养阴益胃汤联合经典四联用药方案治疗慢性萎缩性胃炎的疗效分析  

Yangyin Yiwei decoction combined with quadruple therapy in the treatment of chronic atrophic gastritis

作　　者：张大军 ZHANG Dajun(Department of Traditional Chinese Medicine,Rugao Third People's Hospital,Rugao 226531,China)

机构地区：[1]江苏省如皋市第三人民医院中医科

出　　处：《中国医药科学》2019年第23期30-33,37,共5页China Medicine And Pharmacy

摘　　要：目的研究养阴益胃汤联合含铋制剂的经典四联方案对幽门螺杆菌(Hp)阳性慢性萎缩性胃炎(CAG)患者的临床疗效、炎症因子水平及免疫功能的影响。方法选取2016年6月~2018年6月我院收治的Hp阳性、辨证为胃阴亏虚型CAG患者120例,随机分为两组,对照组60例接受含铋制剂的经典四联方案治疗;实验组60例在含铋制剂的经典四联方案基础上联合养阴益胃汤治疗,养阴益胃汤根据本院配方配制。1个疗程为4周,持续治疗3个疗程。治疗前后观察消化道症状、内镜下黏膜征象和病理改变;Hp转阴情况;白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)等炎症因子和CD3、CD4、CD8等免疫指标的变化。结果对照组临床有效率90.00%,实验组91.67%,两组差异无统计学意义(P> 0.05),但整体有效率高达90.83%。实验组治疗后恶心呕吐、嗳气返酸临床评分分别为(0.85±0.66)分、(0.73±0.66)分,较治疗前明显下降,同时明显低于对照组(1.82±0.39)分和(1.75±0.44)分,差异均有统计学意义(P<0.05);两组治疗后上腹疼痛和饱胀评分较治疗前均有下降,但差异无统计学意义(P> 0.05)。实验组的Hp转阴根除率明显高于对照组,差异有统计学意义(P <0.05)。实验组治疗后IL-6、TNF-α和CRP含量分别为(7.16±1.09)ng/L、(1.38±0.13)ng/L和(11.12±1.65)mg/L,明显低于对照组治疗后水平(10.58±1.67)ng/L、(2.61±0.25)ng/L和(17.26±2.62)mg/L,差异均有统计学意义(P<0.05)。对照组中CD3、CD4、CD8治疗前后变化较小,差异无统计学意义(P> 0.05)。实验组治疗后CD3、CD4、CD8分别为(59.58±4.02)%、(41.16±3.42)%、(41.09±3.47)%,较治疗前明显升高,且高于对照组治疗后水平,差异均有统计学意义(P <0.05)。结论养阴益胃汤联合含铋制剂的经典四联方案的治疗方案对Hp阳性慢性萎缩性胃炎效果显著,消化道刺激症状明显改善,Hp有效根除,炎症因子明显降低,并提高免疫功能。Objective To study the effect of Yangyin Yiwei decoction combined with quadruple therapy containing bismuth preparation on the clinical efficacy, inflammatory factor level and immune function of helicobacter pylori(Hp) positive chronic atrophic gastritis(CAG) patients. Methods 120 cases of Weiyin Kuixu type CAG with Hp positive treated in Rugao Third People’s Hospital between June 2016 and June 2018 were randomly divided into two groups,with 60 cases in each group.The control group was treated with the classical quadruple therapy containing bismuth preparation;while the study group was treated with angyin Yiwei decoction combined with quadruple therapy containing bismuth preparation,and Yangyin Yiwei decoction was prepared according to the formula of our hospital.4 weeks was considered a course,and continued for three courses.Before and after treatment,digestive tract symptoms,endoscopic mucosal signs and pathological changes,HP negative,inflammatory factors such as interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),and immune indexes such as cluster of differentiation 3(CD3),CD4,CD8 were observed. Results The clinical effective rate was 90.00% in the control group and 91.67% in the study group,and the difference was not statistically significant(P > 0.05),but the overall effective rate was as high as 90.83%.After treatment,the clinical scores of nausea and vomiting,belching and acid reflux in the study group were(0.85±0.66) and(0.73±0.66),respectively,which were significantly lower than those before treatment,and significantly lower than those in the control group [(1.82±0.39) and(1.75±0.44)],and the differences were statistically significant(P < 0.05);The scores of epigastric pain and fullness in the two groups were lower than those before treatment,but the differences were not statistically significant(P > 0.05).The eradication rate of HP in the study group was significantly higher than that in the control group(P < 0.05).The levels of IL-6,TNF-α and CRP in the study group were

关 键 词：养阴益胃汤 四联含铋方案 慢性萎缩性胃炎 幽门螺杆菌阳性 

分 类 号：R259[医药卫生—中西医结合]