活血化瘀生肌方对瘀血阻络型胃食管反流病肠道菌群、胃蛋白酶原、食管动力及胃黏膜损伤的影响
Effects of Huoxue Huayu Shengji Formula on intestinal flora,pepsinogen,esophageal motility,gastric mucosal injury repair in patients with gastroesophageal reflux diseaseof blood stasis type
金莹 1吴胜炜 2郭法杰 1徐胜利3
作者信息
- 1. 安徽省宿州市中医医院中药房,安徽 宿州 234000
- 2. 安徽省宿州市中医医院老年科,安徽 宿州 234000
- 3. 安徽省宿州市中医医院脾胃病科,安徽 宿州 234000
- 折叠
摘要
目的 观察活血化瘀生肌方对瘀血阻络型胃食管反流病患者肠道菌群、胃蛋白酶原、食管动力及胃黏膜损伤的影响.方法 将115 例胃食管反流病患者按照随机数字表法分为2 组,对照组57 例予常规西医治疗,治疗组 58例在对照组治疗基础上予活血化瘀生肌方治疗.连续治疗1 个月.比较2 组治疗前后血清胃蛋白酶原Ⅰ(PGⅠ)、转化生长因子α(TGF-α)、胃蛋白酶原Ⅱ(PGⅡ)、胆囊收缩素(CCK)水平,肠道葡萄球菌、乳酸菌、双歧杆菌数量,食管动力指标(食管括约肌压力、食管远端收缩积分平均值、总反流时间百分比),中医证候评分,胃酸分泌量,胃液胆酸量,以及反流性疾病问卷(RDQ)评分,统计2 组临床疗效.结果 治疗组总有效率 96.55%(56/58),对照组总有效率 82.46%(47/57),治疗组临床疗效优于对照组(P<0.05).2 组治疗后PGⅠ、TGF-α水平均较本组治疗前升高(P<0.05),且治疗组治疗后均高于对照组(P<0.05);2 组治疗后PGⅡ、CCK水平均降低(P<0.05),治疗组治疗后均低于对照组(P<0.05).2 组治疗后肠道乳酸菌、双歧杆菌数量均较本组治疗前升高(P<0.05),治疗组治疗后均高于对照组(P<0.05);2 组治疗后葡萄球菌数量均降低(P<0.05),且治疗组治疗后低于对照组(P<0.05).2 组治疗后食管括约肌压力、食管远端收缩积分平均值均较本组治疗前升高(P<0.05),且治疗组治疗后均高于对照组(P<0.05);2 组治疗后总反流时间百分比均较本组治疗前降低(P<0.05),且治疗组治疗后低于对照组(P<0.05).2 组治疗后中医证候各项评分均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05).2 组治疗后胃酸分泌量、胃液胆酸量及RDQ评分均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05).结论 活血化瘀生肌方治疗瘀血阻络型胃食管反流病患者,可改善胃蛋白酶原指标,促进胃黏膜损伤修复,平衡肠道菌群,提高食管动力,缓解患者中医证候及临床症状,提升临床疗效.
Abstract
Objective To observe the effects of Huoxue Huayu Shengji Formula on intestinal flora,pepsinogen,esopha-geal motility,gastric mucosal injury repair in patients with gastroesophageal reflux disease(GERD)of blood stasis type.Meth-ods A total of 115 GERD patients were randomly assigned in a1∶1 ratio to routine Western medicine(RWM,control group)or Huoxue Huayu Shengji Formula+RWM(treatment group)for 1 month.The aim was to compare serum pepsinogen I(PGI),transforming growth factor alpha(TGF-α),pepsinogen Ⅱ(PGⅡ),cholecystokinin(CCK),amount of Staphylococcus,Lac-tobacillus and Bifidobacterium,esophageal motility indexes(esophageal sphincter pressure,mean distal contractile integral[DCI],percentage total reflux time),traditional Chinese medi-cine(TCM)syndrome score,gastric acid output,gastric bile acid content,Reflux Disease Questionnaire(RDQ).The curative effect was assessed.Results The overall effective rate in the treatment group was better than that in the control group(96.55%[56/58]vs 82.46%[47/57],P<0.05).After treatment,significantly increased PGⅠand TGF-α levels,and decreased PGⅡ and CCK levels were found in the both groups than those before treatment(all P<0.05),and the different was significant between groups for the above indexes(all P<0.05).Signifi-cantly increased amount of Lactobacillus and Bifidobacterium,and decreased amount of Staphylococcus were detected in the both groups(all P<0.05),and the treatment group was superior to the control group for amount of Staphylococcus,Lactobacillus and Bifidobacterium(all P<0.05).Significantly higher esophageal sphincter pressure and mean DCI,and reducedproportion of total reflux timewere found in the both groups after treatment(all P<0.05),which were significantly pronounced in treatment group(all P<0.05).After treatment,TCM symptom scores in the both groups were significantly decreased(P<0.05),which de-creased notably in the treatment group compared with the control group(P<0.05).After treatment,gastric acid output,gastric bile acid content,RDQ score in the both groups were significantly decreased(P<0.05),which were significantly lower in the treatment group than in the control group(P<0.05).Conclusion Huoxue Huayu Shengji Formula can improve pepsinogen in-dicators,promote gastric mucosal injury repair,balance intestinal flora,improve esophageal motility,TCM syndromes and clini-cal symptoms,and enhance clinical efficacy in patients with GERD of blood stasis type.
关键词
胃食管反流病/中药疗法/胃蛋白酶原/胃黏膜/肠道菌群/食管动力Key words
Gastroesophageal reflux disease/Traditional Chinese medicine therapy/Pepsinogen/Gastric mucosa/In-testinal flora/Esophageal motility引用本文复制引用
基金项目
2021年度中国民族医药学会科研项目(2021Z1126-1002009)
出版年
2024
国家科技期刊平台
NSTL
万方数据