荜铃胃痛颗粒联合标准四联疗法治疗慢性萎缩性胃炎伴轻中度肠上皮化生患者的效果研究  

Effect of Biling Weitong Granule Combined with Standard Quadruple Therapy in the Treatment of Chronic Atrophic Gastritis with Mild to Moderate Intestinal Metaplasia and Its Influence on Gastric Function and Inflammatory Factors

作　　者：姚鹏[1] 田晶晶[2] 康洪昌[1] 王江 李明越[1] 蔡宝琪 尹洁 YAO Peng;TIAN Jing-jing;KANG Hong-chang(Department of Gastroenterology,the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin(300183),China)

机构地区：[1]天津中医药大学第一附属医院消化科/国家中医针灸临床医学研究中心,天津300183 [2]天津市南开医院消化科,天津300193 [3]天津市红桥区西于庄街卫生服务中心中医科,天津300130 [4]天津市和平区五大道街社区卫生服务中心中医科,天津300050

出　　处：《中国中西医结合外科杂志》2021年第6期855-859,共5页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金青年项目(8190414)。

摘　　要：目的:探讨荜铃胃痛颗粒联合标准四联疗法治疗慢性萎缩性胃炎伴轻中度肠上皮化生患者的疗效及对患者胃功能、炎性因子的影响。方法:选择2018年1月—2020年2月我院收治的60例慢性萎缩性胃炎伴轻中度肠上皮化生患者,随机分为对照组30例和观察组30例,对照组单纯给予标准四联疗法治疗,观察组在对照组的基础上再给予荜铃胃痛颗粒,4周为1个疗程,治疗3个疗程,治疗前后观察临床症状改善情况及胃镜检查变化情况,抽空腹静脉血,进行血清白细胞介素-6(IL-6)、白细胞介素-23(IL-23)、肿瘤坏死因子-a(TNF-α)检查,采用酶联免疫吸附试验法(ELISA)测定胃功能相关指标[胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、胃泌素-17(G-17)],治疗3个疗程结束时评价两组临床疗效,并记录治疗过程中不良反应发生情况。结果:治疗3个疗程结束时,两组中医症候积分、胃黏膜病理组织学积分明显低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗3个疗程结束时,两组IL-6、IL-23、TNF-α明显低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗3个疗程结束时,两组PGⅠ、PGⅡ、G-17明显高于治疗前,且观察组明显高于对照组,差异有统计学意义(P<0.05)。观察组临床总有效率为93.33%,明显高于对照组的86.67%,差异有统计学意义(P<0.05)。两组患者治疗期间未见不良反应发生。结论:荜铃胃痛颗粒联合胶体果胶铋胶囊治疗慢性萎缩性胃炎伴轻中度肠上皮化生患者能明显抑制炎性因子水平,改善胃功能,从而改善患者的临床不适症状及胃镜表现,提高临床疗效,且安全性良好。Objective To investigate the effect of Biling Weitong granule combined with standard quadruple therapy in the treatment of chronic atrophic gastritis with mild to moderate intestinal metaplasia and its influence on gastric function and inflammatory factors.Methods From January 2018 to February 2020,a total of 60 chronic atrophic gastritis patients with mild to moderate intestinal metaplasia in our hospital were selected as the research objects,which were randomly divided into control group(30 cases)and observation group(30 cases).The control group was treated with standard quadruple therapy,and the observation group was treated with Biling Weitong granule on the basis of the control group.4 weeks were regarded as a course of treatment and the groups had been treated for 3 courses.The improvement of clinical symptoms and changes of gastroscopy were observed before and after treatment.Fasting venous blood was drawn for serum interleukin-6(IL-6),interleukin-23(IL-23)and tumor necrosis factor-A(TNF-α)examination.Enzyme linked immunosorbent assay(ELISA)was used to determine gastric function related indicators[pepsinogenⅠ(PGⅠ),pepsinogenⅡ(PGⅡ)].At the end of three courses of treatment,the clinical efficacy of the two groups was evaluated,and the occurrence of adverse reactions was recorded.Results The TCM symptom score,the gastric mucosal histopathology score of the control group and the observation group at the end of three courses of treatment were significantly lower than those before treatment(P<0.05).The TCM symptom score and gastric mucosal histopathology score of the observation group at the end of three courses of treatment were significantly lower than those of the control group(P<0.05).The levels of IL-6,IL-23 and TNF–αof the control group and the observation group at the end of three courses of treatment were significantly lower than those before treatment(P<0.05).The levels of IL-6,IL-23 and TNF–αof the observation group at the end of three courses of treatment were significantly lower than t

关 键 词：荜铃胃痛颗粒 慢性萎缩性胃炎 轻中度肠上皮化生 胃功能 炎性因子 

分 类 号：R537.32[医药卫生—内科学]