升阳益胃汤治疗幽门螺杆菌阳性胃癌前病变临床观察  

Clinical observation on Shengyang Yiwei Decoction in the treatment of Helicobacter pylori positive gastric precancerous lesions

作　　者：彭丽丽 任燕燕 贾海波[1] 孙建民 张芬 王宝亮 张洪珍[1] PENG Lili;REN Yanyan;JIA Haibo;SUN Jianmin;ZHANG Fen;WANG Baoliang;ZHANG Hongzhen(Hebei General Hospital, Shijiazhuang 050051, Hebei, China;Hebei North College, Zhangjiakou 075000, Hebei, China;Gucheng County Hospital of Traditional Chinese Medicine, Gucheng 253800, Hebei, China)

机构地区：[1]河北省人民医院,河北石家庄050051 [2]河北北方学院,河北张家口075000 [3]故城县中医院,河北故城253800

出　　处：《现代中西医结合杂志》2022年第7期905-908,913,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：河北省中医药管理局科研计划项目(2018075)。

摘　　要：目的观察升阳益胃汤治疗幽门螺杆菌阳性胃癌前病变患者的临床疗效。方法选取2018年7月—2021年2月河北省人民医院消化科、肿瘤科门诊和故城县中医院治疗的178例幽门螺杆菌阳性胃癌前病变患者,随机分为观察组和对照组,每组89例。对照组患者给予四联疗法治疗,观察组患者在四联疗法治疗基础上给予升阳益胃汤治疗,2组疗程均为3个月。观察2组患者治疗前后胃黏膜病理组织积分及血清C反应蛋白(CRP)、癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、糖类抗原724(CA724)水平变化,比较2组中医证候疗效及幽门螺杆菌根除率。结果治疗3个月后,2组患者病理组织积分及血清CRP、CEA、CA19-9、CA724水平均明显降低(P均<0.05),且观察组均明显低于对照组(P均<0.05)。观察组中医证候总有效率为93.26%(83/89),幽门螺杆菌根除率为91.01%(81/89),对照组分别为76.40%(68/89)和74.16%(66/89),2组比较差异均有统计学意义(P均<0.05)。结论在四联疗法基础上联合升阳益胃汤治疗幽门螺杆菌阳性胃癌前病变患者能显著改善患者胃黏膜病理变化和临床症状,提高幽门螺杆菌根除率,降低CRP及肿瘤标记物水平,有利于延缓胃黏膜病变发展。Objective It is to observe the clinical efficacy of Shengyang Yiwei Decoction in the treatment of patients with Helicobacter pylori-positive gastric precancerous lesions.Methods One hundred and seventy-eight patients with H.pylori-positive gastric precancerous lesions treated in the Gastroenterology and Oncology Outpatient Clinics of Hebei General Hospital and Gucheng County Hospital of Traditional Chinese Medicine from July 2018 to February 2021 were selected and randomly divided into observation and control groups,with 89 cases in each group.The patients in the control group were treated with quadruple therapy plus Weifuchun tablets,and the patients in the observation group were treated with Shengyang Yiwei Decoction on the basis of quadruple therapy,and the duration of treatment for both groups was 3 months.The changes in the histological score of gastric mucosa pathology and the levels of serum C-reactive protein(CRP),carcinoembryonic antigen(CEA),glycoantigen 19-9(CA19-9)and glycoantigen 724(CA724)of the patients in the two groups were observed before and after treatment,and the efficacy of Chinese medical syndrome and the eradication rate of H.pylori in the two groups were compared.Results After 3 months of treatment,the pathological tissue scores and the levels of serum CRP,CEA,CA19-9 and CA724 were significantly decreased in the 2 groups(all P<0.05),and the indexes in the observation groups were significantly lower than those in the control group(all P<0.05).The total effective rate of TCM syndrome was 93.26%(83/89)and the eradication rate of H.pylori was 91.01%(81/89)in the observation group,compared with 76.40%(68/89)and 74.16%(66/89)in the control group,respectively,the differences between were statistically significant the 2 groups(all P<0.05).Conclusion Combining the treatment with Shengyang Yiwei Decoction on the basis of quadruple therapy can significantly improve the pathological changes of gastric mucosa and clinical symptoms,increase the eradication rate of H.pylori,reduce the level of CRP and t

关 键 词：升阳益胃汤 幽门螺杆菌 胃癌前病变 C反应蛋白 肿瘤标记物 

分 类 号：R735.2[医药卫生—肿瘤]