摘要
目的:观察香砂六君子合失笑散加减治疗消化性溃疡(PU)脾虚肝郁证对中医证候积分及复发的影响.方法:选择我院2020年1月～2022年2月期间收治的95例PU患者,按照随机数表法分为对照组48例(奥美拉唑+瑞巴派特)和治疗组47例(对照组基础上采用香砂六君子合失笑散加减治疗),比较两组临床疗效、中医证候积分、胃分泌功能、肠屏障功能、生长因子不良反应及复发情况.结果:治疗组治疗有效率高于对照组(97.87％vs.83.33％)(P＜0.05).治疗后两组患者中医证候积分降低,治疗组胃脘隐痛、得食痛减、胸胁胀痛、胃纳呆滞、四肢倦怠、畏寒肢冷的中医证候积分低于对照组(P＜0.05).治疗后两组患者胃分泌功能[胃泌素(GAS)、胃蛋白酶原(PG)-Ⅰ、PG-Ⅱ]、肠屏障功能[二胺氧化酶(DAO)、D-乳酸、内毒素(ET)]、生长因子[表皮生长因子(EGF)、血管内皮生长因子(VEGF)、转化生长因子-α(TGF-α)]得到显著改善,治疗组改善幅度更大(P＜0.05).治疗组1年内复发率低于对照组(4.26％vs.18.75％)(P＜0.05).结论:香砂六君子合失笑散加减治疗PU脾虚肝郁证疗效显著,可有效改善临床症状、胃分泌功能、肠屏障功能及生长因子,并降低复发率.
Abstract
Objective:To observe the effect of modified Xiangsha Liujunzi and Shixiao San on TCM syndrome scores and re-currence in patients with peptic ulcer(PU)and spleen deficiency and liver stagnation syndrome.Methods:A total of 95patients with PU admitted to the hospital from January 2020to February 2022were selected and divided into th control group(48patients treated with omeprazole and rebamiprate)and the treatment group(47patients treated with modified Xiangsha Liujunzi and Shixi-ao San based on the treatment of control group).Clinical effects,TCM syndrome scores,gastric secretion function,intestinal bar-rier function,growth factors,adverse reactions and recurrence were compared between the two groups.Results:The treatment re-sponse rate in the treatment group was higher than that in the control group(97.87％vs.83.33％)(P＜0.05).After treatment,TCM syndrome scores of the two groups decreased.The scores for dull stomachache,pain relief during eating,swelling pain in chest and hypochondrium,poor appetite,limb burnout,intolerance of cold and cold limbs in the treatment group were lower than those in the control group(P＜0.05).After treatment,gastric secretion function[gastrin(GAS),pepsinogen(PG)-Ⅰ and PG-Ⅱ],intestinal barrier function[diamine oxidase(DAO),D-lactic acid and endotoxin(ET)]and growth factors[epider-mal growth factor(EGF),vascular endothelial growth factor(VEGF)and transforming growth factor-α(TGF-α)]in the two groups were significantly improved,with greater improvement in the treatment group(P＜0.05).The 1-year recurrence rate in the treatment group was lower than that in the control group(4.26％vs.18.75％)(P＜0.05).Conclusion:Modified Xiangsha Liujunzi and Shixiao San is effective in the treatment of PU with spleen deficiency and liver depression syndrome,which can ef-fectively improve clinical symptoms,gastric secretion function,intestinal barrier function and growth factors,and reduce the re-currence rate.
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