柴枳平肝汤合消痞宽胃汤治疗肝胃不和型慢性胃炎的临床疗效  

Clinical efficacy of Chai-Zhi Ping-Gan decoction combined with Xiao-Pi Kuan-Wei decoction in the treatment of liver-stomach disharmony type chronic gastritis

作　　者：周彩彩 苏垠旭 Zhou Caicai;Su Yinxu(Department of Rehabilitation Medicine,No.215 Hospital of Shaanxi Nuclear Industry,Xianyang 712000,China;Internal Medicine of Chinese medicine,Baoji People's Hospital,Baoji 721000,China)

机构地区：[1]陕西省核工业二一五医院康复医学科,咸阳712000 [2]宝鸡市人民医院中医科,宝鸡721000

出　　处：《国际医药卫生导报》2024年第16期2766-2771,共6页International Medicine and Health Guidance News

基　　金：陕西省自然科学基础研究计划(2021JQ-923)。

摘　　要：目的评估柴枳平肝汤合消痞宽胃汤治疗肝胃不和型慢性胃炎的临床疗效。方法本研究为随机对照试验。纳入2020年1月至2023年4月期间陕西省核工业二一五医院收治的94例肝胃不和型慢性胃炎患者,采用分层随机抽样法分为研究组和对照组,每组47例。对照组男24例,女23例,年龄(44.81±5.62)岁,病程(2.60±1.35)年;研究组男23例,女24例,年龄(45.20±5.47)岁,病程(2.56±1.24)年。对照组接受标准的四联疗法,艾司奥美拉唑镁肠溶片、阿莫西林片、呋喃唑酮片和枸橼酸铋钾胶囊连续用药2周后,停止使用阿莫西林片、呋喃唑酮片和枸橼酸铋钾胶囊,继续服用艾司奥美拉唑镁肠溶片2周;研究组接受柴枳平肝汤合消痞宽胃汤治疗。两组疗程均为4周。对比两组患者临床疗效,中医症状积分,胃肠功能指标[生长抑素(SST)、胃泌素(GAS)、胃动素(MTL)、血管活性肠肽(VIP)]、炎性因子[白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子(TNF-α)]水平,腹痛、反酸、嗳气消失时间,幽门螺杆菌(Hp)根除率。统计学方法采用t检验、χ^(2)检验。结果研究组的临床治疗总有效率高于对照组[97.87%(46/47)比85.11%(40/47)],差异有统计学意义(χ^(2)=4.919,P=0.027)。治疗4周后,研究组中医症状积分总分为(3.70±0.53)分,对照组为(5.52±0.79)分,差异有统计学意义(t=13.116,P<0.001);研究组的SST、GAS、MTL、VIP水平分别为(299.60±20.18)ng/L、(81.38±6.15)ng/L、(51.60±6.28)ng/L、(22.35±2.79)ng/L,对照组分别为(200.19±17.96)ng/L、(70.18±5.62)ng/L、(43.57±5.65)ng/L、(26.16±4.15)ng/L,差异均有统计学意义(t=25.228、9.216、6.517、5.223,均P<0.001);研究组的IL-6、hs-CRP、TNF-α水平分别为(22.52±7.16)μg/L、(10.65±1.46)mg/L、(1.50±0.28)μg/L,均低于对照组的(35.51±7.74)μg/L、(15.88±2.18)mg/L、(1.94±0.34)μg/L,差异均有统计学意义(t=8.446、13.666、6.849,均P<0.001)。研究组患者的腹痛、反酸、�Objective To evaluate the clinical efficacy of Chai-Zhi Ping-Gan decoction combined with Xiao-Pi Kuan-Wei decoction in the treatment of liver-stomach disharmony type chronic gastritis.Methods A total of 94 patients with liver-stomach disharmony type chronic gastritis admitted to No.215 Hospital of Shaanxi Nuclear Industry from January 2020 to April 2023 were included and were divided into a study group and a control group by stratified random sampling method,with 47 cases in each group.In the control group,there were 24 males and 23 females,aged(44.81±5.62)years,with a duration of disease of(2.60±1.35)years.In the study group,there were 23 males and 24 females,aged(45.20±5.47)years,with a duration of disease of(2.56±1.24)years.The control group received standard quad therapy,esomeprazole magnesium enteric-coated tablets,amoxicillin tablets,furazolidone tablets,and bismuth potassium citrate capsules for 2 weeks,after stopping the use of amoxicillin tablets,furazolidone tablets,and bismuth potassium citrate capsules,and continued to take esomeprazole magnesium enteric-coated tablets for 2 weeks.The study group received Chai-Zhi Ping-Gan decoction combined with Xiao-Pi Kuan-Wei decoction treatment.The treatment course of both groups was 4 weeks.The clinical efficacy,traditional Chinese medicine(TCM)symptom score,gastrointestinal function indexes[somatostatin(SST),gastrin(GAS),motilin(MTL),and vasoactive intestinal peptide(VIP)],inflammatory markers[interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP),and tumor necrosis factorα(TNF-α)],disappearance time of abdominal pain,acid reflux,and belching,and eradication rate of Helicobacter pylori(Hp)of the two groups were compared.Statistical methods used were t test andχ^(2) test.Results The total effective rate of clinical treatment in the study group was higher than that in the control group[97.87%(46/47)vs.85.11%(40/47)],with a statistically significant difference(χ^(2)=4.919,P=0.027).After 4 weeks of treatment,the total TCM symptom score in the study

关 键 词：慢性胃炎 肝胃不和型 柴枳平肝汤 消痞宽胃汤 胃肠功能 HP根除率 

分 类 号：R259[医药卫生—中西医结合]