半夏泻心汤加味联合西药治疗寒热错杂证慢性萎缩性胃炎的临床效果  

Clinical Effect of Modified Banxia Xiexin Decoction Combined with Western Medicine on Patients with Chronic Atrophic Gastritis and Mixed Cold and Heat Syndrome

作　　者：韦彩雯 朱杰 顾慧锋 王萍 黄美琴 WEI Caiwen;ZHU Jie;GU Huifeng;WANG Ping;HUANG Meiqin(Department of General Practice,Chongming Hospital Affiliated to Shanghai University of Medicine&Health Sciences,Shanghai 202150,China;Department of Gastroenterology,Chongming Hospital Affiliated to Shanghai University of Medicine&Health Sciences,Shanghai 202150,China;Department of TCM Internal Medicine,Chongming Hospital Affiliated to Shanghai University of Medicine&Health Sciences,Shanghai 202150,China;Community Health Service Center,Gangyan Town,Chongming District,Shanghai 202158,China;Community Health Service Center of Yangxing Town,Baoshan District,Shanghai 201901,China)

机构地区：[1]上海健康医学院附属崇明医院全科,上海202150 [2]上海健康医学院附属崇明医院消化内科,上海202150 [3]上海健康医学院附属崇明医院中医内科,上海202150 [4]上海市崇明区港沿镇社区卫生服务中心,上海202158 [5]上海市宝山区杨行镇社区卫生服务中心,上海201901

出　　处：《临床误诊误治》2025年第6期85-89,100,共6页Clinical Misdiagnosis & Mistherapy

基　　金：上海市崇明区科学技术委员会科技项目(CKY2022-04)。

摘　　要：目的探究半夏泻心汤加味联合西药对寒热错杂证慢性萎缩性胃炎的疗效。方法选择2022年3月至2023年3月收治的寒热错杂证慢性萎缩性胃炎患者133例,按随机数字表法分为观察组66例和对照组67例。对照组予以西药抑酸护胃治疗,观察组在对照组基础上予以半夏泻心汤加味治疗。比较2组临床疗效、治疗前后中医证候积分、血清胃肠激素水平及胃蛋白酶原含量、胃黏膜萎缩与肠上皮化生评分变化、血清炎性因子水平,记录2组不良反应发生情况。结果观察组总有效率[96.97%(64/66)]高于对照组[77.61%(52/67)],差异有统计学意义(P<0.05)。观察组治疗后中医证候积分、血清降钙素基因相关肽及胃肠激素内皮素、胃蛋白酶原Ⅰ、表皮生长因子水平、胃黏膜萎缩与肠上皮化生情况评分、白细胞介素-2(IL-2)及IL-6改善情况均优于对照组(P<0.05)。2组治疗过程均未发现严重不良反应。结论半夏泻心汤加味联合西药治疗寒热错杂证慢性萎缩性胃炎临床效果好,安全可靠。Objective To explore the curative effect of modified Banxia Xiexin decoction on chronic atrophic gastritis(CAG)combined with mixed cold and heat syndrome.Methods A total of 133 patients with CAG combined with mixed cold and heat syndrome treated from March 2022 to March 2023 were divided into the observation group(n=66)and the control group(n=67)according to random number table method.The control group was treated with western medicine to suppress acid and protect the stomach,and the observation group was supplemented with Banxia Xiexin decoction on the basis of the control group.The clinical efficacy,Traditional Chinese Medicine(TCM)syndrome score,serum gastrointestinal hormone level and pepsinogen content before and after treatment,changes in gastric mucosa atrophy and intestinal metaplasia score,and serum inflammatory factor levels were compared between the two groups,and the occurrence of adverse reactions were recorded.Results The total effective rate of the observation group[96.97%(64/66)]was higher than that of the control group[77.61%(52/67)],and the difference was significant(P<0.05).After treatment,improvement in TCM syndrome scores,serum levels of calcitonin gene-related peptide(CGRP),gastrointestinal hormones endothelin,pepsinogenⅠ(PGⅠ),epidermal growth factor(EGF),scores of gastric mucosa atrophy and intestinal metaplasia,interleukin-2(IL-2)and IL-6 levels in the observation group was better than that in the control group(P<0.05).No serious adverse reactions were found during treatment in both groups.Conclusion Modified Banxia Xiexin decoction combined with Western medicine has good clinical effect in the treatment of CAG combined with mixed cold and heat syndrome,with good safety and reliability.

关 键 词：胃炎 萎缩性 半夏泻心汤加味 降钙素基因相关肽 表皮生长因子 胃蛋白酶原Ⅰ 胃黏膜萎缩 肠上皮化生 白细胞介素-2 

分 类 号：R573.32[医药卫生—消化系统]