和胃化湿汤合厚朴三物汤治疗慢性萎缩性胃炎临床研究  

Clinical Study on Hewei Huashi Decoction Combined with Houpu Sanwu Decoction for Chronic Atrophic Gastritis

作　　者：费侃强 刘加新 李莉 FEI Kanqiang;LIU Jiaxin;LI Li(Zhejiang Chinese Medical University,Hangzhou Zhejiang 310053,China;Huzhou Hospital of Chinese Medicine Affiliated to Zhejiang Chinese Medical University,Huzhou Zhejiang 313000,China)

机构地区：[1]浙江中医药大学,浙江杭州310053 [2]浙江中医药大学附属湖州中医院,浙江湖州313000

出　　处：《新中医》2023年第17期107-111,共5页New Chinese Medicine

基　　金：湖州市科学技术局项目(2019GY22)。

摘　　要：目的:观察和胃化湿汤合厚朴三物汤治疗慢性萎缩性胃炎(CAG)的效果及对核转录因子-κB(NF-κB)/B淋巴细胞瘤2 (Bcl-2)通路的影响。方法:选择CAG患者120例,按随机数字表法分为对照组和观察组各60例。对照组接受常规对症治疗,观察组在对照组基础上加用和胃化湿汤合厚朴三物汤口服。2组均治疗1个月。评价2组临床疗效,比较2组治疗前后中医证候评分、血清胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)水平、PGⅠ/PGⅡ及胃黏膜NF-κB、Bcl-2蛋白变化。观察不良反应发生情况。结果:观察组总有效率为93.33%,高于对照组78.33%(P<0.05)。治疗后,2组胃脘痞胀、恶心呕吐、口苦口臭、大便黏滞、胃脘灼热评分较治疗前下降(P<0.05),且观察组各项评分低于对照组(P<0.05)。治疗后,2组血清PGⅠ水平及PGⅠ/PGⅡ较治疗前升高,PGⅡ水平较治疗前下降(P<0.05);且观察组PGⅠ水平及PGⅠ/PGⅡ高于对照组,PGⅡ水平低于对照组(P<0.05)。治疗后,2组NF-κB、Bcl-2蛋白阳性表达率较治疗前下降(P<0.05),且观察组低于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:和胃化湿汤合厚朴三物汤治疗CAG效果确切,安全性良好,有助于降低胃黏膜萎缩程度,修复胃黏膜,机制可能与抑制NF-κB/Bcl-2信号通路激活有关。Objective:To observe the curative effect of the therapy of Hewei Huashi Decoction combined with Houpu Sanwu Decoction on chronic atrophic gastritis(CAG)and its effect on nuclear transcription factor-κB(NF-κB)and B-cell lymphoma 2(Bcl-2)pathway.Methods:A total of 120 CGA patients were selected and divided into the control group and the observation group according to the random number table method,with 60 cases in each group.The control group was given routine symptomatic treatment,and the observation group was additionally treated with oral administration of Hewei Huashi Decoction combined with Houpu Sanwu Decoction based on the treatment of the control group.Both groups were treated for 1 month.The clinical effects in the two groups were evaluated;the traditional Chinese medicine syndrome scores,levels of serum pepsinogenⅠ(PGⅠ)and pepsinogenⅡ(PGⅡ),and changes of PGⅠ/PGⅡ,NF-κB in gastric mucosa and Bcl-2 protein were compared before and after treatment between the two groups;the incidence of adverse reactions was observed.Results:The total effective rate was 93.33%in the observation group,higher than that of 78.33%in the control group(P<0.05).After treatment,the scores of stuffiness and distension of gastric cavity,nausea and vomiting,bitter taste and fetid breath,sloppy stool and scorching heat in the gastric cavity in the two groups were decreased when compared with those before treatment(P<0.05),and the above five scores in the observation group were lower than those in the control group(P<0.05).After treatment,the serum PGⅠlevels and PGⅠ/PGⅡin both groups were increased when compared with those before treatment,and the serum PG II levels were decreased when compared with those before treatment(P<0.05);the serum PGⅠlevel and PGⅠ/PGⅡin the observation group were higher than those in the control group,and the serum PG II level was lower than that in the control group(P<0.05).After treatment,the positive expression rates of NF-κB and Bcl-2 protein in the two groups were decreased when c

关 键 词：慢性萎缩性胃炎 和胃化湿汤 厚朴三物汤 核转录因子-κB/B淋巴细胞瘤2 胃蛋白酶原 中医证候评分 

分 类 号：R573.32[医药卫生—消化系统]