和胃愈疡方结合奥美拉唑治疗脾虚郁热型胃ESD后溃疡的临床研究

Clinical Study on the Efficacy of Hewei Yuyang Formula Combined with Omeprazole on the Postoperative Ulcer Induced by Gastric Endoscopic Submucosal Dissection for Patients with Spleen Deficiency and Heat Constraint

目的观察和胃愈疡方结合奥美拉唑治疗脾虚郁热型胃内镜黏膜下剥离术(ESD)后溃疡的临床疗效和安全性。方法将60例脾虚郁热型胃ESD后溃疡患者随机分为对照组和治疗组,对照组予以奥美拉唑治疗,治疗组给予和胃愈疡方结合奥美拉唑治疗,2组疗程均为4周。疗程结束后比较2组的溃疡面积缩小率、溃疡再生黏膜组织学成熟度、血清前列腺素E2(PGE2)水平以及中医证候积分。结果治疗后2组溃疡面积均较治疗前缩小(P<0.05),治疗组溃疡缩小率大于对照组(P<0.05),治疗组溃疡再生黏膜组织学成熟度优于对照组(P<0.05);2组患者治疗后血清PGE2水平较治疗前升高,证候积分较治疗前下降(P<0.05),治疗组均较对照组显著(P<0.05)。结论和胃愈疡方结合奥美拉唑治疗脾虚郁热型胃ESD后溃疡疗效确切,能加快溃疡愈合速度,提高溃疡愈合质量,显著缓解临床症状,同时具有较高的安全性。

OBJECTIVE To observe the clinical efficacy and safety of the Hewei Yuyang formula combined with Omeprazole on the postoperative ulcers induced by gastric endoscopic submucosal dissection(ESD)for patients with spleen deficiency and heat constraint.METHODS Sixty post-operative ulcer patients with spleen deficiency and heat constraint type induced by gastric ESD were randomly divided into the control group and the treatment group with 30 cases in each group.The control group was given Omeprazole while the treatment group was given Omeprazole and Hewei Yuyang formula for four weeks.After treatment,the ulcer area reduction rates,the ulcer regenerated mucosal histological maturity,serum prostaglandin E2(PGE2)levels,and traditional Chinese medicine(TCM)syndrome scores were compared.RESULTS After treatment,the ulcer area reduction rates in the two groups were decreased(P<0.05),and the reduction rate in the treatment group decreased more significantly(P<0.05).The ulcer regenerated mucosal histological maturity in the treatment group was better than that of the control group(P<0.05).Serum PGE2 levels in two groups were higher than those before treatment while the TCM syndrome scores were lower than those before treatment(P<0.05),and the treatment group showed more significant differences(P<0.05).CONCLUSION Hewei Yuyang formula combined with Omeprazole has exact efficacy on the postoperative ulcer induced by gastric ESD for patients with spleen deficiency and heat constraint.The combined therapy can significantly speed up the healing of ulcers,improve the quality of healing,and relieve clinical symptoms with higher safety.