温阳愈溃汤治疗脾胃虚寒型幽门螺杆菌感染性胃溃疡临床研究

Clinical Study on the Treatment of Deficient Cold of Spleen and Stomach Helicobacter Pylori Infectious Gastric Ulcer with Wenyang Yukui Decoction

目的探讨温阳愈溃汤治疗脾胃虚寒型幽门螺杆菌感染性胃溃疡的临床疗效。方法将100例脾胃虚寒型幽门螺杆菌感染性胃溃疡患者按照随机数字表法分为观察组和对照组,每组50例。对照组采用四联疗法(胶体果胶铋+阿莫西林+奥美拉唑+克拉霉素)治疗,观察组在对照组基础上采用温阳愈溃汤治疗。治疗6周后,比较2组胃镜下溃疡直径、底部厚苔面积、再生上皮面积和溃疡周围黏膜充血面积等变化;检测2组血清白细胞介素-6(interleukin-6,IL-6)、γ干扰素(interferon-γ,IFN-γ)、C反应蛋白(C-reaction protein,CRP)等炎症因子水平,以及胃黏膜表皮生长因子(epidermal growth factor,EGF)及表皮生长因子受体(epithelial growth factor receptor,EGFR)等溃疡相关因子水平;根据胃镜检查情况评价2组临床疗效。结果治疗后,观察组溃疡直径、底部厚苔面积、溃疡周围黏膜充血面积较治疗前缩小(P<0.05),且明显小于对照组(P<0.05);再生上皮面积较治疗前增大(P<0.05),且明显大于对照组(P<0.05)。观察组血清IL-6、IFN-γ、CRP水平较治疗前降低(P<0.05),且明显低于对照组(P<0.05);胃黏膜EGF、EGFR水平较治疗前升高(P<0.05),且明显高于对照组(P<0.05)。观察组临床总有效率为98.00%,明显高于对照组(P<0.05);观察组Hp根除率为100.00%,明显高于对照组(P<0.05)。结论温阳愈溃汤联合四联疗法治疗脾胃虚寒型幽门螺杆菌感染性胃溃疡能够明显促进溃疡愈合,提高治愈率,这可能与其调节血清炎症因子水平,改善溃疡相关因子有关。

Objective To explore the clinical efficacy of Wenyang Yukui decoction in the treatment of gastric ulcer caused by helicobacter pylori(Hp)with syndrome of deficient cold of spleen and stomach.Methods A total of 100 cases of Hp infective gastric ulcer patients with deficient cold of spleen and stomach were randomly divided into observation group and control group,with 50 cases in each group.The control group was treated with quadruple therapy(colloidal pectin bismuth+amoxicillin+omeprazole+clarithromycin),and the observation group was treated with Wenyang Yukui decoction on the basis of the control group.After six weeks of treatment,the changes of gastroscopic ulcer(diameter of ulcer,area of thick moss at the bottom,area of regenerated epithelium,and area of mucosal hyperemia around the ulcer)in the two groups were compared.The levels of serum interleukin-6(IL-6),interferon-γ(IFN-γ),C-reaction protein(CRP)and ulcer-related factors such as epidermal growth factor(EGF)and epithelial growth factor receptor(EGFR)in the gastric mucosa were detected.The clinical efficacy of the two groups were evaluated according to the gastroscopy situation.Results After treatment,the diameter of the ulcer,the area of thick moss at the bottom,and the area of hyperemia around the ulcer in the observation group were significantly smaller than those before treatment(P<0.05),which were significantly smaller than those in the control group(P<0.05).The area of regenerated epithelium was larger than that before treatment(P<0.05),which was significantly larger than that in the control group(P<0.05).The serum levels of IL-6,IFN-γ,and CRP in the observation group were lower than those before treatment(P<0.05),which were significantly lower than those of the control group(P<0.05).The level of EGF and EGFR in the gastric mucosal of the observation group were higher than those before treatment(P<0.05),which were significantly higher than those of the control group(P<0.05).The total clinical effective rate in the observation group was 98.00%,which was significantly higher than that in the control group(P<0.05).The Hp eradication rate in the observation group was 100.00%,which was significantly higher than that in the control group(P<0.05).Conclusion Wenyang Yukui decoction combined with quadruple therapy could significantly promote ulcer healing and improve healing rate in patients with Hp-infected gastric ulcer with syndrome of deficient cold of spleen and stomach.This may be related to the regulation of serum levels of inflammatory factors and improvement of ulcer-related factors.