中山医院)中药药剂科,浙江省杭州市310009 [2]浙江省杭州市红会医院风湿肾内科,浙江省杭州市310003

出　　处：《世界华人消化杂志》2018年第4期236-242,共7页World Chinese Journal of Digestology

摘　　要：目的分析参芪益胃汤治疗脾胃虚寒型萎缩性胃炎的临床疗效及对TXB_2和6-Keto-PGF1α的影响.方法选择从2016-01/2017-10浙江中医药大学附属第三医院就诊86例脾胃虚寒型萎缩性胃炎患者,采用简单随机单双就诊号的方法分为试验组43例和对照组43例,对照组患者给予奥美拉唑西药治疗,试验组患者给予参芪益胃汤治疗.两组患者治疗8 wk.观察两组患者的临床治疗效果,治疗前后主要症状积分(包括上腹饱胀、口干口苦、纳差、乏力和消化不良)及内镜积分(包括黏膜白相、黏膜糜烂、胆汁返流、黏膜皱襞、血管透见)改善情况.采用酶联免疫方法测定两组患者治疗前后TXB_2和6-Keto-PGF1α的变化,同时观察两组患者治疗期间不良反应情况.结果试验组患者治疗后的总临床有效率为95.35%,对照组患者的治疗总有效率为81.40%,两组患者治疗后的总临床有效率比较,差异有统计学意义(χ~2=4.0741,P=0.0436).两组患者治疗前上腹饱胀、口干口苦、纳差、乏力和消化不良积分比较,差异均无明显统计学意义(P>0.05),治疗后上述积分均显著降低,差异有统计学意义(P<0.05),且试验组患者治疗后上腹饱胀、口干口苦、纳差、乏力和消化不良积分均显著低于对照组患者,差异有统计学意义(P<0.05).两组患者治疗前黏膜白相、黏膜糜烂、胆汁返流、黏膜皱襞、血管透见积分比较,差异均无明显统计学意义(P>0.05),治疗后上述积分均显著改善,差异有统计学意义(P<0.05),且试验组患者治疗后黏膜白相、黏膜糜烂、胆汁返流、黏膜皱襞、血管透见积分均显著优于对照组患者,差异有统计学意义(P<0.05).两组患者治疗前TXB_2和6-Keto-PGF1α比较,差异均无明显统计学意义(P>0.05),治疗后TXB_2降低,6-Keto-PGF1α升高,差异有统计学意义(P<0.05),且试验组患者治疗后TXB_2和6-Keto-PGF1α均显著优于对照组患者,差异有统计学意义(P<0.05).两组�AIM To evaluate the clinical efficacy of Shenqi Yiwei decoction in the treatment of atrophic gastritis of spleen-stomach deficiency cold type and investigate its influence on TXB2 and 6-keto-PGF1α. METHODS Eighty-six patients with atrophic gastritis of spleen- stomach deficiency cold type were selected from January 2016 to October 2017 at the Third Affiliated Hospital of Zhejiang Chinese Medicine University, and the patients were randomly divided into either an experimental group （n = 43） or a control group （n = 43）. The control group was treated with omeprazole, while the experimental group was treated with Shenqi Yiwei decoction. The patients in both groups were treated for 8 wk. The effective rates of the two groups were compared. Main symptom scores （including abdominal distension, dry mouth, anorexia, fatigue, and indigestion）, endoscopic scores （including mucosal appearance, mucosal erosion, bile reflux, mucous folds, and blood vessels）, TXB2 and 6-keto-PGF1α, and complications were also compared between the two groups. RESULT The total effective rate was significantly higher in the experimental group than in the control group （95.35% vs 81.40%, 2 - 4.0741, P = 0.0436）. Before treatment, abdominal distension, dry mouth, anorexia, fatigue,and indigestion scores were not statistically significant between the two groups （P 〉 0.05）; after treatment, these scored significantly decreased in both groups （P 〈 0.05）, and the decrease was more significant in the experimental group. Before treatment, scores of mucosal appearance, mucosal erosion, bile reflux, mucous folds, and blood vessels were not statistically significant between the two groups （P 〉 0.05）; after treatment, these scores were significantly improved in both groups （P 〈 0.05）, and the improvement was more significant in the experimental group （P 〈 0.05）. Before treatment, TXB2 and 6-keto-PGF1α differed significantly between the two groups （P 〉 0.05）; after treatment, TXB2 decreased significantl

关 键 词：参芪益胃汤 奥美拉唑 脾胃虚寒型 萎缩性胃炎 TXB2 6-Keto—PGF1α 

分 类 号：R259[医药卫生—中西医结合]