疏肝和胃汤治疗老年慢性萎缩性胃炎伴Hp阳性

Clinical Study of Shugan Hewei Decoction in Treating for Senile Chronic Atrophic Gastritis with Hp Positive

目的:探讨疏肝和胃汤治疗老年慢性萎缩性胃炎伴幽门螺杆菌(helicobacterpylori,Hp)阳性的临床疗效及对患者炎症因子、氧化应激指标的影响。方法:将慢性萎缩性胃炎伴Hp阳性的老年患者78例随机分为两组。对照组39例,予临床常规治疗;试验组39例,在对照组的基础上联合疏肝和胃汤治疗。观察两组患者治疗前后炎症因子、氧化应激指标、中医证候评分变化及临床疗效。结果:与治疗前比较,治疗后两组患者的血清C-反应蛋白(C-reactionprotein,CRP)、白细胞介素-6(Interleukelin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平降低,血清一氧化氮(nitric oxide,NO)、超氧化物歧化酶(superoxide orgotein dismutase,SOD)水平升高,丙二醛(malondialdehyde,MDA)水平降低,胃部刺痛、倦怠乏力、胃脘胀满及食少纳呆症状评分降低。与对照组比较,试验组患者治疗后血清CRP、IL-6及TNF-α水平低于对照组,血清NO、SOD水平高于对照组,血清MDA水平低于对照组,胃部刺痛、倦怠乏力、胃脘胀满及食少纳呆症状评分低于对照组。试验组有效率94.87%明显高于对照组(76.92%),差异均有统计学意义(P<0.05)。结论:疏肝和胃汤能够有效减轻老年慢性萎缩性胃炎患者的炎症反应、氧化应激水平,改善症状,且临床疗效较好。

Objective:To investigate the clinical efficacy of Shugan Hewei Decoction in treatment of elderly patients with chronic atrophic gastritis with Helicobacter pylori(Hp) and its effects on inflammatory factors and oxidative stress.Methods:78 elderly patients with chronic atrophic gastritis and Hp positive were randomly divided into two groups.39 patients in the control group were treated with routine clinical treatment;39 patients in the experimental group were treated with Shugan Hewei Decoction on the basis of the control group.The inflammatory factors,oxidative stress index,TCM syndrome score changes and clinical efficacy were observed before and after treatment.Results:Compared with before treatment,serum C-reactive protein(CRP),interleukinlin-6(IL-6) and tumor necrosis factor-α(TNF-α) were measured in the two groups after treatment.The level of TNF-α decreased,while serum nitric oxide(NO) and superoxide orgotein dismutase(SOD) levels increased,malondialdehyde(MDA) levels decreased.Besides,stomach stinging,fatigue,stomach cramps,and low-dose symptoms were reduced.Compared with that of the control group,the serum CRP,IL-6 and TNF-α levels in the experimental group were lower than those in the control group,serum NO and SOD levels were higher than the control group.The serum MDA levels were lower than the control group,and the stomach was stinging and burning.The scores of fatigue,stomach cramps and food intake were lower than those of the control group.The effective rate of the experimental group was 94.87%,which was significantly higher than that of the control group(76.92%).The difference was statistically significant(P<0.05).Conclusion:Western medicine combined application of Shugan Hewei Decoction can effectively alleviate the inflammatory reaction and oxidative stress level in elderly patients with chronic atrophic gastritis,improve the symptoms,and the clinical effect is significantly better.