越鞠丸加减联合硫糖铝治疗慢性萎缩性胃炎疗效观察

Clinical Efficacy Observation on Modified Yueju Pills Combined with Sucralfate in Treating for Chronic Atrophic Gastritis with 60 Cases

目的:观察越鞠丸加减联合硫糖铝治疗慢性萎缩性胃炎肝胃气滞证的临床疗效,以及对血清中白细胞介素-12(interleukin-12,IL-12)和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平的影响。方法:将120例慢性萎缩性胃炎肝胃气滞证患者按数字表法随机分为治疗组和对照组,每组60例。对照组口服吗丁啉片治疗,每次10 mg,每天3次;兰索拉唑片,每次30 mg,每天1次,对幽门螺杆菌阳性患者加用标准4联根除方案治疗。治疗组口服硫糖铝口服混悬液,每次2~5 m L,每天3次;越鞠丸加减治疗,每天1剂。两组患者均连续治疗3个月。比较两组患者肝胃气滞证症状、胃黏膜组织病理评分和临床疗效,检测两组患者血清中IL-12和TNF-α水平。结果:治疗后,治疗组患者症状评分、炎症活动度、黏膜炎症、腺体减少以及肠上皮化生评分均明显低于对照组,差异均有统计学意义(P<0.01)。治疗组患者有效率为91.67%,显著高于对照组的76.67%,差异有统计学意义(P<0.05)。治疗组治疗后血清中IL-12和TNF-α水平显著高于对照组,差异有统计学意义(P<0.01)。结论:越鞠丸加减联合硫糖铝治疗慢性萎缩性胃炎肝胃气滞证疗效显著,且能调血清中IL-12和TNF-α水平,减轻炎症反应,能有助于改善病情。

Objective：To observe the clinical efficacy of Yueju Pills combined with Sucralfate in treatment of chronic atrophic gastri- tis with Liver and Stomach Qi stagnation Syndrome, and its effect on serum IL-12 and tumor necrosis factor-co （TNF-α） level. Methods ： 120 patients with chronic atrophic gastritis with Liver Qi stagnation Syndrome were randomly divided into treatment group and control group, with 60 cases in each group. The control group was treated with oral Dinglin tablets, 10 mg each time,3 times a day;lansoprazole tablets,30 mg each time, once a day,and HP positive patients were treated with standard 4 eradication protocol. Sucralfate group was given oral suspension of Sucralfate i,2 -5 mL each time, 3 times a day and modified Yueju pills in treatment, with 1 dose per day and twice being boiled. Both groups of patients were treated continuously for 3 months. The symptoms of Liver Qi stagnation syndrome, gastric mucosal histopathological score and clinical efficacy of the two groups were compared. Serum IL-12 and TNF-ot levels were measured in both groups. Results：After treatment,the symptoms of Liver Qi stagnation Syndrome,inflam- matory activity, mucosal inflammation, glandular reduction and intestinal metaplasia scores in the treatment group were significantly relieved than those in the control group （ P 〈 0.01 ）. The effective rate of the treatment group was 91.67 %, which was significantly higher than that （76.67%） of the control group （P 〈0.05）. The levels of serum IL-12 and TNF-α in the treatment group were significantly higher than those in the control group （P〈0.01 ）. Conclusion： Modified Yueju Pills combined with Sucralfate in treatment of chronic atrophic gastritis with Liver and Stomach Qi stagnation Syndrome is effective, by down-regulating the levels of IL-12 and TNF-α in serum and reducing the in^lammation and eventually improving the physical condition of patients.