健脾活血方联合针刺法治疗胃络瘀血型慢性萎缩性胃炎的临床疗效及对炎症指标和胃黏膜功能的影响  

Clinical Effect of Jianpi Huoxue Prescription Combined with Acupuncture on Chronic Atrophic Gastritis with Gastric Blood Stasis and Its Impact on Inflammatory Indicators and Gastric Mucosal Function

作　　者：康文婷 时昭红[1,2] 刘嵩[2] 张书[2] 石拓[2] 杨林[2] 曹丹 KANG Wenting;SHI Zhaohong;LIU Song;ZHANG Shu;SHI Tuo;YANG Lin;CAO Dan(Clinical College of Traditional Chinese Medicine,Hubei University of Chinese Medicine,Wuhan 430000,China;Wuhan First Hospital,Wuhan 430000,China)

机构地区：[1]湖北中医药大学中医学院,武汉430000 [2]武汉市第一医院,武汉430000

出　　处：《中国实验方剂学杂志》2024年第5期103-110,共8页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家重点研发计划项目(2017YFC170060);武汉市卫计委科研项目(WZ20A07)。

摘　　要：目的:探讨健脾活血方联合针刺法方案在胃络瘀血型慢性萎缩性胃炎(CAG)患者中的应用效果。方法:选取武汉市第一医院2021年11月至2023年3月收治CAG患者86例,按随机数字表法均分为两组(每组43例),对照组给予常规西药治疗,观察组在其基础上加用健脾活血方联合针刺法方案治疗,观察两组治疗后临床疗效、中医证候积分、病理组织评分、幽门螺杆菌(Hp)转阴率、炎症指标[中性粒细胞/淋巴细胞比值(NLR)、白细胞介素(IL)-1β]、胃蛋白酶(PG)Ⅰ、PGⅠ/PGⅡ、胃泌素-17(G-17)水平变化及治疗期间药物安全性情况。结果:研究结果显示,治疗后观察组患者总有效率为95.35%(41/43),对照组患者总有效率为79.07%(34/43),观察组患者临床疗效明显高于对照组,差异具有统计学意义(χ^(2)=5.108,P<0.05)。与本组治疗前比较,观察组与对照组患者中医证候主次证积分及总分均明显降低(P<0.05);治疗后与对照组比较,观察组患者中医证候主次证积分及总分降低更明显(P<0.05)。与本组治疗前比较,观察组与对照组患者胃黏膜萎缩、活动性、慢性炎症、肠化生及异型增生病理评分均明显降低(P<0.05);治疗后与对照组比较,观察组患者胃黏膜萎缩、活动性、慢性炎症、肠化生及异型增生病理评分降低更明显(P<0.05)。治疗后与对照组比较,观察组患者Hp转阴率明显提高(χ^(2)=3.957,P=0.047)。与本组治疗前比较,观察组与对照组患者炎症指标NLR、IL-1β水平均明显较低(P<0.05);治疗后与对照组比较,观察组患者炎症指标NLR、IL-1β水平均明显较低(P<0.05)。与本组治疗前比较,观察组与对照组患者PGⅠ、PGⅠ/PGⅡ水平则明显较高(P<0.05);治疗后与对照组比较,观察组患者PGⅠ、PGⅠ/PGⅡ水平则明显较高(P<0.05)。与本组治疗前比较,观察组与对照组患者不同时间点的G-17水平差异有统计学意义(P<0.05),治疗后与对照组相比,观察组不同Objective:To explore the application effect of Jianpi Huoxue prescription combined with acupuncture in patients with chronic atrophic gastritis(CAG)of gastric blood stasis type.Method:A total of 86 patients with CAG admitted to Wuhan First Hospital from November 2021 to March 2023 were selected and randomly divided into two groups.The control group was treated with conventional Western medicine,while the observation group was treated with Jianpi Huoxue prescription combined with acupuncture.The clinical efficacy,traditional Chinese medicine(TCM)syndrome score,pathological score,negative conversion rate of Helicobacter pylori(Hp),inflammatory indicators[neutrophils/lymphocytes(NLR)and interleukin(IL)-1β],changes in levels of gastric protease(PG)Ⅰ,PGⅠ/PGⅡ,and gastrin-17(G-17),and drug safety during treatment were observed after treatment in both groups.Result:After treatment,the total effective rate of the observation group[95.35%(41/43)]was significantly better than that of the control group[79.07%(34/43)],and the difference was statistically significant(χ^(2)=5.108,P<0.05).After treatment,the scores of the primary and secondary TCM syndromes in the observation group and the control group were significantly decreased(P<0.05).After treatment,the scores of primary and secondary TCM syndromes in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the pathological scores of gastric mucosa atrophy,activity,chronic inflammation,intestinal metaplasia,and dysplasia were significantly lower in the observation group and control group(P<0.05).After treatment,the pathological scores of gastric mucosa atrophy,activity,chronic inflammation,intestinal metaplasia,and dysplasia in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the Hp conversion rate in the observation group was significantly increased compared with the control group(P<0.05).After treatment,the levels of inflammatory indicators NLR and IL-1βin the obs

关 键 词：慢性萎缩性胃炎 胃络瘀血 健脾活血方 针刺 临床疗效 

分 类 号：R2-0[医药卫生—中医学] R22R242R2-031R259R573.32R256.3