健脾益胃通络方联合四联疗法治疗脾胃虚弱型慢性萎缩性胃炎临床研究  

Clinical Study on Jianpi Yiwei Tongluo Prescription Combined with Quadruple Therapy for Chronic Atrophic Gastritis of Spleen-Stomach Weakness Type

作　　者：蔡宗宗 余维微[1] 陈志坚[1] 曾耀明[1] CAI Zongzong;YU Weiwei;CHEN Zhijian;ZENG Yaoming(Department of Gastroenterology,Wenzhou Hospital of Traditional Chinese Medicine,Wenzhou Zhejiang 325000,China)

机构地区：[1]温州市中医院消化内科,浙江温州325000

出　　处：《新中医》2024年第12期52-56,共5页New Chinese Medicine

基　　金：温州市基础性医疗卫生科技项目(Y20211078)。

摘　　要：目的:观察健脾益胃通络方联合四联疗法治疗脾胃虚弱型慢性萎缩性胃炎(CAG)伴幽门螺杆菌(Hp)阳性患者的临床疗效。方法:选择104例CAG伴Hp阳性患者,随机分为联合组和西药组各52例。西药组予以四联疗法治疗,联合组给予健脾益胃通络方联合四联疗法。连续治疗8周后,比较2组临床疗效、中医证候评分、病理组织学指标评分、中文版健康调查简表(SF-36)评分及血清胃蛋白酶原水平。结果:治疗后,联合组总有效率为94.23%,西药组为80.77%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组胃脘胀满或隐痛、喜温喜按、食后脘闷、食少纳呆、倦怠乏力、气短懒言等中医证候评分均较治疗前降低(P<0.05),且联合组各项评分均低于西药组(P<0.05)。治疗后,2组异型增生、肠化程度、萎缩程度、慢性炎症、活动性、Hp感染评分均较治疗前降低(P<0.05),且联合组上述各项组织病理学指标评分均低于西药组(P<0.05)。治疗前,2组SF-36评分比较,差异无统计学意义(P>0.05);治疗后,2组SF-36评分较治疗前升高(P<0.05),且联合组SF-36评分高于西药组(P<0.05)。治疗后,2组胃蛋白酶原Ⅰ水平较治疗前升高(P<0.05),且联合组胃蛋白酶原Ⅰ水平高于西药组(P<0.05);2组胃蛋白酶原Ⅱ水平较治疗前降低(P<0.05),且联合组胃蛋白酶原Ⅱ水平低于西药组(P<0.05)。结论:健脾益胃通络方联合四联疗法治疗脾胃虚弱型CAG伴Hp阳性患者效果良好,可加快临床症状和胃黏膜病理组织恢复,调节胃蛋白酶原分泌,提高患者生活质量。Objective:To observe the clinical effect of Jianpi Yiwei Tongluo Prescription combined with quadruple therapy on chronic atrophic gastritis(CAG)of spleen-stomach weakness type with helicobacter pylori(Hp)positive patients.Methods:A total of 104 CAG with Hp positive patients were randomly divided into the combination group and the western medicine group,with 52 cases in each group.The western medicine group was given quadruple therapy,and the combination group was given Jianpi Yiwei Tongluo Decoction combined with quadruple therapy.After eight weeks of continuous treatment,the clinical effects,traditional Chinese medicine(TCM)syndrome scores,scores of histopathological indexes,Chinese version of the MOS item short-from health survey(SF-36)and serum pepsinogen levels were compared between the two groups.Results:After treatment,the total effective rate was 94.23%in the combination group and 80.77%in the western medicine group,the difference being significant(P<0.05).After treatment,the TCM syndrome scores of stomach cavity distention and fullness or dull pain,relief with warmth and pressing,stomach cavity oppression after meals,poor appetite and digestion,fatigue and lack of strength,and shortness of breath and laziness to talk in the two groups were decreased when compared with those before treatment(P<0.05),and the above scores in the combination group were lower than those in the western medicine group(P<0.05).After treatment,the scores of dysplasia,intestinal metaplasia,atrophy,chronic inflammation,activity and Hp infection in the two groups were decreased when compared with those before treatment(P<0.05),and the above scores of histopathological indexes in the combination group were lower than those in the western medicine group(P<0.05).Before treatment,there was no significant difference in the comparison of SF-36 score between the two groups(P>0.05);after treatment,the SF-36 scores in the two groups were significantly increased when compared with those before treatment(P<0.05),and the SF-36 score in the combi

关 键 词：慢性萎缩性胃炎 脾胃虚弱 健脾益胃通络方 四联疗法 胃蛋白酶原 SF-36量表 

分 类 号：R573.32[医药卫生—消化系统]