双金胃肠胶囊联合枸橼酸铋钾治疗十二指肠溃疡的临床研究

Clinical study on Shuangjin Weichang Capsules combined with bismuth potassium citrate in treatment of duodenal ulcer

目的探讨双金胃肠胶囊联合枸橼酸铋钾治疗十二指肠溃疡的临床疗效。方法选取2017年10月-2018年10月在郑州大学附属洛阳中心医院进行治疗的84例十二指肠溃疡,根据用药方案的不同分为对照组(42例)和治疗组(42例)。对照组口服枸橼酸铋钾颗粒,2.0 g/次,2次/d。治疗组在对照组基础上口服双金胃肠胶囊,2.0 g/次,3次/d。两组均连续治疗4周。观察两组的临床疗效,比较两组治疗前后症状积分、血清学指标、胃肠激素水平的变化情况。结果治疗后,对照组和治疗组的总有效率分别是80.95%、97.62%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组溃疡痛评分、腹胀评分、反酸嗳气评分均较治疗前显著降低,同组治疗前后比较差异有统计学意义(P<0.05);治疗后,治疗组症候积分显著低于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,两组血清白介素1β(IL-1β)、白细胞介素-17(IL-17)、白细胞介素-23(IL-23)、肿瘤坏死因子-α(TNF-α)、基质金属蛋白酶9(MMP-9)水平均较治疗前显著降低,而白细胞介素-10(IL-10)、前列腺素E2(PGE2)水平均明显增高,同组治疗前后比较差异有统计学意义(P<0.05);治疗后,治疗组IL-1β、IL-17、IL-23、TNF-α、MMP-9水平低于对照组,而IL-10、PGE2水平高于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血清胃泌素(GAS)水平较治疗前明显降低,而降钙素基因相关肽(CGRP)、生长抑素(SS)水平都明显增高,同组治疗前后比较差异有统计学意义(P<0.05);治疗后,治疗组GAS水平低于对照组,而CGRP、SS水平高于对照组,两组比较差异具有统计学意义(P<0.05)。结论双金胃肠胶囊联合枸橼酸铋钾治疗十二指肠溃疡具有较好的临床疗效,可有效改善患者临床症状,改善机体炎症因子水平和胃肠激素水平,具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of Shuangjin Weichang Capsules combined with bismuth potassium citrate in treatment of duodenal ulcer. Methods Patients(84 cases) with duodenal ulcer in Luoyang Central Hospital Affiliated to Zhengzhou University from October 2017 to October 2018 were divided into control group(42 cases) and treatment group(42 cases) according to different drug regimens. Patients in the control group were po administered with Bismuth Potassium Citrate Granules, 2.0 g/time,twice daily. Patients in the treatment group were po administered with Shuangjin Weichang Capsules on the basis of the control group,2.0 g/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the changes of symptom scores, serological indexes, and gastrointestinal hormone levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 80.95% and 97.62%,respectively, and there were differences between two groups(P < 0.05). After treatment, ulcer pain score, abdominal distension score,and acid belching score in two groups were significantly decreased, and there were differences in the same group(P < 0.05). After treatment, these symptoms score in the treatment group were lower than those in the control group, and there were differences between two groups(P < 0.05). After treatment, IL-1β, IL-17, IL-23, TNF-α, and MMP-9 in two groups were significantly decreased, but IL-10 and PGE2 were significantly increased, and there were differences in the same group(P < 0.05). After treatment, IL-1β, IL-17, IL-23,TNF-α, and MMP-9 in the treatment group were lower than those in the control group, but IL-10 and PGE2 were higher than those in the control group, and there were differences between two groups(P < 0.05). After treatment, GAS in two groups were significantly decreased, but CGRP and SS were significantly increased, and there were differences in the same group(P < 0.05). After treatment, GAS in the treatment group were lower than those in the control group, but CGRP and SS were higher than those in the control group, and there were differences between two groups(P < 0.05). Conclusion Shuangjin Weichang Capsules combined with bismuth potassium citrate has significant effect in treatment of duodenal ulcer, and can effectively improve the clinical symptoms of patients, and improve the level of inflammatory cytokines and gastrointestinal hormones in the body, which has a certain clinical application value.