调肝理脾益胃降逆方联合针刺治疗胃癌术后胃食管反流病的疗效及对血清LTB4和CX3CL1水平的影响  

Effect of Tiaoganlipiyiweijiangni decoction combined with acupuncture on postoperative gastric cancer gastroesophageal reflux disease and serum LTB4and CX3CL1levels

作　　者：赵志幸 郭启涛 史晓花 刘亚莉 李路宝 霍献红 杨玉巧[1] ZHAO Zhixing;GUO Qitao;SHI Xiaohua(Handan Traditional Chinese Medicine Hospital,Hebei Handan 056001,china)

机构地区：[1]邯郸市中医院,河北邯郸056001

出　　处：《四川中医》2024年第6期119-122,共4页Journal of Sichuan of Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(编号:2019381)。

摘　　要：目的:评估调肝理脾益胃降逆方联合针刺对胃癌术后胃食管反流病的治疗效果及对血清LTB4和CX3CL1水平的影响。方法:本研究选取了在我院收治的120例胃癌手术后出现胃食管反流病的患者,随机分为对照组和观察组,每组60例。对照组接受奥美拉唑肠溶胶囊和多潘立酮片治疗,观察组在对照组基础上,采用调肝理脾益胃降逆方联合针刺治疗。通过比较两组的临床疗效、中医证候积分、胃肠激素、炎症因子以及血清LTB4和CX3CL1水平来评估治疗效果。结果:观察组在治疗后表现出了更高的有效率(91.67%vs 78.33%,P<0.05)。此外,观察组的中医证候积分较对照组低(P<0.001)。观察组在治疗后GAS和MTL水平较高于对照组(P<0.001)。同时,观察组在治疗后的IL-1β、IL-6和TNF-α水平较对照组低(P<0.001)。治疗后,观察组的LTB4和CX3CL1水平较对照组高(P<0.001)。结论:调肝理脾益胃降逆方联合针刺治疗可以显著提高胃食管反流患者的临床疗效,减轻反酸、烧心等症状,改善胃肠道运动,抑制炎症反应,并降低血清中LTB4和CX3CL1水平。因此,该疗法在临床上具有重要价值。Objective To investigate the clinical effectiveness of combining acupuncture with Tiaoganlipiyiweijiangni decoction in the treatment of postoperative gastroesophageal reflux disease(GERD)in gastric cancer patients,as well as its effects on serum levels of LTB4and CX3CL1.Methods A total of 120patients who underwent gastric cancer surgery and developed GERD were enrolled in this study from August 2019to May 2023.The patients were randomly divided into two groups:the control group and the observation group,with 60cases in each group.The control group received treatment with omeprazole enteric-coated capsules and domperidone tablets,while the observation group received treatment with Tiaoganlipiyiweijiangni decoction combined with acupuncture in addition to the same medication given to the control group.The clinical effectiveness,TCM syndrome scores,gastrointestinal hormones,inflammatory factors,and serum levels of LTB4and CX3CL1were compared between the two groups.Results The observation group exhibited a higher effective rate compared to the control group(91.67%vs 78.33%)(P<0.05).After treatment,the TCM syndrome score of the observation group was significantly lower than that of the control group(P<0.001).The observation group also showed higher levels of gastrointestinal hormones and motilin(MTL)compared to the control group after treatment(P<0.001).Additionally,the levels of IL-1β,IL-6,and TNF-αwere significantly lower in the observation group than in the control group after treatment(P<0.001).Moreover,the levels of LTB4and CX3CL1in the observation group were significantly higher than those in the control group after treatment(P<0.001).Conclusion The combination of Tiaoganlipiyiweijiangni decoction with acupuncture improved the clinical effectiveness of GERD patients by alleviating symptoms such as acid reflux and heartburn,improving gastrointestinal motility,inhibiting inflammation,and reducing serum levels of LTB4and CX3CL1.This treatment approach holds great clinical value.

关 键 词：调肝理脾益胃降逆方 针刺 胃癌术后 胃食管反流病 LTB4 CX3CL1 

分 类 号：R735.2[医药卫生—肿瘤]