健脾益气方治疗慢性萎缩性胃炎临床疗效

贾靖; 徐甜甜; 张毅; 汪洋

doi:10.3969/j.issn.1671-038X.2021.08.10

健脾益气方治疗慢性萎缩性胃炎临床疗效

- 1. 惠州市第三人民医院消化内科(广东惠州, 516000);
- 2. 惠州市第三人民医院胃肠外科

详细信息

通讯作者: 贾靖,E-mail:mciwds66@163.com

中图分类号: R573.3

收稿日期: 2021-03-23

修回日期: 2021-07-03

Effect of Jianpi Yiqi Decoction on chronic atrophic gastritis

- 1. Department of Gastroenterology, Huizhou Third People's Hospital, Huizhou, 516000, China;
- 2. Department of Gastrointestinal Surgery, Huizhou Third People's Hospital

More Information

Corresponding author: JIA Jing, E-mail: mciwds66@163.com

Received Date: 23 March 2021

Revised Date: 03 July 2021

摘要

摘要: 目的：观察中药健脾益气方治疗慢性萎缩性胃炎（CAG）的临床疗效。方法：将110例CAG患者按照随机数字表法分为2组，每组55例，对照组予以四联疗法，观察组在对照组治疗基础上应用中药健脾益气方，疗程均为12周。比较2组治疗前后中医证候评分、胃镜评分和病理评分，并比较2组治疗前后血清蛋白酶原（PG）Ⅰ、PGⅡ、核转录因子-κB （NF-κB）、环氧合酶-2（COX-2）、白细胞介素-8（IL-8）水平和PGⅠ/PGⅡ值，并比较2组治疗总有效率。结果：治疗后观察组主证、次证评分均低于对照组（P<0.05）；黏膜色泽、血管透见度、黏膜隆起、黏膜质地评分和腺体萎缩、肠上皮化生、异型增生积分均低于对照组（P<0.05），血清NF-κB、PGⅠ、PGⅡ水平及PGⅠ/PGⅡ值均高于对照组（P<0.05），血清COX-2、IL-8水平均低于对照组（P<0.05），治疗总有效率高于对照组（P<0.05），差异均有统计学意义。结论：健脾益气方有效缓解中医证候，调节胃蛋白酶原水平，改善胃黏膜病变程度，控制疾病进展，治疗CAG效果确切，其机制可能与调节血清NF-κB、COX-2、IL-8水平有关。
- 慢性萎缩性胃炎 /
- 中药 /
- 健脾益气方 /
- 机制
Abstract: Objective: To observe the clinical efficacy of Jianpi Yiqi Decoction in the treatment of chronic atrophic gastritis(CAG). Methods: One hundred and ten patients with CAG were randomly divided into two groups, with 55 cases in each group. The control group were given quadruple therapy, and the observation group were given Jianpi Yiqi Decoction on the basis of the control group. The course of treatment was for 12 weeks. The TCM syndrome score, gastroscope score and pathological score were compared between the two groups before and after treatment, and the serum levels of Pepsinogen (PG)Ⅰ, PGⅡ, Nuclear transcription factor NF-κB(NF-κB), Cyclooxygenase-2(COX-2), Interleukin-8(IL-8) level and value of PGⅠ/PGⅡ were compared between the two groups before and after treatment, and the total effective rate of the two groups was compared. Results: After treatment, the scores of main syndrome and secondary syndrome of the observation group were lower than those of the control group(P<0.05); The scores of mucosal color, vascular permeability, mucosal eminence, mucosal texture, glandular atrophy, intestinal metaplasia and dysplasia of the observation group were lower than those of the control group(P<0.05); The levels of serum NF-κB, PGⅠ, PGⅡand PGⅠ/PG Ⅱ of the observation group were higher than those of the control group(P<0.05); The levels of serum COX-2 and IL-8 of the observation group were lower than those in the control group(P<0.05) The total effective rate of the treatment group was higher than that of the control group(P<0.05). The differences were statistically significant.Conclusion: Jianpi Yiqi Decoction can effectively relieve TCM syndrome, regulate pepsinogen level, improve the degree of gastric mucosal lesions, control the progress of the disease, and it has definite effect on CAG. Its mechanism may be related to the regulation of serum NF-κB, COX-2 and IL-8 levels.
- chronic atrophic gastritis /
- Traditional Chinese Medicine /
- Jianpi Yiqi Decoction /
- mechanism

HTML全文

参考文献(25)

