和胃方治疗慢性萎缩性胃炎脾胃虚弱证临床观察

Clinical Effect of Hewei Decoction in Treatment of Chronic Atrophic Gastritis with Deficiency of Spleen and Stomach

目的 观察和胃方对慢性萎缩性胃炎脾胃虚弱证的临床疗效。方法 将71例慢性萎缩性胃炎脾胃虚弱证患者分为治疗组35例和对照组36例,治疗组患者口服加减和胃方,对照组患者口服胃复春片,疗程均为3个月,治疗1个疗程后比较两组临床症状评分及其临床疗效、血清胃蛋白酶原(pepsinogen,PG)、血清胃蛋白酶原Ⅰ和Ⅱ比值(pepsinogen Ⅰ/Ⅱ ratio,PGR)、胃泌素17(gastrin17,G17)水平、胃黏膜组织形态学积分。结果 与治疗前比较,两组治疗后各临床症状评分及总评分均显著减少(P<0.05);两组患者治疗前后饱胀、纳差、疲乏、气短懒言、总积分差值比较,差异均有统计学意义(P<0.05)。两组患者临床疗效分布比较,差异有统计学意义(P<0.05)。与治疗前比较,两组治疗后血清PGⅠ、PGⅡ、G17水平改变均有统计学意义(P<0.05)。两组治疗前后PGⅠ、PGR差值比较,差异均有统计学意义( P <0.05)。两组治疗后胃黏膜组织形态学积分均较治疗前下降,差异有统计学意义(P<0.05);两组治疗前后胃黏膜组织形态学积分差值比较,差异无统计学意义(P>0.05)。结论 和胃方能有效缓解慢性萎缩性胃炎临床症状,明显改善病理及理化指标。

Objective To investigate the clinical effect of Hewei Decoction in the treatment of chronic atrophic gastritis with deficiency of spleen and stomach. Methods A total of 71 patients with chronic atrophic gastritis with deficiency of spleen and stomach were enrolled and randomly divided into treatment group with 35 patients and control group with 36 patients. The patients in the treatment group were given oral modified Hewei Decoction, and those in the control group were given oral Weifuchun Tablet. The course of treatment was 3 months for both groups. After one course of treatment, the two groups were compared in terms of clinical symptom score, clinical outcome, serum pepsinogens [pepsinogen Ⅰ(PGⅠ) and pepsinogen Ⅱ(PGⅡ)], serum pepsinogen Ⅰ/Ⅱ ratio (PGR), gastrin17 (G17) level, and histomorphological features of gastric mucosa. Results Both groups had significant reductions in the scores of all clinical symptoms and the total symptom score after treatment (P<0.05), and there were significant differences between the two groups in the changes in the scores of satiety, poor appetite, fatigue, and short breath and laziness to speak and the total symptom score after treatment (P<0.05). There was a significant difference in the distribution of clinical outcomes between the two groups (P<0.05). Both groups had significant changes in serum PGⅠ, PGⅡ, PGR, and G17 after treatment (P<0.05), and there were significant differences between the two groups in the changes in PGⅠ and PGR after treatment (P<0.05). Both groups had a significant reduction in the histomorphological score of gastric mucosa after treatment (P<0.05), and there was no significant difference in the reduction in this score between the two groups (P>0.05). Conclusion Hewei Decoction can effectively relieve the clinical symptoms of chronic atrophic gastritis and improve pathological and physicochemical indices.