荜铃胃痛颗粒联合艾司奥美拉唑四联疗法治疗Hp相关性慢性胃炎的疗效及对外周血T淋巴细胞亚群和血清炎症相关细胞因子水平的影响

Efficacy of Biling Weitong Granule combined with esomeprazole in the treatment of Hp related chronic gastritis and effects on T lymphocyte and inflammatory cytokine levels in peripheral blood

目的:探讨荜铃胃痛颗粒联合艾司奥美拉唑四联疗法治疗幽门螺杆菌(Hp)相关性慢性胃炎的临床疗效以及其对患者外周血T淋巴细胞亚群和血清炎症相关细胞因子水平的影响。方法:选择廊坊市人民医院消化科2021年2月—2022年2月收治的100例Hp相关性慢性胃炎患者作为研究对象,按随机数字表法分成观察组与对照组各50例。观察组采用荜铃胃痛颗粒联合艾司奥美拉唑四联疗法治疗,对照组采用常规艾司奥美拉唑四联疗法治疗。连续治疗14 d后观察2组临床疗效和胃镜疗效,统计2组Hp根除率与不良反应情况。比较治疗前后2组中医证候积分、外周血T淋巴细胞亚群和血清炎性因子水平。结果:观察组临床及胃镜总有效率分别为94.00%(47/50)、90.00%(45/50),与对照组[78.00%(39/50)、72.00%(36/50)]比较均显著升高(P<0.05)。2组治疗后气滞血瘀证的各项症状积分均较治疗前显著降低(P<0.05),且均以观察组的下降更显著(P<0.05)。观察组Hp根除率达94.00%(47/50),较对照组[80.00%(40/50)]显著提高(P<0.05)。与治疗前比较,2组患者治疗后外周血CD4^(+)、CD4^(+)/CD8^(+)和血清干扰素γ(IFN-γ)水平均显著升高(P<0.05),外周血CD8^(+)和血清肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6水平均显著降低(P<0.05);且均以观察组的改善更显著(P<0.05)。观察组不良反应发生率与对照组比较差异无统计学意义[6.00%(3/50)vs.14.00%(7/50)](P>0.05)。结论:荜铃胃痛颗粒联合艾司奥美拉唑四联疗法治疗Hp相关性慢性胃炎的整体疗效显著,该联合方案能有效改善患者细胞免疫状态,下调血清IFN-γ、TNF-α、IL-6的表达水平,提高Hp根除率,且安全性好。

Objective:To investigate the clinical efficacy of Biling Weitong Granule combined with esomeprazole in the treatment of Helicobacter Pylori(Hp)related chronic gastritis and its effects on peripheral blood T lymphocyte and serum levels of inflammatory cytokines.Methods:A total of 100 patients with Hp related chronic gastritis admitted to our hospital from February 2021 to February 2022 were randomly divided into observation group(50 cases)and control group(50 cases).The observation group was treated with Biling Weitong Granule combined with esomeprazole quadruple therapy,while the control group was treated with conventional esomeprazole quadruple therapy.After 14 days of continuous treatment,the clinical and gastroscopic efficacy,Hp eradication rate and adverse reactions were observed.Before and after treatment,TCM syndrome integral was performed in both groups,and the levels of T lymphocyte in peripheral blood of both groups were detected by flow cytometry,serum levels of IFN-γ,tumor necrosis factorsαand interleukin 6 were measured by enzyme linked immunosorbent assay(ELISA).Results:The total effective rates of clinical and gastroscopic of observation group were 94.00%(47/50)and 90.00%(45/50)respectively,which were significantly higher than those of control group(78.00%[39/50]and 72.00%[36/50])(P<0.05).After treatment,the symptom scores of Qi stagnation and blood stasis syndrome in both groups were significantly lower than those before treatment(P<0.05),and the decrease was more significant in the observation group(P<0.05).The eradication rate of Hp in the observation group was 94.00%(47/50),which was significantly higher than that in the control group(P<0.05).After treatment,the levels of CD4^(+),CD4^(+)/CD8^(+)and IFN-γin peripheral blood were significantly increased(P<0.05),and the level of CD8^(+),TNF-αand IL-6 in peripheral blood were significantly decreased(P<0.05).Conclusion:The combined therapy of Biling Weitong Granule and esomeprazole has a significant effect on Hp related chronic gastritis.The combined therapy can effectively correct the imbalance of T lymphocyte in peripheral blood and enhance the cellular immune function of patients,reduce the body’s inflammatory reaction,improve the eradication rate of Hp,and of good security.