替普瑞酮联合复胃散治疗慢性萎缩性胃炎的疗效观察

Therapeutic effect of Teprenone combined with Fuweisan in treatment of patients with chronic atrophic gastritis

目的评价替普瑞酮联合复胃散治疗慢性萎缩性胃炎(CAG)的临床疗效。方法选取2013年1月-2016年10月南京中医药大学附属徐州市中医院门诊及住院接受治疗的H.pylori阴性的CAG患者180例。随机分为A组60例,复胃散1 200 mg/次,3次/d;B组60例,替普瑞酮50 mg/次,3次/d,C组60例,联合复胃散及替普瑞酮,3次/d,服药疗程为6个月。比较各组患者治疗前后的临床症状改善情况及胃黏膜组织病理学改善情况。组间比较采用χ_2检验。结果 A、B、C组临床症状方面的总有效率分别为46.7%(28/60)、41.7%(25/60)和70.0%(42/60),C组疗效与A组和B组比较,差异有统计学意义(P<0.016)。3组胃黏膜组织病理学(黏膜萎缩、肠上皮化生、异型增生)显效率及总有效率方面,C组高于A组和B组,差异有统计学意义(P<0.017)。结论替普瑞酮联合复胃散治疗CAG疗效显著,具有临床推广价值。

Objective To explore the efficacy of Teprenone and Fuweisan in the treatment of patients with chronic atrophic gastritis(CAG).Methods A random prospective and self-control clinical trial was carried out.A total of 180 H.pylori-negative patients with CAG in our hospital from January 2013 to October 2016 were selected and divided into a group A(60 cases treated with Fuweisan,1200 mg/time,three times a day),a group B(60 cases treated with Teprenone,50 mg/time,three times a day),and a group C(60 cases treated by Fuweisan and Teprenone with the same dosages and administration as group A and group B).The treatment course lasted for half a year.The improvement of clinical symptoms in each group was observed before and after treatment.The pathological improvement of gastric mucosa was inspected before and after treatment by marking targeting biopsy.The chi-square test was performed for the comparison between the groups.Results The total effective rates of clinical symptoms in the groups A,B and C were 46.7%(28/60),41.7%(25/60)and 70.0%(42/60)respectively;the curative effect of the group C was higher than that of the group A and the group B,the differences were statistically significant(P<0.017).The total effective rates and the significant effective rates on gastric mucosal pathological changes(including atrophy,intestinal metaplasia and dysplasia)in the group C were significantly higher than those of the group A and the group B,the differences were statistically significant(P<0.017).Conclusions Fuweisan and Teprenone combination can obviously improve the curative effect on CAG,and has good clinical application value.