摘要
目的探讨加味逍遥散治疗肝郁脾虚型慢性萎缩性胃炎的临床价值。方法选取诊治的肝郁脾虚症慢性萎缩性胃炎患者100例,随机分为治疗组和对照组两组,每组50例,对照组采用西医常规治疗,治疗组在对照组用药基础上加用加味逍遥散治疗,治疗1个月,观察治疗前后患者中医证候积分、胃镜下组织学积分及血清胃泌素17、胃蛋白酶原I和胃蛋白酶原II变化,对治疗疗效进行评定。结果两组患者治疗前胃痛、胃脘或胁肋胀满、乏力、嗳气、口干苦、反酸、便溏、便结等证候积分比较差异无统计学意义(P>0.05),治疗后较治疗前证候积分下降,且治疗组下降幅度大于对照组,差异有统计学意义(P<0.05);两组患者治疗前胃镜下腺体萎缩、肠上皮化生、慢性炎症、异型增生、病变活动度严重程度评分比较,差异无统计学意义(P>0.05),治疗后较治疗前评分下降,且治疗组下降幅度大于对照组,差异有统计学意义(P<0.05);两组患者治疗前血清胃泌素17、胃蛋白酶原I及胃蛋白酶原II水平比较,差异无统计学意义(P>0.05),治疗后较治疗前胃泌素17、胃蛋白酶原I、胃蛋白酶原II、胃蛋白酶原I/胃蛋白酶原II水平升高,且治疗组升高幅度大于对照组,差异有统计学意义(P<0.05);治疗组治疗总有效率为88.00%(44/50),高于对照组72.00%(36/50),差异有统计学意义(P<0.05)。结论加味逍遥散治疗肝郁脾虚型慢性萎缩性胃炎有助于促进症状和胃镜组织学改善,提高治疗疗效,具有较高的临床治疗价值,其作用可能与调节胃泌素-17及胃蛋白酶原的分泌有关。
Objective To discuss the clinical value of Jiawei Xiaoyao Powder(加味逍遥散)treating chronic atrophic gastritis with liver stagnation and spleen deficiency.Methods A total of 100 cases of patients with chronic atrophic gastritis were randomly divided into control group and treatment group and each group had 50 cases.The control group was treated with conventional western medicine.The treatment group was additionally treated with Jiawei Xiaoyao Powder on the basis of medication in the control group.The two groups were treated for 1 month.We observed TCM syndrome scores,endoscopic histology,serum levels of gastrin 17,pepsinogen I and pepsinogen II before and after treatment.Results Scores for symptoms of stomachache,epigastric or flank distension,fatigue,belching,dry and bitter mouth,acid regurgitation,loose stool,constipation,there was no significant difference in the above symptom scores between the two groups in before treatment(P>0.05).The scores of TCM syndromes were decreased after treatment compared with those before treatment and the decrease amplitude of the treatment group was larger than that of the control group.The difference was statistically significant(P<0.05).Gland atrophy,intestinal metaplasia,chronic inflammation,dysplasia and severity of lesion activity were scored under gastroscopy.There was no significant difference in the above scores between the two groups before treatment(P>0.05).The scores histological was decreased after treatment compared with that before treatment and the decrease amplitude of the treatment group was larger than that of the control group.The difference was statistically significant(P<0.05).Serum levels of gastrin 17,pepsinogen I and pepsinogen II had no significant difference between the two groups before treatment(P>0.05).The serum levels of gastrin 17,pepsinogen I,pepsinogen II and pepsinogen I/pepsinogen II were elevated after treatment compared with those before treatment,and the ascending range of the treatment group was higher than that of the control group.T
作者
马燕
唐伟
陈久红
MA Yan;TANG Wei;CHEN Jiuhong(Lu'an Hospital of Traditional Chinese Medicine,Lu'an 237006,Anhui,China)
出处
《中华中医药学刊》
CAS
北大核心
2022年第4期111-114,共4页
Chinese Archives of Traditional Chinese Medicine
基金
中华医学会临床医学科研专项基金(192673935681)。
关键词
慢性萎缩性胃炎
加味逍遥散
肝郁脾虚
胃泌素-17
胃蛋白酶原
chronic atrophic gastritis
Jiawei Xiaoyao Powder(加味逍遥散)
liver stagnation and spleen deficiency
gastrin-17
pepsinogen
