加减黄芪建中汤联合奥美拉唑对消化性溃疡患者消化道激素及炎症因子的影响

Effect of Modified Huangqi Jianzhong Decoction Combined with Omeprazole on Gastrointestinal Hormones and Inflammatory Cytokines in Patients with Peptic Ulcer

目的观察加减黄芪建中汤联合奥美拉唑对消化性溃疡患者消化道激素及炎症因子的影响。方法选取2018年3月—2021年3月期间亳州市人民医院收治的100例消化性溃疡患者为研究对象,按随机数字表法分为对照组和研究组,每组各50例。对照组给予奥美拉唑治疗,研究组在对照组治疗的基础上给予加减黄芪建中汤治疗。治疗1个月后,观察比较两组患者治疗前后中医证候积分(胃部隐痛、喜热喜按、得食痛减、不思饮食、食后脘闷、神疲乏倦、泛吐清水、畏寒肢冷)、消化道激素水平[血清胃动素(Motilin,MTL)、生长抑素(Somatostatin,SS)、胃泌素(Gastrin,GAS)、表皮生长因子(Epidermalgrowthfactor,EGF)]、炎症因子[肿瘤坏死因子-α(Tumornecrosisfactor-alpha,TNF-α)、白介素-17(Interleukin-17,IL-17)、一氧化氮(NitricOxide,NO)]水平及临床疗效。结果治疗后研究组总有效率为98.00%(49/50)明显高于对照组84.00%(42/50),差异有统计学意义(P<0.05)。治疗后两组患者胃部隐痛、喜热喜按、得食痛减、不思饮食、食后脘闷、神疲乏倦、泛吐清水、畏寒肢冷评分均明显低于治疗前,差异有统计学意义(P<0.05);且研究组各项中医证候评分明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者MTL、GAS水平均较治疗前降低,SS、EGF水平高于治疗前,差异有统计学意义(P<0.05);且研究组MTL、GAS水平均明显低于对照组,SS、EGF水平明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者TNF-α、IL-17、NO水平均明显低于治疗前,差异有统计学意义(P<0.05);且研究组TNF-α、IL-17、NO水平明显低于对照组,差异有统计学意义(P<0.05)。结论加减黄芪建中汤联合奥美拉唑能够调节消化性溃疡患者MTL、SS、GAS、EGF,降低TNF-α、IL-17、NO水平,从而发挥调节胃肠激素,降低炎症因子的水平,效果显著,值得临床推广使用。

Objective To observe the effect of modified Huangqi Jianzhong Decoction combined with omeprazole on gastrointestinal hormones and inflammatory cytokines in patients with peptic ulcer.Methods A total of 100 patients with peptic ulcer treated in the People′s Hospital of Bozhou from March 2018 to March 2021 were enrolled and randomly assigned into a control group(treated with omeprazole)and an observation group(treated with omeprazole combined with modified Huangqi Jianzhong Decoction),with 50 patients in each group.The treatments in both groups lasted for a month.The TCM syndrome scores(dull pain in stomach,preference to warm and compression,pain reduction after eating,poor appetite,abdominal distention after eating,fatigue,vomiting water,and chilling in limbs)were compared between before and after treatment and between the two groups.Furthermore,the levels of gastrointestinal hormones[motilin(MTL),somatostatin(SS),gastrin(GAS),and epidermal growth factor(EGF)]and inflammatory cytokines[tumor necrosis factor-alpha(TNF-α),interleukin 17(IL-17),and nitric oxide(NO)]were compared.The clinical efficacy was compared between the two groups.Results The observation group showed higher total effective rate[98.00%(49/50)vs.84.00%(42/50),P<0.05]than the control group.After treatment,the TCM syndrome scores declined compared with those before treatment and were lower in the observation group than in the control group(P<0.05).The treatments in both groups reduced the levels of MTL and GAS and elevated the levels of SS and EGF(P<0.05).Moreover,the observation group had lower levels of MTL and GAS and higher levels of SS and EGF than the control group(P<0.05).After treatment,the TNF-α,IL-17,and NO levels reduced compared with those before treatment and were lower in the observation group than in the control group(P<0.05).Conclusion Modified Huangqi Jianzhong Decoction combined with omeprazole can regulate MTL,SS,GAS,and EGF and reduce the levels of TGF-α,IL-17,and NO,being worthy of promotion for treating peptic ulcer.