运用疏肝健脾法治疗消化性溃疡的临床及实验研究

A study on treating peptic ulcer by the Shugan Jianpi therapy

目的:观察运用疏肝健脾法治疗消化性溃疡的临床疗效。方法:150例患者随机分成疏肝健脾组与西医对照组,西医对照组采用健康宣教、根除幽门螺杆菌(Helicobacter pylori,Hp)及抑酸护胃常规治疗,疏肝健脾组在对照组基础上加用疏肝健脾方,6周为一个疗程。治疗前后行进行中医证候积分、并行内镜检查夹取溃疡周边黏膜组织行前列腺素E2(Prostaglandin E2,PGE2)检测,所有患者进行了一年随访。结果:疏肝健脾组中医证候总有效率明显高于西医对照组,差异有统计学意义;疏肝健脾组内镜下溃疡愈合总有效率高于西医组的总有效率,两组治疗后溃疡黏膜组织中PGE2的表达水平均较治疗前升高明显(P<0.05),但疏肝健脾组PGE2表达水平明显高于西医对照组(P<0.05);疏肝健脾组一年复发率明显低于西医对照组,复发率比较差异有统计学差异。结论:疏肝健脾法能改善肝郁脾虚型消化性溃疡患者中医证候积分,增加溃疡黏膜组织中PGE2的分泌促进溃疡愈合,从而提高溃疡愈合质量,减少复发。

Objective:To observe the clinical efficacy of the Shugan Jianpi therapy(疏肝健脾法)on peptic ulcer.Methods:150 patients were randomly divided into the Shugan Jianpi group and the control group.The control group was treated by health education,Hp eradication and other conventional treatments.The Shugan Jianpi group was given the Shugan Jianpi decoction more,6 weeks as a course,and followed up for one year.Results:The total efficiency of TCM syndromes in the Shugan Jianpi group was significantly higher than that in the control group.The total efficiency for endoscopic ulcer healing in the Shugan Jianpi group was higher than the control group.After treatment,the expression level of PGE2 in the ulcerative mucosa in two groups was significantly higher than before treatment(P﹤0.05),the PGE2 expression level in the Shugan Jianpi group was significantly higher than that in the control group(P﹤0.05).The one-year recurrence rate in the Shugan Jianpi group was significantly lower than the control group.Conclusion:The Shugan Jianpi therapy on peptic ulcer of the Ganyu Pixu syndrome(肝郁脾虚型)shows good effects,can improve TCM syndrome score,increase the secretion of PGE2 in ulcer mucosa,promote ulcer healing,improve efficacy,and reduce recurrence.