自拟温脾养胃方联合督灸对脾胃虚寒型慢性非萎缩性胃炎患者胃肠功能及血清胃肠激素水平的影响观察

Effects of self-made Wenpi Yangwei recipe combined with du-moxibustion on gastrointestinal function and levels of gastrointestinal hormones in patients with chronic non-atrophic gastritis of spleen-stomach deficiency cold

[目的]对探讨自拟温脾养胃方联合督灸对脾胃虚寒型慢性胃炎患者胃肠功能及血清胃泌素水平的影响观察。[方法]选取112例脾胃虚寒型慢性胃炎病例随机分为对照组和观察组,每组56例,对照组给予常规西药+自拟温脾养胃方治疗,观察组在此基础上加予督灸治疗,评估2组治疗前及治疗4周后的中医症状总积分和治疗4周后的中医证候疗效,对比治疗前及治疗4周后2组患者的血清胃肠激素水平、胃黏膜组织相关生化指标及胃黏膜组织病理评分。[结果]治疗4周后,2组中医症状总积分与治疗前比较有显著性降低(P<0.05),观察组显著低于对照组(P<0.05);观察组的中医证候总有效率显著低于对照组(94.64%和80.36%,P<0.05);治疗4周后,2组血清胃泌素(GAS)水平与治疗前比较有显著性降低(P<0.05),血清生长抑素(SS)及表皮生长因子(EGF)水平与治疗前比较有显著性提高(P<0.05),2组胃黏膜组织中骨桥蛋白(OPN)的阳性细胞面密度值与治疗前比较显著提高(P<0.05),β-连环蛋白(β-Catenin)阳性细胞面密度值与治疗前比较显著降低(P<0.05),2组胃黏膜炎症、炎症活动度、腺体及肠上皮化生共4项胃黏膜组织病理评分与治疗前比较有显著性降低(P<0.05),以上指标观察组变化幅度显著大于对照组(P<0.05);2组均未见明显不良反应。[结论]自拟温脾养胃方联合督灸治应用于脾胃虚寒型慢性胃炎患者的常规西医治疗中的疗效确切,能明显减轻相关症状,调节胃肠激素水平,能有效上调胃黏膜组织中OPN的表达含量,并抑制胃黏膜组织中β-Catenin的阳性表达,以有效减轻并修复胃黏膜组织病理损伤,药物安全性高。

[Objective]To investigate the effects of self-made Wenpi Yangwei recipe combined with dumoxibustion on gastrointestinal function and serum gastrin level in patients with chronic gastritis of spleenstomach deficiency cold.[Methods]One hundred and twelve cases of chronic gastritis with spleen-stomach deficiency cold were selected and randomly divided into control group and observation group,with 56cases in each group.Control group was treated with conventional Western medicine+self-made Wenpi Yangwei recipe,and observation group was additionally given du-moxibustion on this basis.The total score of TCM symptoms before treatment and after 4weeks of treatment and the efficacy of TCM syndromes after 4 weeks of treatment were evaluated in the two groups.The levels of serum gastrointestinal hormones,related biochemical indicators of gastric mucosal tissues and gastric mucosal histopathology score were compared before treatment and after 4weeks of treatment.[Results]After 4weeks of treatment,the total score of TCM symptoms in the two groups was significantly lower than that before treatment(P<0.05),and the score in observation group was significantly lower than that in control group(P<0.05).The total effective rate of TCM syndromes in observation group was significantly lower than that in control group(94.64%vs 80.36%,P<0.05).After 4weeks of treatment,the level of serum gastrin(GAS)in the two groups was significantly decreased compared with that before treatment(P<0.05),while the levels of serum somatostatin(SS)and epidermal growth factor(EGF)were significantly increased compared with those before treatment(P<0.05).The positive cell surface density value of osteopontin(OPN)in gastric mucosal tissues of the two groups was significantly increased compared with that before treatment(P<0.05).The positive cell surface density value ofβ-catenin was significantly decreased compared with that before treatment(P<0.05).The gastricmucosal histopathology scores of 4items of gastric mucosal inflammation,inflammatory activity,glandular and intestinal metaplasia in the two groups were significantly lower than those before treatment(P<0.05).The changes of the above indexes in observation group were significantly greater than those in control group(P<0.05).There were no obvious adverse reactions in the two groups.[Conclusion]Self-made Wenpi Yangwei recipe combined with du-moxibustion is efficacious in the conventional Western medicine treatment of patients with chronic gastritis of spleen-stomach deficiency cold.It can significantly improve related symptoms,regulate gastrointestinal hormones levels,effectively increase the expression of OPN in gastric mucosal tissues and inhibit the positive expression ofβ-Catenin in gastric mucosal tissues,and can effectively reduce and repair the pathological damage of gastric mucosal tissues,with high drug safety.