加味生胃方联合铝碳酸镁治疗慢性萎缩性胃炎临床观察

Clinical Observation on Modified Shengwei Prescription Combined with Hydrotalcite for Chronic Atrophic Gastritis

目的:观察加味生胃方联合铝碳酸镁咀嚼片治疗慢性萎缩性胃炎(CAG)的临床疗效。方法:选取136例CAG患者为研究对象,按照随机数字表法分为对照组和观察组,每组68例。对照组给予铝碳酸镁咀嚼片治疗,观察组在此基础上联合加味生胃方治疗,2组均连续治疗8周。对比2组临床疗效,观察治疗前后白细胞介素(IL)-6、肿瘤坏死因子(TNF)-α、IL-10、胃蛋白酶原(PG)Ⅰ、PGⅡ、PGⅠ/PGⅡ值及焦虑自评量表(SAS)和抑郁自评量表(SDS)评分的变化。结果:观察组总有效率91.18%,高于对照组的73.53%(P <0.05)。2组治疗后血清TNF-α、IL-6水平均较治疗前降低(P <0.05),观察组2项指标水平下降更明显(P <0.05);观察组治疗后血清IL-10水平较治疗前升高(P <0.05),对照组治疗前后血清IL-10水平无明显变化(P> 0.05)。2组治疗后血清PGⅠ水平及PGⅠ/PGⅡ值均较治疗前升高(P <0.05),观察组2项指标均升高更明显(P <0.05);观察组治疗后血清PGⅡ水平较治疗前降低(P <0.05),对照组治疗前后血清PGⅡ水平无明显变化(P> 0.05)。2组治疗后SAS、SDS评分均较治疗前降低(P <0.05),观察组SAS、SDS评分均比对照组下降更明显(P <0.05)。结论:加味生胃方联合铝碳酸镁咀嚼片治疗CAG疗效显著,能有效缓解患者的焦虑、抑郁情绪,其作用机制与调节促炎、抗炎因子平衡及PG亚群密切相关。

Objective： To observe the clinical effect of modified Shengwei prescription combined with hydrotalcite for chronic atrophic gastritis（CAG）. Methods： Selected 136 cases of patients with CAG as study subjects and divided them into the control group and the observation group according to random number table method,68 cases in each group. The control group received hydrotalcite chewable tablets for treatment,while the observation group additionally received modified Shengwei prescription based on the treatment of the control group. The two groups were all treated for eight weeks continuously. Compared the clinical effect,and observed changes of levels of interleukins-6（IL-6）,tumor necrosis factor-α（TNF-α）,interleukins-10（IL-10）,pepsinogen Ⅰ（PG Ⅰ）,pepsinogen Ⅱ（PG Ⅱ）and PG Ⅰ/PG Ⅱ as well as scores of self-rating anxiety scale（SAS） and self-rating depression scale（SDS） before and after treatment.Results：The total effective rate was 91.18% in the observation group,higher than that of 73.53% in the control group（P〈0.05）. After treatment,levels of TNF-α and IL-6 in serum in the two groups were decreased when compared with those before treatment（P〈0.05）,and the decrease in the observation group was more obvious than that in the control group（P〈0.05）. After treatment,the level of IL-10 in serum in the observation group was increased when compared with that before treatment（P〈0.05）, while no obvious change was found in the level of IL-10 in serum in the control group before and after treatment（P〈0.05）. After treatment,the level of PGI in serum and the value of PGI/PGⅡ in the two groups were increased when compared with those before treatment（P〈0.05）,and the increase in the observation group was more obvious than that in the control group（P〈0.05）. After treatment, the level of PGII in serum in the observation group was decreased when compared with that before treatment（P〈0.05）,while no obvious change was found in the level of PG II in serum in the control group before and after treatment（P〈0.05）. After treatment,scores of SAS and SDS in the two groups were decreased when compared with those before treatment（P〈0.05）,and the decrease in the observation group was more obvious than that in the control group（P〈0.05）. Conclusion： The therapy of modified Shengwei prescription combined with hydrotalcite chewable tablets for CAG has significant effect, which can relieve anxiety and depression of patients. Its mechanism is closely related to the regulation of the pro-and anti-inflammatory balance and PG subsets.