芪贝消痈汤治疗幽门螺杆菌阳性胃溃疡临床研究  

Clinical study of Qibei Xiaoyong decoction in treating helicobacter pylori-positive gastric ulcer

作　　者：王婧 秦燕鸿[1] 刘刚[1] 李国霞 WANG Jing;QIN Yanhong;LIU Gang;LI Guoxia(Cangzhou Hospital of Integrative Medicine,Cangzhou 062650,China)

机构地区：[1]河北省沧州中西医结合医院,河北沧州062650

出　　处：《陕西中医》2024年第2期217-221,共5页Shaanxi Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局科研项目(2020462)。

摘　　要：目的:基于氧化应激反应、核因子κB(NF-κB)信号通路探讨芪贝消痈汤治疗幽门螺杆菌(HP)阳性胃溃疡的效果观察。方法:选取HP阳性胃溃疡患者96例为研究对象,按照随机数字表法分为对照组和观察组,各48例。对照组采用西医药物治疗,观察组在对照组基础联合芪贝消痈汤治疗。比较两组治疗4周后临床疗效,治疗前及治疗4周后中医症候积分、胃镜检查指标(溃疡直径、底部厚苔面积、溃疡周围黏膜充血面积及再生上皮面积)、氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)、一氧化氮(NO)]、炎性反应指标[肿瘤坏死因子-α(TNF-α)、白细胞介素8(IL-8)、基质金属蛋白酶9(MMP-9)、基质金属蛋白酶抑制剂1(TIMP-1)]、NF-κB阳性表达率,比较治疗后1个月HP根除率及12个月内复发情况。结果:治疗4周后,观察组临床疗效为93.75%,高于对照组的79.17%(P<0.05);治疗4周后,两组胃脘胀痛、恶心呕吐、嗳气反酸、胃脘灼烧感症候积分、溃疡直径、底部厚苔面积及周围黏膜充血面积、血清MDA、TNF-α、IL-8、MMP-9、TIMP-1水平较治疗前降低,且观察组低于对照组(P<0.05);两组再生上皮面积、血清SOD及NO水平较治疗前升高,且观察组高于对照组(P<0.05);治疗4周后观察组NF-κB阳性表达率为22.92%,低于对照组的43.75%(P<0.05);治疗后1个月观察组HP根除率为93.75%,高于对照组的70.83%(P<0.05);治疗后12个月内观察组复发率为6.25%,低于对照组的20.83%(P<0.05)。结论:芪贝消痈汤能通过减弱氧化应激反应、抑制NF-κB信号通路表达,改善HP阳性胃溃疡患者临床症状,缓解胃的炎性反应,进而促进溃疡修复,减少复发风险。Objective:To observe the effect of Qibei Xiaoyong decoction in the treatment of helicobacter pylori(HP)-positive gastric ulcer based on oxidative stress response and nuclear factor κB(NF-κB) signaling pathway.Methods:A total of 96 patients with HP-positive gastric ulcer were selected as the research subjects,and were divided into control group and observation group according to the random number table method,with 48 cases in each group.The control group was treated with western medicine,and the observation group was given Qibei Xiaoyong decoction on the basis of the control group.The clinical efficacy after 4 weeks of treatment,TCM syndromes scores,gastroscopy indicators(ulcer diameter,bottom thick moss area,mucosal congestion area around ulcer and regenerated epithelial area),oxidative stress indicators [superoxide dismutase(SOD),malondialdehyde(MDA),nitric oxide(NO)],inflammatory response indicators [tumor necrosis factor-α(TNF-α),interleukin-8(IL-8),matrix metalloproteinase-9(MMP-9),tissue inhibitor of metalloproteinase-1(TIMP-1)] and positive expression rate of NF-κB before treatment and after 4 weeks of treatment and HP eradication rate at 1 month after treatment and recurrence within 12 months were compared.Results:After 4 weeks of treatment,the clinical efficacy in observation group was 93.75%,which was higher than 79.17% in control group(P<0.05).The scores of syndromes such as epigastric distension pain,nausea and vomiting,belching and acid regurgitation and epigastric burning sensation,ulcer diameter,bottom thick moss area and surrounding mucosal congestion area and levels of serum MDA,TNF-α,IL-8,MMP-9 and TIMP-1 in both groups after 4 weeks of treatment were reduced compared with those before treatment,and the above indicators in observation group were lower than those in control group(P<0.05).The regenerated epithelial area and levels of serum SOD and NO in both groups were enhanced compared to before treatment,and the indicators in observation group were higher than those in control group(P<0.05

关 键 词：HP阳性胃溃疡 芪贝消痈汤 氧化应激反应 NF-ΚB信号通路 炎性反应 溃疡修复 

分 类 号：R256.3[医药卫生—中医内科学]