滋培汤治疗胃阴不足型慢性萎缩性胃炎临床研究

Clinical Study of Zipei Decoction for the Treatment of Chronic Atrophic Gastritis with Stomach Yin Deficiency Syndrome

【目的】研究滋培汤治疗胃阴不足型慢性萎缩性胃炎的临床疗效。【方法】将64例胃阴不足型慢性萎缩性胃炎患者随机分为治疗组和对照组,每组各32例。对照组给予艾司奥美拉唑肠溶胶囊和铝镁加混悬液口服的西医常规治疗,治疗组在对照组的基础上给予滋培汤口服治疗,疗程为2个月。观察2组患者治疗前后中医证候评分、可操作的与胃癌风险联系的胃炎评估(OLGA)分期评分及血清胃蛋白酶原(PG)Ⅰ、PGⅡ及PGⅠ/PGⅡ比值(PGR)的变化情况,并评价2组患者的临床疗效。【结果】(1)疗效方面:治疗2个月后,治疗组的总有效率为93.75%(30/32),对照组为71.88%(23/32),组间比较,治疗组的疗效明显优于对照组(P<0.05)。(2)中医证候评分方面:治疗后,治疗组的胃脘灼痛、饥不欲食、口干、大便干结评分均较治疗前明显改善(P<0.01),而对照组仅胃脘灼痛、饥不欲食评分较治疗前明显改善(P<0.05或P<0.01);组间比较,治疗组对各项证候评分的改善作用均明显优于对照组(P<0.05或P<0.01)。(3)检测指标方面:治疗后,除对照组的PGⅡ外,2组患者的血清PGⅠ、PGⅡ及PGR水平均较治疗前明显改善(P<0.01),且治疗组对血清PGⅠ、PGⅡ及PGR水平的改善作用均明显优于对照组(P<0.01)。(4)OLGA分期评分方面:治疗后,2组患者的OLGA分期评分均较治疗前明显下降(P<0.05或P<0.01),且治疗组对OLGA分期评分的下降作用明显优于对照组(P<0.01)。【结论】在西医常规治疗的基础上联合滋培汤治疗胃阴不足型慢性萎缩性胃炎疗效确切,能有效缓解患者临床症状,延缓甚至逆转慢性萎缩性胃炎的进程。

Objective To observe the clinical efficacy of Zipei Decoction(a herbal compound prescription with the actions of nourishing yin)in treating chronic atrophic gastritis(CAG)with stomach yin deficiency syndrome.Methods A total of 64 CAG patients with stomach yin deficiency syndrome were randomly divided into treatment group and control group,with 32 cases in each group.The control group was given western medicine conventional treatment with esomeprazole enteric-soluble capsules and almagate suspension orally,the treatment group was given oral use of Zipei Decoction together with western medicine conventional treatment,and the course of treatment lasted for 2 months.The changes of traditional Chinese medicine(TCM)syndrome scores,operative link on gastritis assessment(OLGA)staging scores,and serum pepsinogenⅠ(PGⅠ)and pepsinogenⅡ(PGⅡ)levels as well as PGⅠ/PGⅡratio(PGR)in the two groups were observed before and after treatment.After treatment,the clinical efficacy of the two groups was also evaluated.Results(1)Therapeutic effect:after 2 months of treatment,the total effective rate of the treatment group was 93.75%(30/32),and that of the control group was 71.88%(23/32).The intergroup comparison showed that the curative effect of the treatment group was significantly superior to that of the control group(P<0.05).(2)TCM syndrome scores:after treatment,the scores of epigastric burning pain,hunger while unwilling to eat,dry mouth and dry stool in the treatment group were significantly improved compared with those before treatment(P<0.01),while in the control group only the scores of epigastric burning pain and hunger while unwilling to eat were significantly improved(P<0.05 or P<0.01).The intergroup comparison showed that the improvement of TCM syndrome scores in the treatment group was significantly superior to that in the control group(P<0.05 or P<0.01).(3)Laboratory indicators:after treatment,except for the PGⅡin the control group,the levels of serum PGⅠ,PGⅡand PGR in the two groups were significantly improved compared with those before treatment(P<0.01),and the effect on improving the levels of serum PGⅠ,PGⅡand PGR in the treatment group was significantly superior to that in the control group(P<0.01).(4)OLGA staging scores:after treatment,OLGA staging scores in both groups were significantly lower than those before treatment(P<0.05 or P<0.01),and the effect on lowering OLGA staging scores of the treatment group was significantly superior to that of the control group(P<0.01).Conclusion The combination of Zipei Decoction combined with conventional western medicine treatment for CAG with stomach yin deficiency syndrome is effective on relieving the clinical symptoms of patients and slowing down or even reversing the process of CAG.