自拟和中健脾汤结合西医常规疗法对反流性食管炎患者胃肠动力学及炎性细胞因子水平的影响

Effect of self-made Hezhong-Jianpi Decoction combined with western medicine on gastrointestinal motility and level of inflammatory cell factors in patients with reflux esophagitis

目的探讨自拟和中健脾汤结合西医常规疗法对反流性食管炎患者胃肠动力及炎性细胞因子水平的影响。方法选择本院2016年5月-2018年9月符合入选标准的反流性食管炎患者102例,采用随机数字表法分为2组,每组51例。对照组给予西医常规疗法治疗,研究组在对照组基础上加服自拟和中健脾汤。2组均治疗8周。采用放射免疫法检测血清促胃泌素(gastrin,GAS)、促胃动素(motilin,MTL)水平,采用ELISA法检测血清TNF-α、IL-6、IL-17水平,记录治疗期间的不良反应,评价临床疗效。结果研究组总有效率为92.2%(47/51)、对照组为72.6%(37/51),2组比较差异有统计学意义(χ^2=6.746,P=0.009)。治疗后,研究组血清GAS[(152.93±26.85)ng/L比(134.30±29.88)ng/L,t=3.312]、MTL[(291.58±29.75)ng/L比(262.40±38.71)ng/L,t=4.268]水平均高于对照组(P<0.01);血清TNF-α、IL-6、IL-17水平均低于对照组(t值分别为4.653、5.362、4.759,P值均<0.01)。治疗期间,对照组不良反应发生率为9.8%(5/51)、研究组为12.0%(6/51),2组比较差异无统计学意义(χ^2=0.102,P=0.750)。结论自拟和中健脾汤结合西医常规疗法可促进反流性食管炎患者的胃肠动力,减轻炎症反应,提高临床疗效。

Objective To investigate the effects of self-made Hezhong-Jianpi Decoction on gastrointestinal motility and level of inflammatory cell factors in patients with reflux esophagitis.Methods A total of 102 patients with reflux esophagitis who met the inclusion criteria in our hospital from May 2016 to September 2018 were divided into two group according to the random number table method,51 cases in each group.The control group was treated with conventional western medicine.The intervention group was treated with self-made Hezhong-Jianpi Decoction based on the control group.Both groups were treated for 8 weeks.The levels of serum gastrin(GAS)and motilin(MTL)were detected by radioimmunoassay,the levels of TNF-a,IL-6 and IL-17 were detected by ELISA,the adverse reactions during the treatment were recorded,and the clinical efficacy was evaluated.Results The total effective rate of the experimental group was 92.1%(47/51)and that of the control group was 72.5%(37/51).The difference between the two groups was statistically significant(χ^2=6.746,P=0.009).After the treatment,the levels of serum GAS(152.93±26.85 ng/L vs.134.30±29.88 ng/L,t=3.312),MTL(291.58±29.75 ng/L vs.262.40±38.71 ng/L,t=4.268)in the intervention group were significantly higher than those in the control group(P<0.05),and serum TNF-a,IL-6,IL-17 levels were significantly lower than those in the control group(t value were 4.653,5.362,4.759,respectively,all Ps<0.01).During the treatment,the incidence of adverse reactions was 9.8%(5/51)in the control group and 12.0%(6/51)in the intervention group,and there was no significant difference between the two groups(χ^2=0.102,P=0.750).Conclusions The self-made Hezhong-Jianpi Decoction combined with the conventional western medicine can promote the gastrointestinal motility of patients with reflux esophagitis,reduce the inflammatory reaction and improve the clinical efficacy.