健脾化湿养胃方治疗脾虚湿阻型慢性萎缩性胃炎伴肠上皮化生Hp阳性患者的疗效及作用机制分析  

Effect and Action Mechanism of Jianpi Huashi Yangwei Decoction(健脾化湿养胃方)in Treatment of Chronic Atrophic Gastritis Combined with Intestinal Metaplasia(Spleen Deficiency and Dampness Stagnation Type)

作　　者：王莹[1] 章宸一瑜 靳兰洁 WANG Ying;ZHANG Chenyiyu;JIN Lanjie(Wuxi Hospital of Ruijin Hospital Affiliated to Shanghai Jiao Tong University,Wuxi 214000,Jiangsu,China)

机构地区：[1]上海交通大学医学院附属瑞金医院无锡分院,江苏无锡214000

出　　处：《辽宁中医杂志》2024年第12期100-103,共4页Liaoning Journal of Traditional Chinese Medicine

摘　　要：目的探讨健脾化湿养胃方治疗慢性萎缩性胃炎伴肠上皮化生(脾虚湿阻型)的疗效并分析其作用机制。方法选取2021年1月-2023年1月在该院(门诊诊治)收治的幽门螺杆菌(Helicobacter pylori,Hp)阳性慢性萎缩性胃炎伴肠上皮化生(脾虚湿阻型)”患者120例,据简单随机法将其分为中药联合组与对照组,各60例。对照组予以常规西药治疗(15 d),中药联合组在对照组基础上予以健脾化湿养胃方治疗(28 d)。治疗后,评估病患临床疗效,比较两组病患治疗前和治疗后的中医证候积分、Hp转阴率和血清胃肠激素[胃蛋白酶原Ⅰ(pepsinogen-Ⅰ,PGI),胃蛋白酶原Ⅱ(pepsinogen-Ⅱ,PG-Ⅱ),胃泌素-17(gastrin-17,GAS-17),内皮素-1(endothelin-1,ET-1)]、炎症因子[白细胞介素8(interleukin-8,IL-8),肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α),白细胞介素23(interleukin-23,IL-23)]变化情况;记录不良反应发生情况。结果中药联合组治疗和有效率和Hp转阴率与对照组比较,差异具有统计学意义(P<0.05);治疗后两组PGⅠ、GAS-17值均升高,中医证候积分、PGⅡ、ET-1、IL-8、TNF-α、IL-23值均降低;且中药联合组PGⅠ、GAS-17值高于对照组;中医证候积分、PGⅡ、ET-1、IL-8、TNF-α、IL-23值低于对照组,差异有统计学意义(P<0.05)。两组病患不良反应发生率比较,差异无统计学意义(P>0.05)。结论健脾化湿养胃方可以促进Hp转阴,改善胃功能和胃黏膜病理情况,进而有效治疗慢性萎缩性胃炎伴肠上皮化生(脾虚湿阻型)。Objective To explore the curative effect of Jianpi Huashi Yangwei Decoction(健脾化湿养胃方)on chronic atrophic gastritis(CAG)combined with intestinal metaplasia(spleen-deficiency dampness stagnation type),and to analyze its action mechanism.Methods A total of 120 patients with CAG and intestinal metaplasia(spleen deficiency dampness stagnation type)admitted to the hospital were enrolled between January 2021 and January 2023.According to simple randomization method,they were divided into TCM combination group and control group,60 cases in each group.The control group was treated with routine western medicine(15 d),while TCM combination group was additionally treated with Jianpi Huashi Yangwei Decoction(28 d).After treatment,clinical curative effect was evaluated.The changes in scores of TCM symptoms,negative conversion rate of Helicobacter pylori(Hp),serum gastrointestinal hormones[pepsinogen-Ⅰ(PGI),PG-Ⅱ,gastrin-17(GAS-17),endothelin-1(ET-1)]and inflammatory factors[interleukin-8(IL-8),tumor necrosis factor-α(TNF-α),IL-23]before and after treatment were compared between the two groups.The occurrence of adverse reactions was recorded.Results There were significant differences in response rate of treatment and negative conversion rate of Hp between the two groups(P<0.05).After treatment,the levels of PG-I and GAS-17 were increased,while scores of TCM syndromes,the levels of PG-II,ET-1,IL-8,TNF-αand IL-23 were decreased in both groups.The levels of PG-I and GAS-17 in TCM combination group were higher than those in control group,while scores of TCM syndromes,the levels of PG-II,ET-1,IL-8,TNF-αand IL-23 were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P<0.05).Conclusion Jianpi Huashi Yangwei Decoction can promote negative conversion of Hp,improve gastric function and gastric mucosa pathology,and thus effectively treat CAG combined with intestinal metaplasia(spleen-deficiency dampness stagnation type).

关 键 词：慢性萎缩性胃炎 中医证候积分 幽门螺杆菌 转阴率 胃功能 

分 类 号：R256.3[医药卫生—中医内科学]