五丹胃福汤联合针刺治疗慢性萎缩性胃炎临床研究

Clinical Study on Treatment of Chronic Atrophic Gastritis with Wudan Weifu Decoction Combined with Acupuncture and Moxibustion

目的:观察五丹胃福汤联合针刺治疗慢性萎缩性胃炎(chronic atrophic gastritis,CAG)的临床疗效及其对胃黏膜病理组织学、核转录因子-κB(nuclearfactor-kappa B,NF-κB)及环氧化酶-2(cyclooxygenenase-2,COX-2)水平的影响。方法:将98例CAG患者按照随机数字表法分为观察组和对照组,每组各49例。对照组采用针刺治疗,观察组在对照组治疗的基础上联合五丹胃福汤治疗。比较两组患者的临床疗效和病理组织学疗效,观察两组患者治疗前后中医证候积分、胃黏膜病理组织学评分、NF-κB及COX-2表达水平变化情况。结果:观察组有效率为93.88%,对照组有效率为79.59%,两组患者临床疗效比较,差异具有统计学意义(P<0.05)。两组患者治疗后中医证候积分低于本组治疗前,且治疗后观察组低于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后胃黏膜病理组织学评分低于本组治疗前,且治疗后观察组低于对照组,差异具有统计学意义(P<0.05)。观察组有效率为87.76%,对照组有效率为71.43%,两组患者病理组织学疗效比较,差异具有统计学意义(P<0.05)。两组患者治疗后NF-κB和COX-2水平低于本组治疗前,且治疗后观察组低于对照组,差异具有统计学意义(P<0.05)。结论:五丹胃福汤联合针刺治疗CAG,改善患者的中医证候,抑制胃黏膜病理组织学变化,降低血清NF-κB和COX-2水平。

Objective:To observe the clinical efficacy of Wudan Weifu Decoction(五丹胃福汤,WDWFD) combined with acupuncture and moxibustion on chronic atrophic gastritis(CAG) and its influence on gastric mucosal histopathology,nuclear factor-κB(NF-κB) and cyclooxygenase-2(COX-2) levels.Methods:A total of 98 patients with CAG were divided into the observation group and the control group according to the method of random number table,with 49 cases in each group.The control group was treated with acupuncture and moxibustion,while the observation group was treated with WDWFD on the basis of the control group.The clinical efficacy and histopathological efficacy of the two groups of patients were compared,and the changes of TCM syndrome scores,gastric mucosal histopathological score,NF-κB and COX-2 expression levels were observed before and after treatment.Results:The effective rate of the observation group was 93.88%,and that of the control group was 79.59%,and the difference was statistically significant(P<0.05).The TCM syndrome scores of the two groups after treatment were lower than those of the same group before treatment,and the TCM syndrome scores of the observation group were lower than those of the control group after treatment,and the difference was statistically significant(P<0.05).The histopathological score of gastric mucosa in the two groups after treatment was lower than that of the same group before treatment,and the index in the observation group was lower than that in the control group after treatment,and the difference was statistically significant(P<0.05).The effective rate of the observation group was 87.76%,and that of the control group was 71.43%.The difference between the two groups was statistically significant(P<0.05).The levels of NF-κB and COX-2 in the two groups after treatment were lower than those in the group before treatment,and those levels in the observation group were lower than those in the control group after treatment,and all the differences were statistically significant(P<0.05).Conclusion:WDWFD combined with acupuncture and moxibustion in the treatment of CAG can improve the TCM syndromes of patients,inhibit the pathological and histological changes of gastric mucosa,and reduce the levels of serum NF-κB and COX-2.