健脾清胃汤治疗脾胃虚弱型慢性萎缩性胃炎疗效及对患者免疫功能的影响

Effect of Jianpi Qingwei decoction on chronic atrophic gastritis of spleen and stomach deficiency and its influence on patients’ immune function

目的:探讨健脾清胃汤治疗脾胃虚弱型慢性萎缩性胃炎(CAG)的疗效及对患者免疫功能影响。方法:选择完全随机数字表方式将符合脾胃虚弱型CAG诊断纳入标准的88例患者均分为两组。对照组采用三联抗菌法治疗,观察组则在对照组基础上服用健脾清胃汤。统计两组治疗前后胃黏膜中肠上皮化生、慢性炎症、腺体萎缩及胃脘隐痛、喜按喜暖、纳差、食后胀闷、乏力、大便溏稀等中医证候变化情况;测量两组治疗前后外周血中T淋巴细胞亚群CD4^+、CD8^+、CD3^+含量。对比两组临床效果。结果:与对照组比,观察组治疗前胃黏膜中肠上皮化生、腺体萎缩、慢性炎症程度分级情况改善效果更优(P<0.05);中医证候胃脘隐痛、喜按喜暖、纳差、食后胀闷、乏力、大便溏稀等主要中医症状评分下降更明显(P<0.05);病理组织及中医证候总体效果更好(P<0.05);外周血中CD4^+、CD3^+含量及CD4^+/CD8^+比值增大显著,CD8^+含量下降更显著(P<0.05)。结论:健脾清胃汤可有效改善脾胃虚弱型CAG患者中医证候,加速萎缩性胃黏膜逆转,这可能与其对患者免疫功能调节有关。

Objective:To explore the curative effect of Jianpi Qingpi decoction on chronic atrophic gastritis (CAG) of spleen and stomach and its effect on immune function.Methods: 88 patients who met the criteria for the diagnosis of spleen-stomach-deficiency CAG were divided into two groups by selecting a completely random number table. The control group was treated with triple antibacterial therapy,while the observation group was treated with Jianpi Qingwei decoction on the basis of the control group. The changes of TCM syndromes in gastric mucosa,intestinal epithelial biochemical,chronic inflammation,glandular atrophy and gastric cramps,hi-like warming,anorexia,post-feeding suffocation,fatigue,loose stools were counted before and after treatment. The contents of CD 4 ^+,CD 8 ^+ and CD 3 ^+ in peripheral blood of the two groups before and after treatment were measured. The clinical effects of the two groups was compared.Results: Compared with the control group,the improvement of the grade of intestinal epithelial biochemical,glandular atrophy and chronic inflammation in the gastric mucosa before treatment was better ( P <0.05);stomach cramps,hi,warm,anorexia,postprandial bloating,fatigue,loose stools and other major TCM symptom scores decreased more significantly ( P <0.05);the overall effect of pathological tissue and TCM syndromes was better ( P <0.05);the increase of CD 4 ^+,CD 3 ^+ content and CD 4 ^+/CD 8 ^+ in peripheral blood was more significant,and the decrease of CD 8 ^+ content was more significant ( P <0.05).Conclusion:Jianpi Qingwei decoction can effectively improve the TCM syndrome of patients with spleen and stomach weak CAG and accelerate the reversal of atrophic gastric mucosa,which may be related to the regulation of immune function in patients.