黄连汤合柴龙逆萎汤联合四联疗法治疗慢性非萎缩性胃炎伴糜烂临床研究  

Clinical Study on Huanglian Decoction and Chailong Niwei Decoction Combined with Quadruple Therapy for Chronic Non-Atrophic Gastritis Complicated with Erosion

作　　者：王冬[1] 唐伟[1] WANG Dong;TANG Wei(Anyang Hospital of Traditional Chinese Medicine,Anyang Henan 455000,China)

机构地区：[1]安阳市中医院,河南安阳455000

出　　处：《新中医》2025年第1期6-11,共6页New Chinese Medicine

摘　　要：目的:观察黄连汤合柴龙逆萎汤联合四联疗法治疗慢性非萎缩性胃炎(CNAG)伴糜烂的临床效果。方法:选取2020年6月—2023年6月于安阳市中医院治疗的144例肝胃不和兼脾胃湿热型CNAG伴糜烂患者,采用随机数字表法分为对照组和观察组各72例,2组均采用常规四联疗法治疗,观察组加用黄连汤合柴龙逆萎汤加减治疗。2组均治疗4周。治疗前后评估2组患者的中医证候评分,检测血清炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-8(IL-8)]水平及胃功能指标[胃泌素-17(G-17)、胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)],评估胃黏膜糜烂评分、慢性炎症评分,统计治疗期间不良反应发生情况。比较2组的临床疗效。结果:治疗4周后,观察组总有效率高于对照组(P<0.05)。2组中医证候主症积分、次症积分、总积分及胃黏膜糜烂评分、慢性炎症评分均较治疗前降低(P<0.05),观察组以上5项评分值均低于对照组(P<0.05)。2组TNF-α、IL-1β、IL-8、PGⅡ水平均较治疗前降低,G-17、PGⅠ水平均较治疗前升高,差异均有统计学意义(P<0.05)。观察组TNF-α、IL-1β、IL-8、PGⅡ水平均低于对照组(P<0.05),G-17、PGⅠ水平均高于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:在四联疗法基础上加用黄连汤合柴龙逆萎汤治疗肝胃不和兼脾胃湿热型CNAG伴糜烂患者能够有效缓解症状,提高临床疗效,减轻机体炎症及胃黏膜糜烂程度,安全性较高。Objective:To observe the clinical effect of Huanglian Decoction and Chailong Niwei Decoction combined with quadruple therapy on chronic non-atrophic gastritis(CNAG)complicated with erosion.Methods:A total of 144 cases of CNAG patients with erosion of liver-stomach disharmony and spleen and stomach damp-heat types treated at Anyang Hospital of Traditional Chinese Medicine from June 2020 to June 2023 were randomly divided into the control group and the observation group,with 72 cases in each group.The two groups were treated with conventional quadruple therapy,and the observation group was additionally treated with Huanglian Decoction and Chailong Niwei Decoction.Both groups were treated for four weeks.Before and after treatment,the scores of traditional Chinese medicine(TCM)syndromes in the two groups were evaluated.The levels of inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)and interleukin-8(IL-8)]and gastric function indexes[gastrin-17(G-17),pepsinogenⅠ(PGⅠ),and pepsinogenⅡ(PGⅡ)]in serum were measured.The gastric mucosal erosion scores and chronic inflammation scores were evaluated,and the occurrence of adverse reactions during the treatment period was statistically analyzed.The clinical efficacy in the two groups was compared.Results:After four weeks of treatment,the total effective rate in the observation group was higher than that in the control group(P<0.05).The main symptom scores,secondary symptom scores,total scores of TCM syndromes and gastric mucosal erosion scores and chronic inflammation scores in the two groups were decreased when compared with those before treatment,and the above five scores in the observation group were lower than those in the control group,the difference being statistically significant(P<0.05).The levels of TNF-α,IL-1β,IL-8 and PGⅡin the two groups were decreased when compared with those before treatment(P<0.05),and the levels of G-17 and PGⅠin the two groups were increased when compared with those before treatment(P<0.05).The levels of

关 键 词：慢性非萎缩性胃炎伴糜烂 肝胃不和证 脾胃湿热证 黄连汤 柴龙逆萎汤 炎症因子 胃功能 

分 类 号：R573.32[医药卫生—消化系统] R259[医药卫生—内科学]