黄芪建中汤联合质子泵抑制剂四联序贯疗法防治胃溃疡的疗效及对金属蛋白酶-3、Ghrelin表达的影响  

Huangqi Jianzhong Decoction Combined with Quadruple Sequential Therapy of Proton Pump Inhibitor Treating Gastric Ulcer: Study of Curative Efficacy and Effect on Matrix Metalloproteinase-3 and Ghrelin

作　　者：王昆 张莹[1] WANG Kun;ZHANG Ying(Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院,北京100029

出　　处：《中医药信息》2018年第5期82-86,共5页Information on Traditional Chinese Medicine

摘　　要：目的:观察黄芪建中汤联合质子泵抑制剂四联序贯疗法对胃溃疡的治疗效果及其可能的作用机制。方法:选取符合纳入标准的92例胃溃疡患者,随机分为对照组和治疗组,对照组给予质子泵抑制剂四联序贯疗法治疗,治疗组在对照组基础上口服黄芪建中汤。两组患者治疗6周后,进行胃镜下黏膜愈合质量检查,并检测基质金属蛋白酶-3、ghrelin的表达变化及中医证候积分的变化情况。结果:治疗组患者胃镜下黏膜愈合质量明显高于对照组(P <0. 05),与治疗前相比,两组患者基质金属蛋白酶-3表达量显著升高,且治疗组明显高于对照组(P <0. 05);而治疗后ghrelin显著降低,且治疗组显著低于对照组(P <0. 05);两组患者的中医证候积分显著下降,且治疗组明显低于对照组(P <0. 05)。结论:黄芪建中汤与四联序贯疗法联用具有更好的临床疗效,可以通过调控基质金属蛋白酶-3及ghrelin水平,降低中医证候积分,提高胃黏膜溃疡愈合率,达到防治胃溃疡的效果,值得推广和应用。Objective： To observe the curative efficacy of Huangqi Jianzhong Decoction combined with quadruple sequential therapy of proton pump inhibitor treating gastric ulcer. Methods： 92 patients with gastric ucler were randomly divided into the observation group （n =46） and the control group （n =46）. The control group was treated with quadruple sequential therapy of proton pump inhibitor; on which basis, the observation group was also treated with Huangqi Jianzhong Decoction. After 6 weeks of treatment, the quality of endoscopic mucosal healing, and expressions of matrix metalloproteinase - 3 and ghrelin, as well as TCM syndrome score were detected to assess the curative effect. Results： The quality of gastric mucosal healing was significantly higher in the observation group than that in the control group （P 〈 0.05）. The expression of matrix metalloproteinase- 3 was significantly increased after the treatment in the two groups; the observation group changed more significantly than the control group（P 〈 0.05）. In terms of ghrelin expression and TCM syn- drome scold, they were both significantly decreased after the treatment in the two groups; the changes of the observation group were moe obvious than those of the control group （P 〈 0. 05）. Conclusion： Huangqi Jianzhong Decoction combined with quadruple sequential therapy was better than single use of quadruple se-quential therapy in treatment of gastric ulcer, which may be through regulating matrix metalloproteinase -3 and ghrelin, reducing TCM syndrome score and improving gastric mucosal ulcer healing, to achieve the result of preventing and treating gastric ulcer. This therapy is worthy of promotion in clinical application.

关 键 词：基质金属蛋白酶-3 ghrelin 中医证候积分 黏膜愈合质量 黄芪建中汤 质子泵抑制剂四联序贯疗法 胃溃疡 

分 类 号：R285.6[医药卫生—中药学]