肠化方加减联合西药治疗慢性萎缩性胃炎伴肠上皮化生的临床效果研究  

Clinical study on the treatment of chronic atrophic gastritis with intestinal metaplasia by modified Changhua recipe combined with western medicine

作　　者：陈建荣 CHEN Jian-rong(Putian Traditional Chinese Medicine Hospital,Putian 351100,China)

机构地区：[1]莆田市中医医院,351100

出　　处：《中国现代药物应用》2025年第7期11-15,共5页Chinese Journal of Modern Drug Application

摘　　要：目的探究慢性萎缩性胃炎伴肠上皮化生以肠化方加减联合西药进行治疗的效果。方法纳入60例慢性萎缩性胃炎伴肠上皮化生患者,按双盲法分为对照组和观察组,每组30例。对照组采用西药治疗,观察组在对照组基础上联合肠化方加减治疗。对比两组疗效,不良反应发生情况,治疗前后中医证候积分、胃黏膜组织评分、胃蛋白酶原水平、炎症因子水平。结果治疗后,观察组治疗总有效率96.67%高于对照组的76.67%(P<0.05)。治疗后,两组中医证候积分均较治疗前降低,且观察组胃脘胀满、疼痛、嗳气反酸、胃中嘈杂、纳差积分分别为(0.73±0.10)、(0.75±0.12)、(0.61±0.13)、(0.65±0.20)、(0.70±0.14)分,均低于对照组的(1.61±0.15)、(1.70±0.14)、(1.59±0.12)、(1.60±0.23)、(1.66±0.24)分(P<0.05)。治疗后,两组胃黏膜组织评分均低于治疗前,且观察组慢性炎症、活动性炎症、萎缩、肠上皮化生评分分别为(0.60±0.14)、(0.63±0.12)、(0.65±0.10)、(0.71±0.18)分,低于对照组的(1.54±0.10)、(1.60±0.15)、(1.58±0.13)、(1.68±0.20)分(P<0.05)。治疗后,两组胃蛋白酶原水平均较治疗前显著改善,且观察组胃蛋白酶原Ⅰ(PGⅠ)(56.29±8.08)μg/L、PGⅠ/胃蛋白酶原Ⅱ(PGⅡ)(4.79±0.65)均高于对照组的(50.26±7.41)μg/L、(3.40±0.50),PGⅡ(10.26±2.14)μg/L低于对照组的(13.59±2.88)μg/L(P<0.05)。治疗后,两组炎症因子水平均较治疗前降低,且观察组肿瘤坏死因子-α(TNF-α)(42.16±5.28)μg/L、白细胞介素-32(IL-32)(40.23±5.16)pg/ml、可溶性白细胞介素-2受体(SIL-2R)(300.54±11.96)U/ml均低于对照组的(55.29±6.31)μg/L、(51.67±6.09)pg/ml、(360.57±12.82)U/ml(P<0.05)。两组用药不良反应发生率对比无差异(P>0.05)。结论慢性萎缩性胃炎伴肠上皮化生以肠化方加减联合西药治疗疗效满意,临床症状减轻,同时改善了炎症因子水平,未见额外药毒性,整体达到预期,建议临床推广应用。Objective To explore the effect of modified Changhua recipe combined with western medicine in the treatment of chronic atrophic gastritis with intestinal metaplasia.Methods 60 cases of chronic atrophic gastritis with intestinal metaplasia were divided into control group and observation group according to double-blind method,each with 30 cases.The control group was treated with western medicine,and the observation group was treated with modified Changhua recipe on the basis of the control group.Comparison of curative effect,adverse reactions,traditional Chinese medicine syndrome score,gastric mucosal tissue score,pepsinogen level,and level of inflammatory factor between the two groups.Results After treatment,the total effective rate of 96.67%in the observation group was higher than 76.67%in the control group(P<0.05).After treatment,the traditional Chinese medicine syndrome scores in both groups were lower than those before treatment;in the observation group,the scores of abdominal fullness,pain,belching and acid regurgitation,gastric discomfort and poor appetite were(0.73±0.10),(0.75±0.12),(0.61±0.13),(0.65±0.20)and(0.70±0.14)points,which were lower than(1.61±0.15),(1.70±0.14),(1.59±0.12),(1.60±0.23)and(1.66±0.24)points in the control group(P<0.05).After treatment,the scores of gastric mucosa tissues in both groups were lower than those before treatment;in the observation group,the scores of chronic inflammation,active inflammation,atrophy and intestinal metaplasia were(0.60±0.14),(0.63±0.12),(0.65±0.10)and(0.71±0.18)points,which were lower than(1.54±0.10),(1.60±0.15),(1.58±0.13)and(1.68±0.20)points in the control group(P<0.05).After treatment,the pepsinogen levels in both groups were significantly improved compared with before treatment;the levels of pepsinogenⅠ(PGⅠ)and PGⅠ/pepsinogenⅡ(PGⅡ)in the observation group were(56.29±8.08)μg/L and(4.79±0.65),which were higher than(50.26±7.41)μg/L and(3.40±0.50)in the control group;the observation group had a lower PGⅡof(10.26±2.14)μg/

关 键 词：肠化方 西药 慢性萎缩性胃炎 肠上皮化生 

分 类 号：R573.3[医药卫生—消化系统]