慢萎散治疗胃阴不足证慢性萎缩性胃炎的临床分析

Clinical Analysis of Manwei San in Treating Stomach Yin Deficiency Syndrome of Chronic Atrophic Gastritis

目的:探讨慢萎散治疗慢性萎缩性胃炎(CAG)胃阴不足证的疗效以及对血清蛋白酶原Ⅰ(PGⅠ)和胃泌素(GS)水平的影响。方法:选择符合条件的病例110例,按数字表法随机分为观察组和对照组各55例;对照组口服维酶素片0.2 g,4片/次,3次/d;观察组在对照组治疗的基础上给予慢萎散治疗;将慢萎散中药粉碎成细粉,每次9 g,温开水冲服,3次/d;所有患者均连续治疗3个月。比较两组治疗前后中医(TCM)症状积分、胃黏膜组织病理评分和治疗后临床疗效;检测两组患者血清PGⅠ和GS水平。结果:观察组治疗后各中医症状评分均明显低于对照组(P<0.01);观察组总有效率为90.74%,对照组为75.93%,观察组优于对照组(P<0.05);观察组治疗后黏膜炎症、炎症活动度、腺体减少和肠上皮化生评分均明显低于对照组(P<0.01);治疗后观察组PGⅠ和GS水平均明显高于对照组,比较差异均有统计学意义(P<0.01)。结论:慢萎散治疗慢性萎缩性胃炎胃阴不足证可明显改善患者临床症状、体征和胃黏膜组织病理评分,提高临床治疗效果,其作用可能与升高血清PGⅠ和GS水平相关。

Objective： To investigate clinical efficacy of Manwei San in treating stomach Yin deficiency syndrome of chronic atrophic gastritis（ CAG） and its influence on serum levels of Proteinase Ⅰ（ PG Ⅰ） and gastrin（ GS）. Method： One hundred ten CAG cases were were randomly divided into observation group（ 55cases） and control group（ 55 cases） referring to random number table. Cases in control group received Vitacoenzyme tablets 0. 2 g（ 4 tablets / time,tid）. Patients in observation group was treated with Manwei san,and Chinese herbal medicines were smashed and orally took with water（ 9 g / time,tid）. Course of treatment was for 3months for all cases. Scores of symptoms of traditional Chinese medicine（ TCM） and pathology scores of gastric mucosa were compared between both groups pre-post treatment,and clinical efficacy was analysed after treatment.Serum levels of PGⅠand GS were detected in two groups before and after treatment. Result： Scores of TCM in observation group were obviously lower than those of control group（ P 〈0. 01）. The total efficacy of observation group was 90. 74%,and control group was 75. 93% with statistical difference between both groups（ P 〈0. 05）.After treatment,scores of inflammation of the mucosa,inflammation activity,reducing of gland,and intestinal metaplasia were remarkably lower than control group（ P 〈0. 01）. Compared to control group,serum levels of PGⅠand GS in observation group was obviously increased with statistical difference after treatment（ P 〈0. 01）.Conclusion： Manwei san could evidently improve clinical symptoms and signs, pathology scores of gastric mucosa,and clinical efficacy in treating stomach Yin deficiency syndrome of CAG,and its action may be related with elevating PGⅠand GS content in serum.