香砂六君子汤联合丹参饮加减治疗Hp阳性慢性胃炎疗效观察

Clinical efficiency of Xiangsha Liujunzi decoction combined with modified Danshen decoction in the treatment of chronic gastritis patients with positive Helicobacter pylori infection

目的探讨香砂六君子汤联合丹参饮加减治疗幽门螺杆菌(Hp)感染阳性慢性胃炎患者的临床效果。方法将135例慢性胃炎患者随机分为观察组90例与对照组45例,对照组患者给予标准"克拉霉素片+阿莫西林+雷贝拉唑钠肠溶胶囊"三联疗法,观察组患者则在对照组基础上加用由香砂六君子汤联合丹参饮加减而成的汤剂内服。比较2组临床效果、Hp根除率、中医证候积分,监测治疗前后血清胃泌素17 (G17)、胃蛋白酶原(PG)、白细胞介素-17 (IL-17)、白细胞介素-32(IL-32)、表皮生长因子(EGF)、转化生长因子-β_1(TGF-β_1)水平变化。结果观察组有效率91. 11%,显著高于对照组的71. 11%(P <0. 05)。观察组Hp根除率76. 67%,显著高于对照组44. 44%(P <0. 05)。治疗后,观察组患者的胃脘隐痛、食后胀满、纳呆少食、神疲乏力等中医证候积分水平较对照组显著降低(P <0. 05)。2组患者血清G17、PGⅡ水平较治疗前显著降低,PGⅠ、PGⅠ/PGⅡ水平较治疗前均显著升高,且观察组患者上述指标变化更为显著(P <0. 05)。2组患者血清中IL-17、IL-32、EGF、TGF-β_1水平均较治疗前显著降低,且观察组下降更为显著(P <0. 05)。结论香砂六君子汤联合丹参饮加减有利于根除幽门杆菌,缓解临床症状,改善胃内消化酶分泌,减轻胃黏膜的炎性损伤。

Objective To investigate the clinical effect of Xiangsha Liujunzi decoction combined with modified Danshen decoction on the treatment of chronic gastritis patients with positive Helicobacter pylori （Hp） infection. Methods A total of 135 chronic gastritis patients were randomly divided into observation group （ n =90） and control group （ n =45）. Patients in the control group were given the standard trigeminal therapy of clarithromycin tablet plus amoxicillin plus rabeprazole sodium enteric-coated capsules, while patients in the observation group were given the internal medication of Xiangsha Liujunzi decoction combined with modified Danshen decoction on the basis of the control group. The clinical efficiency, the eradication rate of Hp, the scores of TCM syndrome were compared between two groups, and the levels of serum gastrin17 （G17）, pepsinogen （PG）, interleukin-17 （IL-17）, interleukin-32 （IL-32）, epidermal growth factor （EGF） and transforming growth factor-β 1 （TGF-β 1） were monitored before and after treatment. Results The effective rate of the observation group was 91.11%, which was significantly higher than 71.11% of the control group （ P 〈 0.05）. The eradication rate of Hp in the observation group was 76.67%, which was significantly higher than 44.44% in the control group （ P 〈0.05）. After treatment, the scores of TCM syndromes such as epigastric dull pain, postprandial fullness, lack of food, and mental fatigue in the observation group were significantly lower than those in the control group （ P 〈0.05）. The serum levels of G17 and PG Ⅱ significantly reduced after treatment in both groups, while the levels of PGⅠ and PGⅠ/PG Ⅱincreased significantly, and indexes above in the observation group were significantly better than those in the control group （ P 〈0.05）. The serum levels of IL-17, IL-32, EGF and TGF-β 1 significantly reduced in both group after treatment, and the indexes above in the observation group were significantly lower than the control group （ P 〈0.05）. Conclusion Xiangsha Liujunzi decoction combined with modified Danshen decoction is conducive to the eradication of Hp, which can alleviate clinical symptoms, improve gastric digestive enzyme secretion and alleviate inflammatory damage of gastric mucosa.