摘要
目的 探讨自拟15 味健脾护膜汤加抗幽门螺杆菌(Hp)四联方案治疗慢性消化性溃疡(PU)脾胃虚寒型效果及相关机制.方法 选取2019 年3 月—2022 年10 月收治的慢性PU 80 例,根据治疗方法不同将其分为联合组和西医组2 组各40 例.联合组给予自拟 15 味健脾护膜汤加抗Hp四联方案治疗,西医组给予抗Hp四联方案治疗.比较2 组临床疗效、Hp根除情况、复发情况、中医证候积分、溃疡愈合质量、胃酸分泌情况[基础胃酸分泌量(BAO)、最大胃酸分泌量(MAO)、高峰胃酸分泌量(PAO)、胃液pH值]、胃肠道功能[胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、胃泌素(GAS)、胃动素(MTL)]及不良反应.结果 治疗结束停药 4 周后,联合组总有效率(39/40,97.50%)和Hp根除率(35/40,87.50%)高于西医组(32/40,80.00%;24/40,60.00%);治疗结束后随访3 个月,联合组复发率(2/40,5.00%)低于西医组(8/40,20.00%)(P＜0.05,P＜0.01).治疗 2 和 4 周后,2 组胃痛、胃胀、疼痛喜按、空腹痛甚、纳呆、神疲懒言积分,BAO、MAO、PAO和PGⅠ、PGⅡ、GAS、MTL均低于治疗前,且联合组低于西医组;2组胃液pH值高于治疗前,且联合组高于西医组(P＜0.01).治疗结束后,联合组溃疡愈合优良率高于西医组(P＜0.01).治疗期间,2 组不良反应发生率比较差异无统计学意义(P＞0.05).结论 自拟15 味健脾护膜汤加抗Hp四联方案治疗慢性PU脾胃虚寒型效果显著、安全性好,可改善患者临床症状,抑制胃酸分泌,提高Hp根除率,促进溃疡修复,降低复发率;分析其可能与调节GAS、MTL表达有关.
Abstract
Objective To investigate the effect and related mechanism of self-prepared Shiwuwei Jianpi Humo Decoc-tion plus anti-Helicobacter pylori(Hp)quadruple regimen in treating chronic peptic ulcer(PU)of spleen-stomach deficiency cold type.Methods Eighty patients with chronic PU treated from March 2019 to October 2022 were selected and divided into two groups according to different treatment methods:combination group and Western medicine group with 40 cases in each group.The combination group was treated with Shiwuwei Jianpi Humo decoction plus anti-HP quadruple regimen,and the Western medicine group was treated with anti-HP quadruple regimen.Clinical efficacy,Hp eradication,recurrence,tradition-al Chinese medicine(TCM)syndrome score,ulcer healing quality,gastric acid secretion[maximum gastric acid secretion(MAO),basic gastric acid secretion(BAO),peak gastric acid secretion(PAO),gastric fluid pH values],gastrointestinal function[pepsinogen Ⅰ(PGⅠ),pepsinogen Ⅱ(PGⅡ),gastrin(GAS),motilin(MTL)]and adverse reactions of the two groups were compared.Results At 4 weeks after drug withdrawal following treatment,the total effective rate(39/40,97.50%)and eradication rate of Hp(35/40,87.50%)in combination group were higher than those in Western medicine group(32/40,80.00%;24/40,60.00%).The recurrence rate of the combination group(2/40,5.00%)was lower than that of the Western medicine group(8/40,20.00%)at 3-month follow-up after treatment(P＜0.05,P＜0.01).At 2 and 4 weeks after treatment,the scores of stomach pain,bloating,pain,excessive fasting pain,dizziness,fatigue and lazy speech,as well as BAO,MAO,PAO,PG Ⅰ,PG Ⅱ,GAS,and MTL,in both groups were lower than those before treat-ment,and lower in the combination group than in the Western medicine group.The Ph value of gastric fluid in the two groups was higher than that before treatment,and higher in combination group than in the Western medicine group(P＜0.01).The excellent and good rate of ulcer healing in the combination group after treatment was higher than that in the Western medicine group(P＜0.01).During treatment,there was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion The self-prepared Shiwuwei Jianpi Humo decoction plus anti-HP quadruple regimen has ob-vious effect and good safety in the treatment of chronic PU of spleen-stomach deficiency cold type,which can improve clinical symptoms of patients,inhibit gastric acid secretion,increase Hp eradication rate,promote ulcer repair and reduce recurrence rate,which may be related to the regulation of GAS and MTL expression.
基金项目
安徽省中央引导地方科技发展专项项目(2018080802D0080)
国家科技期刊平台
NSTL
万方数据