黄芪建中汤辨证加减治疗脾胃虚寒型胃溃疡的临床效果

Clinical effect of modified Huangqi Jianzhong decoction based on syndrome differentiation on gastric ulcer of spleen-stomach deficiency cold type

目的 分析黄芪建中汤辨证加减治疗脾胃虚寒型胃溃疡的临床效果。方法 选取2019年1月至2020年6月在我院接受治疗的100例脾胃虚寒型胃溃疡患者,按单双号法将其随机分为对照组和观察组,各50例。对照组采用常规西药四联疗法治疗,观察组在对照组基础上采用黄芪建中汤辨证加减治疗。比较两组的临床疗效、常规康复指标、胃消化功能指标、炎症因子水平。结果 观察组的治疗总有效率为94.00%,高于对照组的80.00%,差异具有统计学意义(P<0.05)。观察组治疗后的溃疡面积小于对照组,治疗后的Hp清除率及半年内复发率均优于对照组,差异具有统计学意义(P<0.05)。治疗前,两组的GAS、MTL、SS、VIP水平比较,差异无统计学意义(P>0.05);治疗后,两组的GAS、VIP水平均降低,MTL、SS水平均升高,且观察组优于对照组,差异具有统计学意义(P<0.05)。治疗前,两组的IL-8、IL-17、TNF-α、NF-κB水平比较,差异无统计学意义(P>0.05);治疗后,两组的IL-8、IL-17、TNF-α、NF-κB水平均较治疗前降低,且观察组低于对照组,差异具有统计学意义(P<0.05)。结论 在常规西药四联疗法基础上采用黄芪建中汤辨证加减治疗脾胃虚寒型胃溃疡的效果显著,可提高Hp清除率,改善患者的胃消化功能,减轻炎症反应,促进溃疡愈合,降低复发风险,值得临床推广应用。

Objective To analyze the clinical effect of modified Huangqi Jianzhong decoction based on syndrome differentiation on gastric ulcer of spleen-stomach deficiency cold type.Methods One hundred patients with gastric ulcer of spleen-stomach deficiency cold type treated in our hospital from January 2019 to June 2020 were selected and randomly divided into control group and observation group according to single and double numbers method,with 50 cases in each group.The control group was treated with conventional western medicine quadruple therapy,and on the basis of the control group,the observation group was treated with modified Huangqi Jianzhong decoction based on syndrome differentiation.The clinical efficacy,routine rehabilitation indexes,gastric digestive function indexes and inflammatory factors levels were compared between the two groups.Results The total effective rate of treatment in the observation group was 94.00%,which was higher than 80.00% in the control group,and the difference was statistically significant(P<0.05).The ulcer area of the observation group after treatment was smaller than that of the control group,the Hp clearance rate after treatment and recurrence rate within half a year were better than those of the control group,and the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in the levels of GAS,MTL,SS and VIP between the two groups(P>0.05);after treatment,the levels of GAS and VIP decreased and the levels of MTL and SS increased in the two groups,and those in the observation group were better than the control group,the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in the levels of IL-8,IL-17,TNF-α and NF-κB between the two groups(P>0.05);after treatment,the levels of IL-8,IL-17,TNF-α and NF-κB in the two groups were lower than those before treatment,and those of the observation group were lower than the control group,the differences were statistically significant(P<0.05).Conclusion On the basis of conventional western medicine quadruple therapy,modified Huangqi Jianzhong decoction based on syndrome differentiation in the treatment of gastric ulcer of spleen-stomach deficiency cold type has a significant effect.It can increase the Hp clearance rate,improve patients’ gastric digestive function,reduce inflammatory reaction,promote ulcer healing,and reduce the risk of recurrence,which is worthy of clinical promotion and application.