新加三合汤辅助瑞巴派特治疗消化性溃疡的效果及对中医证候、溃疡愈合与消化功能的影响

Effect of Using Xinjia Sanhe Decoction Supplemented with Rebamipide in the Treatment of Peptic Ulcers and Its Influence on Traditional Chinese Medicine Symptoms, Ulcer Healing and Digestive Function

目的:观察新加三合汤辅助瑞巴派特治疗消化性溃疡(PU)的效果及对中医证候、溃疡愈合与消化功能的影响。方法:选择92例PU患者随机分为对照组与观察组各46例,对照组以奥美拉唑+瑞巴派特治疗,在此基础上,观察组加用新加三合汤辅助治疗,比较两组临床疗效、中医证候评分、溃疡愈合情况、胃消化功能、胃黏膜生长因子水平及不良反应情况差异。结果:观察组总有效率为,显著高于对照组的(P<0.05);治疗后,两组中医症候胃脘胀痛、泛吐酸水、食少纳呆、倦怠乏力、嗳气评分均显著降低(P<0.05),且观察组低于对照组(P<0.05);两组溃疡愈合(炎性细胞浸润程度、黏膜形态结构、中性黏液含量)的组织学观察评分均显著降低(P<0.05),且观察组低于对照组(P<0.05);两组胃消化功能指标[胃泌素(GAS)、胃动素(MLT)]水平均显著降低(P<0.05),且观察组低于对照组(P<0.05);治疗后,两组血清碱性成纤维细胞生长因子(bFGF)、血管内皮生长因子(VEGF)水平较治疗前显著提高(P<0.05),表皮生长因子(EGF)水平较治疗前显著降低(P<0.05),且观察组治疗后的bFGF、VEGF水平高于对照组,EGF水平低于对照组(P<0.05);两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:新加三合汤辅助瑞巴派特治疗PU疗效显著,可有效改善患者临床症状、促进胃黏膜修复、提高溃疡愈合质量及胃消化功能。

Objective: To observe the effect of using Xinjia Sanhe decoction supplemented with Rebamipide in the treatment of peptic ulcers(PU) and its influence on TCM symptoms, ulcer healing and digestive function. Methods: 92 patients with PU were randomly divided into a controlled group and an observation group, with 46 cases in each group. The controlled group was treated with Omeprazole+Rebamipide, and on this basis, the observation group was additionally treated with Xinjia Sanhe Decoction. The clinical efficacy, TCM syndromes scores, ulcer healing, gastric digestive function, gastric mucosal growth factors levels and adverse reactions were compared between the two groups. Results: The total effective rate of the observation group was significantly higher than that of the controlled group(P < 0.05). After treatment, the scores of TCM symptoms of epigastric distention, acid saliva spitting, poor appetite, fatigue and belching were significantly reduced in the two groups(P < 0.05),and the scores of the observation group were lower than those of the controlled group(P < 0.05). The histological observation scores of ulcer healing(inflammatory cell infiltration, mucosal morphological structure, neutral mucus content) in the two groups were significantly reduced(P < 0.05),and the scores in the observation group were lower than those in the controlled group(P < 0.05). The levels of gastric digestive function indexes [gastrin(GAS),motilin(MLT)] in the two groups were significantly reduced(P < 0.05),and the levels were lower in the observation group than those in the controlled group(P < 0.05). After treatment, the levels of serum basic fibroblast growth factor(bFGF) and vascular endothelial growth factor(VEGF) in the two groups were significantly increased compared with those before treatment(P < 0.05) while the level of epidermal growth factor(EGF) was significantly decreased compared with that before treatment(P < 0.05),and the levels of bFGF and VEGF of the observation group after treatment were higher than those of the controlled group while the level of EGF was lower than that of the controlled group(P < 0.05). There were no statistically significant differences in the incidence rates of adverse reactions between the two groups(P > 0.05). Conclusion: Xinjia Sanhe Decoction supplemented with rebamipide has a significant efficacy in the treatment of PU,and it can effectively improve the clinical symptoms, promote gastric mucosal repair, and enhance the quality of ulcer healing and gastric digestive function.