益气清热汤联合兰索拉唑肠溶胶囊治疗慢性糜烂性胃炎脾虚湿热证59例

Fifty-Nine Cases with Chronic Erosive Gastritis of Spleen Deficiency and Damp Heat Syndrome Treated with Qi-Benefiting and Heat-Clearing Decoction Combined with Lansoprazole Enteric Capsule

目的：观察益气清热汤联合兰索拉唑肠溶胶囊治疗慢性糜烂性胃炎脾虚湿热证的临床疗效。方法：将2013年5月—2014年8月就诊于本院的118例慢性糜烂性胃炎脾虚湿热证118例,随机分为对照组和观察组各59例。对照组给予兰索拉唑肠溶胶囊治疗,每次30 mg,日1次,观察组在对照组治疗的基础上加用益气清热汤治疗,日1剂,连续治疗15 d。治疗前后通过主要证候积分变化观察临床症状的改善情况,检测治疗前后血清炎性因子水平的变化情况。结果：两组患者治疗后症状改善,证候积分下降,观察组患者上腹部疼痛、腹胀、反酸、嗳气等主要症状的改善情况及证候积分的下降程度明显优于对照组,其临床治疗的有效率91.5%亦较对照组的有效率74.6%明显增高,差异具有统计学意义（χ^2=6.020,P=0.025〈0.05）;两组患者血清炎性因子水平降低,观察组患者CRP、TNF-α、IL-6水平降低程度与对照组相比更明显,差异具有统计学意义（P〈0.05）;观察组经胃镜检查显示的胃黏膜糜烂改善优于对照组患者,差异具有统计学意义（P〈0.05）;观察组不良反应发生率及复发率3.4%、5.1%均显著低于对照组的13.5%、18.6%,差异具有统计学意义（P〈0.05）。结论：益气清热汤联合兰索拉唑肠溶胶囊治疗慢性糜烂性胃炎脾虚湿热证疗效满意,其能有效缓解患者临床症状,修复胃黏膜,其机制可能与降低血清炎性因子水平有关。

Objective： To observe the clinical effects of Qi-Benefiting and Heat-Clearing Decoction combined with Lansoprazole Enteric Capsule on chronic erosive gastritis（ CEG） of spleen deficiency and damp heat syndrome. Methods： Totally 118 patients with CEG of spleen deficiency and damp heat syndrome hospitalized between May,2013 and August,2014 were randomized into control group and observation group,with 59 cases in each group. Control group were given Lansoprazole Enteric Capsule for the treatment,with 30 mg once on a daily basis while observation group were additionally given Qi-Benefiting and Heat-Clearing Decoction,one dose daily and for 15 d of continuous treatment. The improvement of the clinical symptoms was determined by the main symptom scores and the changes of the serum inflammatory level before and after the treatment were measured. Results： After the treatment,the symptoms in both groups got improved,the symptom scores declined. The improvements of the main symptoms including upper abdominal pain,abdominal distension,acid regurgitation and belching in observation group were markedly greater than these in control group,and the decline of the symptom scores in observation group were greatly greater than these in control group. The clinical effective rate was 74. 6% in control group and 91. 5% in observation group; the difference had statistical significance（ χ~2= 6. 020,P = 0. 025 〈 0. 05）. The decline of the levels of serum inflammatory factors,CRP,TNF-αand IL-6was bigger in observation group than these in control group,with statistical significance（ P 〈 0. 05）. The improvement of the gastric mucosa showed by gastroscopy in observation group was better than that in control group（ P 〈 0. 05）. The occurrence rate adverse reaction and the recurrence rate were 3. 4% and 5. 1% in observation group,significantly lower than these（ 13. 5%,18. 6% respectively） in control group; the difference was significant（ P 〈 0. 05）. Conclusion： Qi-Benefiting and Heat-Clearing Decoction combined with Lansoprazole Enteric Capsule has satisfactory effects on CEG of spleen deficiency and damp heat syndrome. It can effectively relieve the clinical symptoms and restore the gastric mucosa,and the mechanism may be related with the decline of the serum inflammatory factors.