胃安除幽汤治疗幽门螺杆菌相关性胃炎的疗效研究  

Study on the curative effect of Wei'an Chuyou decoction on Helicobacter pylori associated gastritis

作　　者：王玲玲 胡俊强 李兴瑜 刘玉龄 WANG Lingling;HU Junqiang;LI Xingyu;LIU Yuling(Department of Gastroenterology,the Second Affiliated Hospital of Xingtai Medical College,Xingtai,Hebei,054000,China)

机构地区：[1]邢台医学高等专科学校第二附属医院消化内科,河北邢台054000

出　　处：《中国中西医结合消化杂志》2024年第11期985-992,共8页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：邢台市科技计划重点研发项目(No:2020ZC224)。

摘　　要：目的探讨胃安除幽汤对幽门螺杆菌(Helicobacter pylori,HP)相关性胃炎的疗效及肝细胞生长因子(hepatocyte growth factor,HGF)/肝细胞生长因子受体(c-Mesenchymal to epithelial transition factor,c-Met)信号通路的影响。方法选取2020年6月—2023年12月收治的210例HP相关性胃炎患者,随机分为试验组和对照组,每组各105例。对照组患者行常规四联疗法,试验组在对照组基础上加用胃安除幽汤治疗。对比两组患者在HP根除率、中医症状评分、临床疗效、免疫功能、炎症指标、HGF/c-Met信号通路以及不良反应等方面的差异。随访至2024年3月,分析HP复发的相关影响因素。结果治疗后,试验组患者的HP根除率为98.10%,明显高于对照组的82.86%,差异有统计学意义(χ^(2)=14.147,P<0.05);试验组的所有症状评分均显著低于对照组,差异有统计学意义(P<0.001);试验组的总有效率为94.29%,对照组为85.71%,差异有统计学意义(χ^(2)=4.286,P<0.05);试验组患者的免疫功能(CD4^(+)T细胞百分比、CD4^(+)/CD8^(+))和炎症因子(IL-1β、TGF-β1、TNF-α)指标均显著优于对照组(P<0.001),HGF和c-Met信号通路指标均显著低于对照组(P<0.001)。两组不良反应发生率比较差异无统计学意义(χ^(2)=2.835,P>0.05)。HP复发率为21.93%,logistic回归分析结果表明,治疗方案、家庭人口、HGF/c-Met是HP复发的显著影响因素(P<0.05)。结论胃安除幽汤联合传统四联疗法应用于HP相关性胃炎患者可有效提高HP根除率、减少中医证候积分、增强临床疗效、恢复免疫功能、消除炎症反应,且不增加不良反应发生率,与减轻HGF/c-Met信号通路的表达相关。Objective To explore the efficacy of Wei'an Chuyou decoction on Helicobacter pylori(HP)-related gastritis and its effect on hepatocyte growth factor(HGF)/c-Mesenchymal to epithelial transition factor(c-Met)signaling pathway.Methods A total of 210 patients diagnosed with HP-related gastritis,treated between June 2020 and December 2023,were enrolled and randomly assigned to either an experimental group or a control group,with 105 patients in each group.The control group received standard quadruple therapy,while the experimental group was treated with Wei'an Chuyou decoction in addition to the standard therapy.Outcomes compared between the two groups included HP eradication rates,traditional Chinese medicine(TCM)syndrome scores,clinical efficacy,immune-inflammatory markers,HGF/c-Met signaling pathway activity,and adverse reactions.Follow-up was conducted until March 2024 to evaluate the factors associated with HP recurrence.Results Following treatment,the HP eradication rate in the experimental group was 98.10%,significantly higher than 82.86% in the control group,with a statistically significant difference(χ^(2)=14.147,P<0.05).Symptom scores in the experimental group were significantly lower than those in the control group(P<0.001).The overall effective rate was 94.29% in the experimental group compared to 85.71% in the control group,showing a statistically significant difference(χ^(2)=4.286,P<0.05).Immune function indicators(CD4^(+)T cell percentage,CD4^(+)/CD8^(+)ratio)and inflammatory markers(IL-1β,TGF-β1,TNF-α)were significantly improved in the experimental group(P<0.001),while HGF and c-Met pathway activity was significantly lower(P<0.001)compared to the control group.There was no statistically significant difference in the incidence of adverse reactions between the groups(χ^(2)=2.835,P>0.05).The HP recurrence rate was 21.93%.Logistic regression analysis revealed that treatment regimen,family size,HGF,and c-Met were significant factors influencing HP recurrence(P<0.05).Conclusion The use of Wei'an Chuyou

关 键 词：胃安除幽汤 幽门螺杆菌 胃炎 HGF/c-Met信号通路 

分 类 号：R256.3[医药卫生—中医内科学]