中药分期治疗脾胃湿热型慢性萎缩性胃炎伴低级别上皮内瘤变患者的疗效观察  

Efficacy of Staged Traditional Chinese Medicine Treatment in Patients with Chronic Atrophic Gastritis of Spleen-stomach Damp-Heat Type Accompanied by Low-Grade Intraepithelial Neoplasia

作　　者：张亚秋 汤立华 毕海娇 张超 侯雅娟 ZHANG Ya-qiu;TANG Li-hua;BI Hai-jiao;ZHANG Chao;HOU Ya-juan(Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang Hebei 050000;Department of Oncology,Department of Gastroenterology,Tangshan Nanhu Hospital,Tangshan Hebei 063000;Tangshan Fengnan District Traditional Chinese Medicine Hospital,Tangshan Hebei 063300;The Hospital of Retired Officials Bureau of Qian'an,Qian'an Hebei 064400)

机构地区：[1]河北省中医院,河北石家庄050000 [2]河北省唐山南湖医院(肿瘤科、消化内科),河北唐山063000 [3]唐山市丰南区中医医院,河北唐山063300 [4]迁安市老干部局医院,河北迁安064400

出　　处：《世界中西医结合杂志》2024年第8期1664-1670,共7页World Journal of Integrated Traditional and Western Medicine

基　　金：河北省中医药管理局2024年度中医药类科学研究课题计划项目(2024237)。

摘　　要：目的探讨中药分期治疗脾胃湿热型慢性萎缩性胃炎(Chronic atrophic gastritis,CAG)伴低级别上皮内瘤变(Low-grade gastric intraepithelial neoplasia,LGIN)患者的临床疗效。方法选取2021年3月—2023年5月期间河北省中医院收治的脾胃湿热型CAG伴LGIN患者120例,按照随机数字表法分为对照组和研究组,每组各60例。对照组给予CAG伴LGIN常规治疗,研究组采用清热化湿通络方治疗4周,随后采用健脾益气和胃化湿方治疗4周,两组患者均治疗8周。观察比较两组患者治疗前后中医证候积分、胃黏膜病理学评分、血清b胃蛋白酶原Ⅰ(PepsinogenⅠ,PGⅠ)、b胃蛋白酶原Ⅱ(PepsinogenⅡ,PGⅡ)水平、PGⅠ/PGⅡ、血清炎症因子[白细胞介素-6(Interleukin-6,IL-6)、白细胞介素-8(Interleukin-8,IL-8)、白细胞介素-10(Interleukin-10,IL-10)、肿瘤坏死因子α(Tumor necrosis factor-α,TNF-α)]水平、血清肿瘤标志物[血清癌胚抗原(Carcinoembryonic antigen,CEA)、糖类抗原724(Carbohydrate antigen 724,CA724)、糖类抗原199(Carbohydrate antigen 199,CA199)、糖类抗原125(Carbohydrate antigen 125,CA125)]水平、免疫功能指标[免疫球蛋白A(Immunoglobulin A,IgA)、免疫球蛋白M(Immunoglobulin M,IgM)、免疫球蛋白G(Immunoglobulin G,IgG)、白细胞介素-2(Interleukin-2,IL-2)、干扰素γ(Interferon-γ,IFN-γ)、抑制性T细胞(Inhibitory T cells,CD8^(+))、成熟T淋巴细胞(Mature T lymphocytes,CD3^(+))、诱导性T细胞(Induced T cells,CD4^(+))、CD4^(+)/CD8^(+)]、临床疗效及不良反应情况。结果治疗后研究组临床总有效率96.67%(58/60)明显高于对照组85.00%(51/60),差异有统计学意义(P<0.05)。治疗后两组患者各项中医证候积分及总积分均较治疗前降低,差异有统计学意义(P<0.05);且研究组各项中医证候积分及总积分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者胃黏膜病理学评分均较治疗前降低,差异有统计学意义(P<0.05);且研究组胃�Objective To investigate the clinical efficacy of staged traditional Chinese medicine(TCM)treatment in patients with chronic atrophic gastritis(CAG)of the spleen-stomach damp-heat type accompanied by low-grade gastric intraepithelial neoplasia(LGIN).Methods From March 2021 to May 2023,120 patients with CAG of the spleen-stomach damp-heat type accompanied by LGIN,administered at Hebei Provincial Hospital of Traditional Chinese Medicine,were selected as the research subjects.The patients were randomly divided into a control group and a study group according to the random number table method,with 60 patients in each group.The control group was treated with conventional treatment for CAG with LGIN,while the study group was treated with the Qingre Huashi Tongluo formula for 4 weeks,followed by the Jianpi Yiqi Hewei Huashi formula for another 4 weeks.Both groups were treated for a total of 8 weeks.TCM symptom scores,gastric mucosal pathology scores,serum levels of pepsinogenⅠ(PGⅠ),pepsinogen Ⅱ(PGⅡ),the PGI/PGⅡ ratio,serum inflammatory cytokines[Interleukin-6(IL-6),Interleukin-8(IL-8),Interleukin-10(IL-10),tumor necrosis factor-α(TNF-α)],serum tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen 724(CA724),carbohydrate antigen 199(CA199),carbohydrate antigen 125(CA125)],immune function indicators[Immunoglobulin A(IgA),Immunoglobulin M(IgM),Immunoglobulin G(IgG),Interleukin-2(IL-2),Interferon-γ(IFN-γ),inhibitory T cells(CD8^(+)),mature T lymphocytes(CD3^(+)),induced T cells(CD4^(+)),CD4^(+)/CD8^(+)ratio],clinical efficacy and adverse reactions were observed and compared before and after treatment.Results After treatment,the total clinical efficacy rate in the study group was 96.67%(58/60),significantly higher than the 85.00%(51/60)in the control group,with a statistically significant difference(P<0.05).After treatment,TCM symptom scores and total scores in both groups significantly decreased compared to before treatment,with statistically significant differences(P<0.05);the study group showed si

关 键 词：慢性萎缩性胃炎 低级别上皮内瘤变 脾胃湿热型 中药 分期 炎症因子 

分 类 号：R573.32[医药卫生—消化系统]