脘腹祛痛汤结合埃索美拉唑镁肠溶片治疗慢性萎缩性胃炎临床研究  

Clinical study on Wanfu-Qutong Decoction combined with esomeprazole tablets for atrophic gastritis

作　　者：徐珊珊[1] 程红杰[1] 高岩[2] 张乃卫 张巧妍 Xu Shanshan;Cheng Hongjie;Gao yan;Zhang Naiwei;Zhang Qiaoyan(Department of Gastroenterology,Fangshan Hospital,Beijing University of Traditional Chinese Medicine,Beijing 102400,China;Department of Emergency,Fangshan Hospital,Beijing University of Traditional Chinese Medicine,Beijing 102400,China)

机构地区：[1]北京市房山区中医医院脾胃病科,102400 [2]北京市房山区中医医院急诊科,102400

出　　处：《国际中医中药杂志》2021年第10期976-980,共5页International Journal of Traditional Chinese Medicine

基　　金：北京市科委基金项目(Z161100000516120)。

摘　　要：目的评价脘腹祛痛汤结合埃索美拉唑镁肠溶片治疗慢性萎缩性胃炎(chronic atrophic gastritis,CAG)的临床疗效,探讨对胃黏膜的修复作用。方法将符合入选标准的2017年6月-2019年6月本院脾胃病科106例CAG患者,采用随机数字表法分为2组,每组53例。对照组口服埃索美拉唑镁肠溶片,观察组在对照组基础上服用脘腹祛痛汤。2组均连续治疗3个月。分别于治疗前后进行中医证候评分,采用新悉尼系统直观模拟评分法进行胃黏膜病理组织学评分;采用ELISA法测定胃泌素17(G-17)、胃蛋白酶原(PGⅠ、PGⅡ)水平,计算PGⅠ/Ⅱ比值,评价临床疗效。结果观察组总有效率为96.2%(51/53)、对照组为79.2%(42/53),2组比较差异有统计学意义(χ^(2)=7.414,P<0.01)。观察组治疗后胃脘隐痛、饱胀、喜温喜按、泛吐清水、食少纳呆、四肢倦怠评分低于对照组(t值分别为2.788、3.632、3.816、1.590、2.183、2.103,P值均<0.05),黏膜慢性炎症反应、炎症活动度、萎缩程度、异型增生、肠上皮化生评分低于对照组(t值分别为2.983、2.106、3.773、1.922、3.095,P值均<0.05);观察组治疗后血清G-17[(14.47±3.06)pmol/L比(10.67±2.47)pmol/L,t=10.510]、PGⅠ[(130.31±14.79)μg/L比(102.36±12.63)μg/L,t=8.178]水平及PGⅠ/Ⅱ比值[(10.45±0.48)比(9.17±0.72),t=2.104]高于对照组(P<0.01或P<0.05)。结论脘腹祛痛汤结合埃索美拉唑镁肠溶片可有效改善CAG患者的临床症状,调节G-17、PGⅠ、PGⅡ水平及PGⅠ/Ⅱ比值,促进胃黏膜修复。Objective To evaluate the clinical efficacy of Wanfu-Qutong Decoction combined with esomeprazole in the treatment of chronic atrophic gastritis(CAG).Methods A total of 106 CAG patients who met the inclusion criteria from June 2017 to June 2019 were randomly divided into two groups with 53 in each group.The control group took esomeprazole magnesium enteric coated tablets,and the observation group took Wanfu-Qutong Decoction on the basis of the control group.Both groups were treated continuously for 3 months.TCM syndrome score was performed before and after treatment,and the new Sydney system intuitive simulation score method was used to score the histopathology of gastric mucosa.The levels of gastrin 17(G-17),pepsinogen(PGⅠ,PGⅡ)and the PGⅠ/Ⅱwere measured by ELISA.Results The total effective rate was 96.2%(51/53)in the observation group and 79.2%(42/53)in the control group.There was significant difference between the two groups(χ^(2)=7.414,P<0.01).After treatment,the scores of epigastric pain,fullness,liking temperature and pressing,vomiting clear water,eating less and staying foolish,and limb burnout in the observation group were significantly lower than those in the control group(t values were 2.788,3.632,3.816,1.590,2.183,2.103,respectively,all Ps<0.05),and the scores of chronic inflammatory reaction,inflammatory activity,atrophy degree,dysplasia and intestinal metaplasia in the mucosa were significantly lower than those in the control group(t values were 2.983,2.106,2.106,3.773,1.922,3.095,respectively,all Ps<0.05).After treatment,the serum G-17[(14.47±3.06)pmol/L vs.(10.67±2.47)pmol/L,t=10.510]and PGⅠ[(130.31±14.79)μg/L vs.(102.36±12.63)μg/L,t=8.178]and PGⅠ/Ⅱ[(10.45±0.48)vs.(9.17±0.72),t=2.104]in the observation group were significantly higher than those in the control group(P<0.01 or P<0.05).Conclusion Wanfu-Qutong Decoction combined with esomeprazole tablets can effectively improve the clinical symptoms of CAG patients,regulate the levels of G-17,PGⅠ,PGⅡand PGⅠ/Ⅱ,and promote th

关 键 词：胃炎 萎缩性 胃黏膜 脘腹祛痛汤 埃索美拉唑 胃蛋白酶原A 胃蛋白酶原C 

分 类 号：R573.32[医药卫生—消化系统]