活血化瘀生肌方对瘀血阻络型胃食管反流病肠道菌群、胃蛋白酶原、食管动力及胃黏膜损伤的影响  

Effects of Huoxue Huayu Shengji Formula on intestinal flora,pepsinogen,esophageal motility,gastric mucosal injury repair in patients with gastroesophageal reflux diseaseof blood stasis type

作　　者：金莹 吴胜炜 郭法杰 徐胜利 JIN Ying;WU Shengwei;GUO Fajie;XU Shengli(Department of TCM Pharmacy,Suzhou Hospital of TCM,Suzhou,Anhui 234000;Department of Geriatrics,Suzhou Hospital of TCM,Suzhou,Anhui 234000;Department of Spleen and Stomach Disease,Suzhou Hospital of TCM,Suzhou,Anhui 234000)

机构地区：[1]安徽省宿州市中医医院中药房,安徽宿州234000 [2]安徽省宿州市中医医院老年科,安徽宿州234000 [3]安徽省宿州市中医医院脾胃病科,安徽宿州234000

出　　处：《河北中医》2024年第8期1278-1282,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：2021年度中国民族医药学会科研项目(编号:2021Z1126-1002009)。

摘　　要：目的观察活血化瘀生肌方对瘀血阻络型胃食管反流病患者肠道菌群、胃蛋白酶原、食管动力及胃黏膜损伤的影响。方法将115例胃食管反流病患者按照随机数字表法分为2组,对照组57例予常规西医治疗,治疗组58例在对照组治疗基础上予活血化瘀生肌方治疗。连续治疗1个月。比较2组治疗前后血清胃蛋白酶原Ⅰ(PGⅠ)、转化生长因子α(TGF-α)、胃蛋白酶原Ⅱ(PGⅡ)、胆囊收缩素(CCK)水平,肠道葡萄球菌、乳酸菌、双歧杆菌数量,食管动力指标(食管括约肌压力、食管远端收缩积分平均值、总反流时间百分比),中医证候评分,胃酸分泌量,胃液胆酸量,以及反流性疾病问卷(RDQ)评分,统计2组临床疗效。结果治疗组总有效率96.55%(56/58),对照组总有效率82.46%(47/57),治疗组临床疗效优于对照组(P<0.05)。2组治疗后PGⅠ、TGF-α水平均较本组治疗前升高(P<0.05),且治疗组治疗后均高于对照组(P<0.05);2组治疗后PGⅡ、CCK水平均降低(P<0.05),治疗组治疗后均低于对照组(P<0.05)。2组治疗后肠道乳酸菌、双歧杆菌数量均较本组治疗前升高(P<0.05),治疗组治疗后均高于对照组(P<0.05);2组治疗后葡萄球菌数量均降低(P<0.05),且治疗组治疗后低于对照组(P<0.05)。2组治疗后食管括约肌压力、食管远端收缩积分平均值均较本组治疗前升高(P<0.05),且治疗组治疗后均高于对照组(P<0.05);2组治疗后总反流时间百分比均较本组治疗前降低(P<0.05),且治疗组治疗后低于对照组(P<0.05)。2组治疗后中医证候各项评分均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后胃酸分泌量、胃液胆酸量及RDQ评分均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。结论活血化瘀生肌方治疗瘀血阻络型胃食管反流病患者,可改善胃蛋白酶原指标,促进胃黏膜损伤修复,平衡肠道菌群,提高食管动力,缓解Objective To observe the effects of Huoxue Huayu Shengji Formula on intestinal flora,pepsinogen,esophageal motility,gastric mucosal injury repair in patients with gastroesophageal reflux disease(GERD)of blood stasis type.Methods A total of 115 GERD patients were randomly assigned in a 1∶1 ratio to routine Western medicine(RWM,control group)or Huoxue Huayu Shengji Formula+RWM(treatment group)for 1 month.The aim was to compare serum pepsinogen I(PGI),transforming growth factor alpha(TGF-α),pepsinogenⅡ(PGⅡ),cholecystokinin(CCK),amount of Staphylococcus,Lactobacillus and Bifidobacterium,esophageal motility indexes(esophageal sphincter pressure,mean distal contractile integral[DCI],percentage total reflux time),traditional Chinese medicine(TCM)syndrome score,gastric acid output,gastric bile acid content,Reflux Disease Questionnaire(RDQ).The curative effect was assessed.Results The overall effective rate in the treatment group was better than that in the control group(96.55%[56/58]vs 82.46%[47/57],P<0.05).After treatment,significantly increased PGⅠand TGF-αlevels,and decreased PGⅡand CCK levels were found in the both groups than those before treatment(all P<0.05),and the different was significant between groups for the above indexes(all P<0.05).Significantly increased amount of Lactobacillus and Bifidobacterium,and decreased amount of Staphylococcus were detected in the both groups(all P<0.05),and the treatment group was superior to the control group for amount of Staphylococcus,Lactobacillus and Bifidobacterium(all P<0.05).Significantly higher esophageal sphincter pressure and mean DCI,and reducedproportion of total reflux timewere found in the both groups after treatment(all P<0.05),which were significantly pronounced in treatment group(all P<0.05).After treatment,TCM symptom scores in the both groups were significantly decreased(P<0.05),which decreased notably in the treatment group compared with the control group(P<0.05).After treatment,gastric acid output,gastric bile acid content,RDQ score in the both

关 键 词：胃食管反流病 中药疗法 胃蛋白酶原 胃黏膜 肠道菌群 食管动力 

分 类 号：R573.34[医药卫生—消化系统]