[1]	王萍, 尹晓岚, 张北华, 等.近40年慢性萎缩性胃炎及胃癌前病变中医研究述评[J].中医杂志, 2020, 61(22):1943-1947.
[2]	马学慧, 沈旦蕾, 张征波, 等.扶正活萎汤治疗气虚络瘀型慢性萎缩性胃炎临床研究[J].南京中医药大学学报, 2020, 36(6):809-813.
[3]	曹阳, 顾巍杰, 杨德才, 等.基于临床流调的慢性萎缩性胃炎发病危险因素研究[J].世界科学技术-中医药现代化, 2020, 22(4):1060-1067.
[4]	朱景茹, 黄婉仪, 杨宗保, 等.柴芍六君汤对慢性萎缩性胃炎肝郁脾虚证模型大鼠胃黏膜组织NF-κB、c-Myc、STAT1表达的影响[J].中医杂志, 2021, 62(11):984-989.
[5]	王佳琦, 焦娇, 禄保平.基于"阳明燥土, 得阴自安"探讨慢性萎缩性胃炎[J].中医学报, 2021, 36(5):929-932.
[6]	马贞, 彭亚婷, 荣立洋.连朴饮联合黎药治疗慢性萎缩性胃炎脾胃湿热证临床疗效观察[J].广州中医药大学学报, 2021, 38(2):236-241.
[7]	默雪梅, 刘建平, 张晓玉, 等.化浊解毒汤对Hp相关性慢性萎缩性胃炎伴肠上皮化生疗效的临床研究[J].中国中西医结合消化杂志, 2021, 29(5):320-324.
[8]	王庆泽, 郎晓猛, 刘建平, 等.刘建平教授运用调、益、化法辨治慢性萎缩性胃炎的经验[J].现代中西医结合杂志, 2020, 29(30):3361-3365.
[9]	董凡, 邓银香, 商竞宇, 等.中医治疗慢性萎缩性胃炎研究近况[J].江苏中医药, 2020, 52(7):88-90.
[10]	中国中西医结合学会消化系统疾病专业委员会.慢性萎缩性胃炎中西医结合诊疗共识意见(2017年)[J].中国中西医结合消化杂志, 2018, 26(2):121-131.
[11]	郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社, 2002:72-23.
[12]	中华中医药学会脾胃病分会.脾胃病症状量化标准专家共识意见(2017)[J].中华中医药杂志, 2017, 32(8):3590-3596.
[13]	中华医学会消化内镜学分会.慢性胃炎的内镜分型分级标准及治疗的试行意见[J].中华消化内镜杂志, 2004, 21(2):77-78.
[14]	杨良俊, 李嘉丽, 樊湘珍, 等.基于因子分析及关联规则的慢性萎缩性胃炎胃癌前病变方药分析[J].中华中医药学刊, 2019, 37(7):1642-1645.
[15]	杨振华, 孙波, 黄傲霜, 等.慢性萎缩性胃炎中医证候的胃镜及病理特征分析研究[J].中国中西医结合消化杂志, 2021, 29(1):58-61.
[16]	朱倩倩, 洪靖, 谭辉.中医药治疗慢性萎缩性胃炎研究进展[J].陕西中医药大学学报, 2020, 43(5):88-93.
[17]	杨帅, 王步轶, 李福凤, 等.基于舌诊及面诊信息特征的慢性萎缩性胃炎脾虚气滞证中医疗效评价[J].中华中医药杂志, 2021, 36(5):2957-2960.
[18]	周磊, 王虹, 高建萍, 等.血清胃蛋白酶原和胃泌素17联合检测对上海中心城区胃癌高危人群萎缩性胃炎的预测价值[J].中华消化杂志, 2020, 40(12):819-824.
[19]	庞海江, 许家艳, 丁守坤.益气活血解毒方联合西药治疗幽门螺杆菌阳性慢性萎缩性胃炎患者的疗效及对胃蛋白酶原的影响[J].世界中医药, 2019, 14(1):126-130.
[20]	周明霞, 徐惠明.疏肝理气方治疗疣状胃炎临床疗效及对血清pgⅠ、pgⅡ及CRP表达水平的影响[J].湖北中医药大学学报, 2020, 22(6):32-35.
[21]	Lin CC, Chan CM, Huang YP, et al.Methylglyoxal activates NF-κB nuclear translocation and induces COX-2 expression via a p38-dependent pathway in synovial cells[J].Life Sci, 2016, 149(1):25-33.
[22]	周巍, 杨青, 舒文娜, 等.艾灸与针刺对慢性萎缩性胃炎大鼠胃黏膜细胞凋亡及NF-κB、Bcl-2基因表达的影响[J].针刺研究, 2021, 46(4):284-288.
[23]	黎慧娟, 陈露, 唐畅宇.TLR4/NF-κB/COX-2致炎信号通路对幽门螺杆菌相关性慢性萎缩性胃炎发生、发展的影响及机制研究[J].胃肠病学和肝病学杂志, 2020, 29(7):773-777.
[24]	宫健伟, 李德芳, 刘鲁英, 等.酸味补肝汤对胆汁反流性胃炎小鼠血清IL-8和胃组织COX-2及NF-κB p65表达的影响[J].中药新药与临床药理, 2019, 30(7):802-805.
[25]	张勇.温中消萎汤治疗脾胃虚寒型慢性萎缩性胃炎疗效及机制研究[J].山东中医杂志, 2020, 39(10):1065-1070.