香砂养胃丸联合兰索拉唑治疗脾虚气滞型慢性萎缩性胃炎临床研究

Clinical Study on Xiangsha Yangwei Pills Combined with Lansoprazole for Chronic Atrophic Gastritis of Spleen Deficiency and Qi Stagnation Type

目的:观察香砂养胃丸联合兰索拉唑治疗脾虚气滞型慢性萎缩性胃炎的临床疗效。方法:将脾虚气滞型慢性萎缩性胃炎者216例按随时数字表法分为2组,对照组108例口服兰索拉唑治疗,观察组108例在对照组治疗的基础上加服香砂养胃丸;观察2组治疗前后胃镜病理积分与中医证候积分、血清白细胞介素-11(IL-11)、血清白细胞介素-8(IL-8)及肿瘤坏死因子-α(TNF-α)、胃黏膜丙二醛(MDA)、前列腺素E2(PEG2)含量,并统计2组临床疗效及不良反应情况。结果:总有效率观察组为95.37%,对照组为86.11%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组患者胃镜病理积分及中医证候积分均较治疗前明显降低(P<0.05);且观察组两项积分明显低于对照组(P<0.05)。治疗后,2组患者胃黏膜MDA、血清IL-11、血清IL-8及TNF-α含量较治疗前降低(P<0.05),胃黏膜PEG2含量较治疗前升高(P<0.05);且观察组上述各项指标改善较对照组更显著(P<0.05)。观察组出现恶心、呕吐4例;对照组出现恶心、呕吐6例,2组不良反应率比较,差异无统计学意义(P>0.05)。结论:香砂养胃丸与兰索拉唑合用可改善脾虚气滞型慢性萎缩性胃炎的病理变化及临床症状,降低患者血清炎性因子含量,且安全性较高。

Objective:To observe the curative effect of the therapy of Xiangsha Yangwei pills combined with lansoprazole for chronic atrophic gastritis of spleen deficiency and qi stagnation type.Methods:A total of 216 patients with chronic atrophic gastritis of spleen deficiency and qi stagnation type were divided into two groups according to the random number table method,108 cases in each group.The control group was treated with lansoprazole orally,and the observation group was additionally treated with Xiangsha Yangwei pills based on the treatment of the control group.Before and after treatment,the scores of gastroscopy and Chinese medicine syndromes,the contents of interleukin-11(IL-11),interleukin-8(IL-8)and tumor necrosis factor-α(TNF-α)in serum,malondialdehyde(MDA)and the content of prostaglandin E2(PEG2)in the two groups were observed,and the clinical effect and adverse reactions were also counted.Results:The total effective rate was 95.37%in the observation group and 86.11%in the control group,the difference being significant(P<0.05).After treatment,the scores of gastroscopy and Chinese medicine syndromes in the two groups were significantly decreased when compared with those before treatment(P<0.05),and the above two scores in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the levels of MDA in the gastric mucosa,IL-11 and IL-8 in serum and TNF-αin the two groups were decreased when compared with those before treatment(P<0.05),while the contents of PEG2 were increased when compared with those before treatment(P<0.05);the improvement of the above indexes was more significant in the observation group than that in the control group(P<0.05).There were four cases of nausea and vomiting occurred in the observation group and six cases in the control group;there was no significant difference between the two groups in the comparison of the incidence of adverse reactions(P>0.05).Conclusion:The therapy of Xiangsha Yangwei pills combined with lansoprazole can significantly improve the pathological changes and clinical symptoms of patients with chronic atrophic gastritis of spleen deficiency and qi stagnation type,reduce the contents of inflammatory cytokines in the serum,and has great safety.