益气滋阴清热汤加减治疗阴虚热结证Hp感染合并慢性萎缩性胃炎疗效  

Effect of Modified Yiqi Ziyin Qingre Decoction(益气滋阴清热汤)in Treatment of Yin Deficiency and Heat Accumulation Syndrome and Hp Infection Complicated with Chronic Atrophic Gastritis

作　　者：叶淑云 沈建冲 应旭卿 YE Shuyun;SHEN Jianchong;YING Xuqing(Cixi Third People′s Hospital,Cixi 315300,Zhejiang,China)

机构地区：[1]慈溪市第三人民医院,浙江慈溪315300

出　　处：《辽宁中医杂志》2024年第12期108-111,共4页Liaoning Journal of Traditional Chinese Medicine

摘　　要：目的研究益气滋阴清热汤加减治疗阴虚热结证幽门螺杆菌(Helicobacter pylori,Hp)感染合并慢性萎缩性胃炎(chronic atrophic gastritis,CAG)的效果,及对胃镜组织学疗效、炎症因子水平变化的影响。方法选取80例2021年6月—2022年12月于慈溪市第三人民医院消化内科收治的Hp感染合并CAG患者作为研究对象,通过随机数字表法及双盲法分为对照组和汤药组各40例。两组患者均行四联疗法抗Hp感染治疗,Hp转阴后对照组予叶酸片和替普瑞酮胶囊治疗,汤药组予益气滋阴清热汤加减治疗,治疗4周后观察两组患者中医证候积分、临床疗效、胃镜组织学疗效以及炎症因子水平的变化。结果治疗后,两组患者主症、次症及证候总积分分数显著降低,且汤药组均显著低于对照组(P<0.05);汤药组患者临床疗效和胃镜组织学疗效的总有效率分别为92.50%(37/40)和92.50%(37/40),显著高于对照组的75.00(30/40)%和72.50%(29/40)(P<0.05);治疗后,两组患者转化生长因子β受体Ⅱ(transforming growth factor-βreceptorⅡ,TGF-βRⅡ)水平与治疗前比较显著增高,且汤药组治疗后显著高于对照组(P<0.05);治疗后,两组患者肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)、白细胞介素6(interleukin-6,IL-6)水平与治疗前比较显著降低,且汤药组治疗后显著低于对照组(P<0.05)。结论益气滋阴清热汤加减治疗阴虚热结证Hp感染合并CAG具有良好的临床疗效,有效缓解中医证候,并对胃黏膜萎缩、肠上皮化等组织病理学疗效显著,同时可减轻患者胃黏膜炎症反应,值得在临床应用中推介。Objective To study the effect of Modified Yiqi Ziyin Qingre Decoction(益气滋阴清热汤)in the treatment of yin deficiency and heat accumulation syndrome and Helicobacter pylori(Hp)infection complicated with chronic atrophic gastritis(CAG)and the influence on gastroscopic histology and inflammatory factor levels.Methods A total of 80 patients with Hp infection complicated with CAG who were admitted to the Gastroenterology Department at Cixi Third People′s Hospital from June 2021 to December 2022 were selected as the research subjects.They were randomly divided into the control group and the decoction group with 40 cases in each group.All patients were given quadruple therapy for anti-Hp infection.After Hp turning to be negative,the control group was treated with folic acid tablets and teprenone capsules,while the decoction group was treated with Modified Yiqi Ziyin Qingre Decoction.Four weeks later,traditional Chinese medicine syndrome scores,clinical efficacy,gastroscopic histological efficacy and changes of inflammatory factor levels in the two groups were observed.Results After treatment,the scores for main symptoms and secondary symptoms,and the total scores of syndromes in the two groups were significantly reduced.The above scores of the decoction group were significantly lower than those of the control group(P<0.05).The total clinical response rate and gastroscopic histological response rate in the decoction group[92.50%(37/40)and 92.50%(37/40)]were significantly higher than those in the control group[75.00%(30/40)and 72.50%(29/40)](P<0.05).After treatment,transforming growth factor-βreceptor II(TGF-βR II)levels in the two groups increased significantly,and the level in the decoction group was significantly higher than that in the control group(P<0.05).After treatment,the levels of tumor necrosis factorα(TNF-α)and interleukin-6(IL-6)in the two groups were significantly reduced.The levels in the decoction group were significantly lower than those in the control group(P<0.05).Conclusion Modified Yiq

关 键 词：益气滋阴清热汤 阴虚热结证 辨证加减 Hp感染合并CAG 胃镜组织学 炎症因子 

分 类 号：R256.3[医药卫生—中医内科学]