四逆散合越鞠丸加减配合西药四联疗法治疗肝气犯胃型胆汁反流性胃炎的疗效及对患者内环境的影响

Therapeutic effect of Sini Powder and Yueju Pills combined with western medicine quadruple therapy on Liver Qi invading stomach-type bile reflux gastritis and its influence on patients’ internal environment

目的探讨四逆散合越鞠丸加减配合西药四联疗法治疗肝气犯胃型胆汁反流性胃炎的疗效及对患者内环境的影响。方法选取2017年1月至2018年8月间陕西省第四人民医院消化内科收治的122例肝气犯胃型胆汁反流性胃炎患者作为研究对象,按随机数表法分为对照组和观察组,每组61例,对照组患者给予西医四联疗法治疗,观察组患者在对照组患者基础上给予四逆散合越鞠丸加减中药治疗,4周一个疗程,共治疗一个疗程。比较两组患者的临床疗效以及治疗前后的内环境指标、中医证候评分等指标的变化情况。结果观察组患者的临床治疗总有效率为96.72%,明显优于对照组的86.89%,差异具有统计学意义(P<0.05)。治疗前,两组患者的胃泌素(GAS)、胃动素(MTL)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)水平比较差异均无统计学意义(P>0.05);治疗后,两组患者的GAS、IL-8、TNF-α水平均明显低于治疗前,而MTL水平均明显高于治疗前,且观察组患者的GAS、IL-8、TNF-α水平均明显低于对照组,MTL水平明显高于对照组,差异均具有统计学意义(P<0.05)。治疗前,两组患者的中医症候评分比较差异均无统计学意义(P>0.05);治疗后,两组患者的中医症候评分均较治疗前明显下降,且观察组患者的中医症候评分较对照组降低更明显,差异均具有统计学意义(P<0.05)。结论四逆散合越鞠丸加减配合西医四联疗法治疗肝气犯胃型胆汁反流性胃炎患者能有效改善患者的内环境炎性因子水平,临床治疗效果满意,值得临床推广。

Objective To explore the curative effect of Sini Powder and Yueju Pills combined with western medicine quadruple therapy on liver Qi invading stomach-type bile reflux gastritis and its influence on patients'internal environment.Methods A total of 122 patients with liver Qi invading stomach-type bile reflux gastritis were selected as subjects,who were admitted to the Department of Gastroenterology at the Fourth People's Hospital of Shaanxi from January 2017 to August 2018.According to the random number table method,they were divided into control group and observation group,with 61 cases in each group.The patients in the control group were treated with western medicine quadruple therapy.On the basis of the control group,the patients in the observation group were additionally given Sini Powder and Yueju Pills and/or traditional Chinese medicine treatment.Both groups were treated for a 4-week course.The clinical efficacy of the two groups of patients were compared before and after treatment,as well as the changes in internal and external environmental indicators and TCM syndrome scores.Results The total effective rate of clinical treatment in the observation group was 96.72%,which was significantly better than 86.89%in the control group(P<0.05).Before treatment,there were no significant differences in the levels of gastrin(GAS),motilin(MTL),interleukin-8(IL-8),and tumor necrosis factor-α(TNF-α)between the two groups(P>0.05).After treatment,the levels of GAS,IL-8 and TNF-αin the two groups were significantly lower than those before treatment,while the MTL level was significantly higher than that before treatment;and the levels of GAS,IL-8 and TNF-αin the observation group were significantly lower than those in the control group,and the MTL level was significantly higher than that in the control group;all differences were statistically significant(P<0.05).Before treatment,there was no significant difference in the scores of TCM symptoms between the two groups(P>0.05).After treatment,the TCM symptom scores of the two groups were significantly lower than those before treatment,and the TCM symptom scores of the observation group were significantly lower than those of the control group;all differences were statistically significant(P<0.05).Conclusion Sini Powder and Yueju Pills combined with western medicine quadruple therapy for patients with liver Qi invading stomach-type bile reflux gastritis can effectively improve the levels of inflammatory factors in patients'internal environment,and the therapeutic effect is satisfactory,which is worthy of clinical promotion.