中医健脾疗法对消化性溃疡愈合质量及血清正表皮生长因子的影响

Effects of spleen strengthening therapy on healing quality of peptic ulcer and on serum EGF

[目的]探讨健脾疗法对消化性溃疡愈合质量及血清正表皮生长因子(EGF)的影响。[方法]将90例患者随机分为西药组、中药1组、中药2组,每组30例。经治疗后评估临床疗效、内镜下再生黏膜成熟度、再生黏膜组织学成熟度及血清EGF含量,以判定溃疡愈合质量。[结果]3组均能改善消化性溃疡患者症状及体征,3组临床治愈率分别为76.7%、73.3%、86.7%,差异无统计学意义(P>0.05);中药2组溃疡愈合Sc期为20例(66.7%),再生黏膜组织优级为17例(56.7%),均明显高于其他2组(P<0.05);治疗后3组血清EGF含量增高,中药2组血清EGF含量为(0.84+0.17)ng/ml,与其他2组比较差异有统计学意义(P<0.05)。1年后随访复发率,中药2组的复发率明显低于其他2组,差异有统计学意义(P<0.05)。[结论]健脾益气、祛瘀生肌为法的健脾疗法能提高溃疡愈合质量,降低复发率,其作用机理可能与提高血清EGF含量有关。

[Objective]To investigate the influence of spleen strengthening therapy on the healing quality of peptic ulcer and on the content of serum EGF.[Methods]Ninety cases were randomly divided into western medicine group,herbs No.1group and herbs No.2group.After treatment,the clinical efficacy,maturity of endoscopic regenerated mucosa,histological maturity of regenerated mucosa and serum EGF levels were evaluated to determine the quality of ulcer healing.[Results]The symptoms and signs of peptic ulcer patients in all 3groups were improved.The clinical cure rates of 3groups were 76.7%,73.3%and 86.7%respectively,but there was no obvious difference（P〉0.05）.The number of ulcer healing Sc period in herbs No.2group was 20cases（66.7%）,and the top-grade mucosal tissue regenerations was 17cases（56.7%）.Both of them were significantly higher than the other two groups（P 〈0.05）.After treatment,the serum levels of EGF in all 3groups were increased,with 0.84＋0.17ng/ml in herbs No.2group,which was significantly different with other two groups（P〈0.05）.After 1year of follow-up,the recurrence rate in herbs No.2group was significantly lower than other two groups,with significant difference（P〈0.05）.[Conclusion]Based on strengthening the spleen,replenishing Qi and removing blood stasis to promote muscle regeneration,the spleen strengthening therapy can efficiently improve the quality of ulcer healing and reduce the recurrence rate.It can probably be attributed to the increase of the serum EGF level.