芍药甘草汤联合酪酸梭菌活菌散辅助治疗老年胃溃疡临床研究  

Clinical Study on Shaoyao Gancao Decoction Combined with Clostridium Butyricum Powder in Adjuvant Treatment of Elderly Gastric Ulcer

作　　者：严成杰 李菲 沈鲁佳 YAN Chengjie;LI Fei;SHEN Lujia(Department of Pharmacy,Hangzhou Ninth People's Hospital,Hangzhou Zhejiang 310020,China;Department of Chinese Medicine,Hangzhou Ninth People's Hospital,Hangzhou Zhejiang 310020,China)

机构地区：[1]杭州市第九人民医院药剂科,浙江杭州310020 [2]杭州市第九人民医院中医科,浙江杭州310020

出　　处：《新中医》2025年第5期30-35,共6页New Chinese Medicine

摘　　要：目的:观察芍药甘草汤联合酪酸梭菌活菌散辅助治疗老年胃溃疡的临床疗效。方法:选取2020年11月—2023年11月杭州市第九人民医院收治的120例老年胃溃疡患者为研究对象,根据治疗方案不同分为研究组64例和对照组56例。对照组予以常规四联疗法联合酪酸梭菌活菌散辅助治疗,研究组在对照组基础上联合使用芍药甘草汤治疗。2组均连续治疗4周。比较2组治疗前后的溃疡情况(溃疡底部厚苔面积、溃疡周围黏膜充血面积、溃疡周围再生上皮面积)、肠道菌群变化(肠球菌、双歧杆菌、乳酸杆菌、肠杆菌)、血清胃激素水平[三叶因子(TFF1)、胃动素(MTL)、胃泌素(GAS)]及p38 MAPK mRNA、NF-κB mRNA表达水平。观察2组治疗期间的不良反应情况。结果:治疗后,2组溃疡底部的厚苔面积、溃疡周围再生上皮面积、溃疡周围黏膜充血面积较治疗前降低(P<0.05),且研究组低于对照组(P<0.05)。治疗后,2组肠球菌、肠杆菌、双歧杆菌、乳酸杆菌数量较治疗前均增多(P<0.05),且研究组多于对照组(P<0.05)。治疗后,2组TFF1、MTL及GAS水平较治疗前降低(P<0.05),且研究组低于对照组(P<0.05)。治疗后,2组p38 MAPK mRNA、NF-κB mRNA表达较治疗前降低(P<0.05),且研究组低于对照组(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:芍药甘草汤联合酪酸梭菌活菌散辅助治疗可改善老年胃溃疡患者症状,加速溃疡愈合,调节和促进胃激素、肠道菌群恢复平衡,其可能与调节机体内p38 MAPK/NF-κB通路表达有关。Objective:To observe the clinical effect of the combination use of Shaoyao Gancao Decoction and Clostridium Butyricum Powder in adjuvant treatment of elderly gastric ulcer.Methods:A total of 120 elderly patients with gastric ulcer admitted to the Hangzhou Ninth People's Hospital from November 2020 to November 2023 were selected as the research objects and divided into the study group(64 cases)and the control group(56 cases)according to the random number table method.The control group was treated with conventional quadruple therapy combined with Clostridium Butyricum Powder,and the study group was treated with Shaoyao Gancao Decoction on the basis of treatment in the control group.Both groups were treated for four weeks.The ulcer condition(area of thick moss at the bottom of the ulcer,area of mucosal congestion around the ulcer and area of regenerative epithelium around the ulcer),changes of intestinal flora(Enterococcus,Bifidobacterium,Lactobacillus and Enterobacter),levels of serum gastric hormone[trefoil factor(TFF1),motilin(MTL)and gastrin(GAS)]and expression levels of p38 MAPK mRNA and NF-κB mRNA were compared before and after treatment between the two groups.The incidence of adverse reactions in the two groups during treatment were observed.Results:After treatment,the area of thick moss at the bottom of the ulcer,area of mucosal congestion around the ulcer and area of regenerative epithelium around the ulcer in the two groups were reduced when compared with those before treatment(P<0.05),and the above three areas in the study group were less than those in the control group(P<0.05).After treatment,the number of Enterococcus,Bifidobacterium,Lactobacillus and Enterobacter in the two groups was elevated when compared with that before treatment(P<0.05),and the number of Enterococcus,Bifidobacterium,Lactobacillus and Enterobacter in the study group was respectively higher than that in the control group(P<0.05).After treatment,the levels of TFF1,MTL and GAS in the two groups were down-regulated when compared with

关 键 词：胃溃疡 老年人 芍药甘草汤 酪酸梭菌活菌散 肠道菌群 胃肠激素 p38 MAPK NF-ΚB 

分 类 号：R573.1[医药卫生—消化系统]