健脾逐瘀方辅治Hp阳性胃溃疡的效果及对胃功能三项、生活质量的影响  

Efficacy of Jianpi Zhuyu Formula as adjuvant therapy for Hp-positive gastric ulcers and its effect on three items of gastric function and quality of life

作　　者：常宁甫 袁潇 杨秀 钱小洲 CHANG Ning-fu;YUAN Xiao;YANG Xiu;QIAN Xiao-zhou(Department of Spleen and Stomach Diseases,Xinmi Hospital of Traditional Chinese Medicine,Xinmi 452370,Henan,CHINA;Department of Gastroenterology,the First People's Hospital of Yunnan Province,Kunming 650000,Yunnan,CHINA;Department of Gastroenterology,Wenshan People's Hospital,Wenshan 663099,Yunnan,CHINA)

机构地区：[1]新密市中医院脾胃病科,河南新密452370 [2]云南省第一人民医院消化内科,云南昆明650000 [3]文山市人民医院消化内科,云南文山663099

出　　处：《海南医学》2025年第5期659-664,共6页Hainan Medical Journal

基　　金：2023年度河南省医学科技攻关计划联合共建项目(编号:LHGJ20233200)。

摘　　要：目的探讨健脾逐瘀方辅治幽门螺杆菌(Hp)阳性胃溃疡患者的临床效果。方法选取2020年3月至2024年4月新密市中医院收治的202例Hp阳性胃溃疡患者纳入研究,按随机数表法分为研究组和对照组,每组101例。对照组患者采用四联疗法,观察组患者采用四联疗法+健脾逐瘀方治疗。治疗4周后,比较两组患者的治疗效果、Hp转阴率和治疗前、治疗4周后中医证候积分、胃功能三项[胃蛋白酶原Ⅱ(PGⅡ)、胃蛋白酶原Ⅰ(PGⅠ)、胃泌素-17(G-17)]、生活质量[诺丁汉健康调查问卷(NHP)评分]、NOD样受体热蛋白结构域相关蛋白3(NLRP3)炎症小体相关因子[NLRP3、白介素-18(IL-18)、白介素-1β(IL-1β)],并比较两组患者治疗期间不良反应发生率。结果治疗4周后,观察组患者的Hp转阴率、治疗总有效率分别为90.10%、92.08%,明显高于对照组的79.21%、80.20%,差异均有统计学意义(P<0.05);治疗4周后观察组患者的中医证候积分、NHP评分、萎缩积分、肠上皮化生积分、异型增生积分分别为(8.11±1.04)分、(50.55±4.23)分、(2.42±0.35)分、(2.01±0.33)分、(2.15±0.36)分,明显低于对照组的(10.23±1.48)分、(57.73±5.11)分、(3.01±0.42)分、(2.68±0.34)分、(2.96±0.43)分,差异均有统计学意义(P<0.05);治疗4周后观察组患者的PGⅠ水平为(204.42±20.23)μg/L,明显高于对照组的(152.24±16.63)μg/L,G-17、PGⅡ水平分别为(5.11±0.53)pmol/L、(7.51±1.05)μg/L,明显低于对照组的(7.58±0.86)pmol/L、(9.46±1.34)μg/L,差异均有统计学意义(P<0.05);治疗4周后观察组患者的IL-1β、IL-18、NLRP3分别为(75.13±6.58)pg/mL、(66.44±6.68)pg/mL、(91.77±8.63)pg/mL,明显低于对照组的(89.46±8.19)pg/mL、(83.56±7.39)pg/mL、(122.24±13.46)pg/mL,差异均有统计学意义(P<0.05);两组患者的不良反应总发生率比较差异无统计学意义(P>0.05)。结论健脾逐瘀方辅助治疗Hp阳性胃溃疡可有效减轻患者的炎症反应,增强胃功能,有助于Objective To evaluate the clinical efficacy of Jianpi Zhuyu Formula as adjuvant therapy for patients with Helicobacter pylori(Hp)-positive gastric ulcers.Methods A total of 202 patients with Hp-positive gastric ulcer admitted to Xinmi Hospital of Traditional Chinese Medicine from March 2020 to April 2024 were randomized into a study group(n=101)and a control group(n=101).Patients in the control group received quadruple therapy,while those in the study group received quadruple therapy combined with Jianpi Zhuyu Formula.After 4 weeks of treatment,the therapeutic effect and Hp negative conversion rate of the two groups of patients were compared,as well as the scores of traditional Chinese medicine syndrome,three gastric functions(pepsinogenⅡ[PGⅡ],pepsinogenⅠ[PGⅠ],gastrin-17[G-17]),quality of life(Nottingham Health Profile[NHP]score),NOD-like receptor with pyrin domain-containing 3(NLRP3)inflammasome-related factors(NLRP3,interleukin-18[IL-18],interleukin-1β[IL-1β])before and after treatment for 4 weeks,and adverse reactions during the treatment period.Results After 4 weeks of treatment,the Hp negative conversion rate and total treatment efficacy rate in the observation group were 90.10%and 92.08%,respectively,which were significantly higher than 79.21%and 80.20%in the control group(P<0.05).After 4 weeks of treatment,the scores of TCM syndrome,NHP,atrophy,intestinal metaplasia,and dysplasia in the observation group were(8.11±1.04)points,(50.55±4.23)points,(2.42±0.35)points,(2.01±0.33)points,and(2.15±0.36)points,respectively,which were significantly lower than(10.23±1.48)points,(57.73±5.11)points,(3.01±0.42)points,(2.68±0.34)points,and(2.96±0.43)points in the control group(P<0.05).After 4 weeks of treatment,the level of PGⅠin the observation group was(204.42±20.23)μg/L,which was higher than(152.24±16.63)μg/L in the control group;the levels of G-17 and PGⅡwere(5.11±0.53)pmol/L and(7.51±1.05)μg/L,respectively,which were lower than(7.58±0.86)pmol/L and(9.46±1.34)μg/L in the control group

关 键 词：健脾逐瘀方 HP阳性 胃溃疡 炎症 胃功能 生活质量 

分 类 号：R573.1[医药卫生—消化系统]