石斛养胃汤联合胶体果胶铋干混悬剂及阿莫西林对慢性萎缩性胃炎胃功能及血清炎性因子影响研究

Effect of Shihu Yangwei Decoction Combined with Collidal Bismuth Pectin for Suspension and Amoxicillin on Gastric Function and Serum Inflammatory Factors in Patients with Chronic Atrophic Gastritis

目的:探究石斛养胃汤联合胶体果胶铋干混悬剂及阿莫西林对慢性萎缩性胃炎患者胃功能及血清炎性因子影响,为临床治疗慢性萎缩性胃炎提供指导依据。方法:选取100例慢性萎缩性胃炎患者进行分组研究,以随机数字表法分成两组,分别为观察组(50例)及对照组(50例),给予对照组患者胶体果胶铋干混悬剂及阿莫西林治疗,观察组患者在对照组患者治疗基础上联合石斛养胃汤治疗,比较两组患者临床治疗效果、治疗前后患者症状积分(消瘦积分、食欲不振积分、腹痛积分、贫血积分)及患者治疗前后血清炎性因子水平变化情况、血清胃泌素-17(G-17)、胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶Ⅱ(PGⅡ)水平、患者氧化应激水平指标变化情况、不良反应发生率、治疗前后患者生存质量评分(SF-36量表评分)以及患者对临床治疗满意度。结果:对照组有效率(84.00%)低于观察组(96.00%),P<0.05;治疗前,两组患者消瘦积分、食欲不振积分、腹痛积分、贫血积分相当,P>0.05,治疗后各组患者消瘦积分、食欲不振积分、腹痛积分、贫血积分均改善,观察组治疗后消瘦积分、食欲不振积分、腹痛积分、贫血积分优于对照组,P<0.05;治疗前,两组患者C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)等血清炎症因子水平相当,P>0.05,治疗后各组患者CRP及IL-6、TNF-α水平下降,观察组各项指标均低于对照组,P<0.01;治疗前两组患者G-17、PGⅠ、PGⅡ水平相当,P>0.05,治疗后各组患者水平均改善,观察组改善优于对照组,P<0.05;治疗前,两组患者超氧化物歧化酶(SOD)、一氧化氮(ON)、丙二醛(MDA)等氧化应激反应指标水平及患者SF-36评分均相当,P>0.05,治疗后各组患者SOD、ON、MDA水平、SF-36评分均改善,观察组治疗后SOD、ON、MDA水平、SF-36评分优于对照组,P<0.05;观察组不良反应率同对照组(4.00%),两组比较,P>0.05;观察组治疗满意率(98.00%)高于对照组(84.00%),P<0.05。结论:石斛养胃汤联合胶体果胶铋干混悬剂及阿莫西林治疗慢性萎缩性胃炎临床疗效显著,患者症状改善,血清炎性因子及氧化应激水平、胃泌素等指标水平均明显改善,不良反应率低,安全性高,值得推广及应用。

Objective:To explore the effects of Shihu Yangwei Decoction combined with Collidal Bismuth Pectin for Suspension and amoxicillinon gastric function and serum inflammatory factors in patients with chronic atrophic gastritis, providing the guidance for clinical treatment of chronic atrophic gastritis. Methods:100 cases of patients with chronic atrophic gastritis group, with random number table method,were divided into the observation group(50 cases) and control group(50 cases). The control group patients were treated with Collidal Bismuth Pectin for Suspension and amoxicillin. The observation group added Shihu Yangwei Decoction. We compared two groups’ clinical treatment, before and after treatment symptoms integral(angular points, loss of appetite, abdominal pain, anemia, integral), the change of serum levels of inflammatory cytokines, serum levels of gastric secrete element-17(G-17), pepsinogen Ⅰ(PG Ⅰ), pepsin Ⅱ(PG Ⅱ), oxidative stress levels, the incidence of adverse reactions, the patient quality of life scores before and after treatment(SF-36 scale score)and patients’ satisfaction. Results:The effective rate of the control group(84.00%) was lower than that of the observation group(96.00%)(P<0.05). Before treatment, two groups’ loss of appetite, abdominal pain and anemiaintegral had no sinificance(P>0.05). After treatment, loss of appetite, abdominal pain and anemia integral of the two groups were improved.The observation group’s loss of appetite, abdominal pain and anemiaintegral after treatment were better than those of the control group(P<0.05). Before treatment, the levels of serum inflammatory factors such as c-reactive protein(CRP), interleukin-6(IL-6), tumor necrosis factor-alpha(TNF-α) were similar in the two groups(P>0.05). After treatment, the levels of CRP, IL-6 and TNF-α decreased in each group. G-17,PG Ⅰ and PG Ⅱ levels in both groups before treatment had no difference(P>0.05). The levelswere improved after treatment and the observation group’s improved better than those of the control group(P<0.05). Beforetreatment, two groups’ superoxide dismutase(SOD), nitric oxide(NO), malondialdehyde(MDA) and oxidative stress index level and SF-36 scores had no difference(P>0.05).After treatment, SOD,NO and MDA levels and SF-36 score were improved, and those in the observation group after treatment were better than those of the control group(P<0.05). The adverse reaction rate of the observation group was similar to that of the control group(4.00%). The treatment satisfaction rate of the observation group(98.00%) was higher than that of the control group(84.00%)(P<0.05). Conclusion:The clinical efficacy of Shihu Yangwei Decoction combined with Collidal Bismuth Pectin for Suspension and amoxicillin in the treatment of chronic atrophic gastritis was remarkable. The symptoms of the patients were improved and the serum inflammatory factors, oxidative stress level, gastrin and other indicators were significantly improved. The adverse reaction rate was low. The safety was high, and it was worthy of promotion and application.