芍药八味汤联合艾灸治疗慢性萎缩性胃炎脾胃虚弱证临床研究

Clinical study on Shaoyao-Bawei Decoction combined with moxibustion in the treatment of spleen stomach weakness syndrome of chronic atrophic gastritis

目的评价芍药八味汤联合艾灸治疗慢性萎缩性胃炎(CAG)脾胃虚弱证临床疗效。方法将符合入选标准的2019年1月-2021年1月肇庆市高要区人民医院CAG患者98例,按随机数字表法分为2组,每组49例。对照组接受西医常规治疗,观察组在对照组基础上给予芍药八味汤联合艾灸治疗。分别于治疗前后进行中医症状评分,采用ELISA法检测IL-6、IL-8、TNF-α水平,采用放射免疫法检测血清促胃动素(MLT)、胃泌素-17(G17)、促胃液素(GAS)水平,观察用药安全性,评价临床疗效。结果观察组总有效率为93.9%(46/49)、对照组为71.4%(35/49),2组比较差异有统计学意义(χ^(2)=8.611,P=0.043)。观察组治疗后胃脘灼热、胃脘痞闷、纳呆食少、口干口苦、气短懒言、神疲乏力、舌淡、脉细弱评分低于对照组(t值分别为12.061、7.331、6.869、5.975、5.208、10.567、8.738、8.631,P值均<0.01),血清IL-6、IL-8、TNF-α水平低于对照组(t值分别为8.573、13.423、12.099,P值均<0.01);观察组治疗后血清MLT[(154.52±26.25)ng/L比(180.26±28.13)ng/L,t=4.488]水平低于对照组(P<0.01);G17[(14.28±1.75)pmol/L比(10.28±1.06)pmol/L,t=-7.966]、GAS[(24.73±3.42)ng/L比(19.02±3.38)ng/L,t=-13.115]水平高于对照组(t值分别为-7.966、-13.115,P值均<0.01)。治疗期间,观察组不良反应发生率为8.16%(4/49)、对照组为6.12%(3/49),2组比较差异无统计学意义(χ^(2)=0.152,P=0.695)。结论芍药八味汤联合艾灸可有效缓解CAG脾胃虚弱证患者的临床症状,调节炎性细胞因子水平,促进胃肠功能恢复,提高临床疗效。

Objective To evaluate the clinical efficacy of Shaoyao-Bawei Decoction combined with moxibustion in the treatment of spleen stomach weakness syndrome of chronic atrophic gastritis(CAG).Methods The 98 CAG patients admitted to the Zhaoqing Gaoyao District People’s Hospital from January 2019 to January 2021 who met the selection criteria were divided into 2 groups according to the random number table method,with 49 in each group.The control group received conventional western medicine treatment,and the observation group was treated with Shaoyao-Bawei Decoction combined with moxibustion on the basis of the control group.TCM symptom scores were performed before and after treatment,the levels of IL-6,IL-8 and TNF-awere detected by ELISA,and the levels of serum motilin(MLT),gastrin-17(G17)and gastrin(gas)were detected by radioimmunoassay,the safety of medication was observed and the clinical efficacy was evaluated.Results The total effective rate was 93.9%(46/49)in the observation group and 71.4%(35/49)in the control group.There was significant difference between the two groups(χ^(2)=8.611,P=0.043).After treatment,the scores of epigastric burning,fullness in stomach,dull appetite,dry mouth and bitter mouth,shortness of breath and unwillingness to speak,general lassitude,pale tongue,small and weak pulse in the observation group were significantly lower than those in the control group(t=12.061,7.331,6.869,5.975,5.208,10.567,8.738,8.631,respectively,all Ps<0.01),and the levels of serum IL-6,IL-8 and TNF-αwere significantly lower than those in the control group(t=8.573,13.423,12.099,respectively,all Ps<0.01).After treatment,the level of serum MLT(154.52±26.25 ng/L vs.180.26±28.13 ng/L,t=4.488)in the observation group was lower than that of the control group(P<0.01);the levels of G17(14.28±1.75 pmol/L vs.10.28±1.06 pmol/L,t=-7.966)and GAS(24.73±3.42 ng/L vs.19.02±3.38 ng/L,t=-13.115)in the observation group were significantly higher than those in the control group(t=-7.966 and-13.115,respectively,all Ps<0.01).During the treatment,the incidence of adverse reactions was 8.16%(4/49)in the observation group and 6.12%(3/49)in the control group,and there was no significant difference between the two groups(χ^(2)=0.152,P=0.695).Conclusion Shaoyao-Bawei Decoction combined with moxibustion can alleviate the clinical symptoms of CAG patients with spleen stomach weakness syndrome,regulate the level of inflammatory cytokines,promote the recovery of gastrointestinal function and improve the clinical curative effect.