加味黄芪建中汤治疗慢性萎缩性胃炎伴肠上皮化生

Jiawei Huangqi Jianzhong Decoction for Chronic Atrophic Gastritis with Intestinal Metaplasia

目的:观察加味黄芪建中汤对慢性萎缩性胃炎(chronic atrophic gastritis,CAG)伴肠上皮化生(intestinal metaplasia,IM)患者的临床疗效及对细胞因子的影响。方法:186例CAG伴肠上皮化生患者按照随机数字表法分为治疗组和对照组各93例。对照组给予胃复春片,治疗组给予加味黄芪建中汤。比较两组患者临床疗效、肠上皮化生程度改善情况及治疗前后血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-23(interleukin-23,IL-23)、胃蛋白酶原Ⅰ(pepsinogenI,PGI)及PGⅠ/PGⅡ(PGR)的水平。结果:治疗后,治疗组和对照组有效率分别为92. 47%、77. 42%,两组比较,差异有统计学意义(P <0. 05)。治疗后,治疗组肠上皮化生改善程度优于对照组(P <0. 05)。治疗组患者TNF-α、IL-23、PGⅠ及PGR水平改善程度优于对照组(P <0. 05),差异均有统计学意义(P <0. 05)。结论:加味黄芪建中汤可以有效改善CAG伴肠上皮化生患者的临床症状、减轻肠上皮化生程度甚至逆转肠上皮化生,临床疗效显著。

Objective: To observe the clinical effect of Jiawei Huangqi Jianzhong Decoction for chronic atrophic gastritis( CAG)with intestinal metaplasia( IM) and its effect on cytokines. Methods: 186 CAG patients with intestinal metaplasia were randomly divided into treatment group and control group with 93 cases each. The control group was given Weifuchun Tablet and the treatment group was given Jiawei Huangqi Jianzhong Decoction. The clinical efficacy,improvement of intestinal metaplasia and serum levels of tumor necrosis factor-α( TNF-α),interleukin-23( IL-23),pepsinogen I( PGI) and PGI/PGII( PGR) were compared between the two groups before and after treatment. Results: After treatment,the effective rates of treatment group and control group were 92. 47% and 77. 42%,respectively. There was significant difference between the two groups( P < 0. 05). After treatment,the improvement of intestinal metaplasia in the treatment group was better than that in the control group( P < 0. 05). The levels of TNF-α,IL-23,PGI and PGR in the treatment group were better than those in the control group( P < 0. 05),and the differences were statistically significant( P < 0. 05). Conclusion: Jiawei Huangqi Jianzhong Decoction can effectively improve the clinical symptoms of CAG patients with intestinal metaplasia,alleviate the degree of intestinal metaplasia and even reverse intestinal metaplasia.