温中复原促愈汤治疗慢性萎缩性胃炎临床疗效及对胃肠道激素的影响

Clinical Effect of Wenzhong Fuxing Cuyu Decoction(温中复原促愈汤)on Chronic Atrophic Gastritis and Its Effect on Gastrointestinal Hormones

目的 评价温中复原促愈汤治疗慢性萎缩性胃炎的临床疗效及对胃肠道激素的影响。方法 以2019年3月—2020年11月来该院就诊的124例慢性萎缩性胃炎为研究对象,依据随机对照法将患者分为研究组和参照组,每组62例。参照组患者在生活方式干预的基础上,采用西药常规疗法治疗。生活方式干预包括:规律饮食,劳逸结合、保持心情舒爽,戒烟戒酒等。口服奥美拉唑肠溶胶囊,2次/d, 20 mg/次;口服克拉霉素缓释片,2次/d, 1次0.5 g/次;口服阿莫西林分散片,1次/d, 0.25 g/次。研究组在对照组治疗的基础上,口服温中复原促愈汤治疗。两组连续治疗3个月。比较两组治疗前后脾胃虚寒证中医证候积分变化;比较两组治疗疗效;比较两组治疗前后胃镜下评分、病理组织评分和生活质量评分变化情况;比较两组治疗前后胃肠激素水平变化情况。结果 研究组治疗总有效率高于参照组(P<0.05);两组治疗后胃脘痛、喜温喜按、食少纳呆、大便稀溏和乏力气短等中医证候较治疗前降低,且研究组治疗后中医证候降低幅度大于参照组(P<0.05);两组治疗后胃镜下评分、病理组织评分较治疗前降低,生活质量评分较治疗前升高。且研究组治疗后胃镜下评分、病理组织评分低于参照组,生活质量评分高于参照组(P<0.05);两组治疗后胃肠激素胃动素、胃泌素和生长抑素较治疗前升高,且研究组治疗后胃肠激素胃动素、胃泌素和生长抑素水平高于参照组(P<0.05)。结论 温中复原促愈汤治疗慢性萎缩性胃炎疗效确切,可降低患者的中医证候积分,促进胃功能恢复,调节胃肠道激素,改善患者的生活质量,提高治疗疗效,值得进一步探讨。

Objective To evaluate the clinical effect of Wenzhong Fuquyu Cuyu Decoction(温中复原促愈汤)in the treatment of chronic atrophic gastritis and its effect on gastrointestinal hormones.Methods A total of 124 cases of chronic atrophic gastritis who came to the hospital from March 2019 to November 2020 were selected as the research subjects.According to the randomized control method,the patients were divided into study group and control group,with 62 cases in each group.The control group was treated with western medicine conventional therapy on the basis of lifestyle intervention.Lifestyle interventions included regular diet,combining work and rest,keeping a good mood,giving up smoking and alcohol.Omeprazole Enteric-Dissolved Capsule was taken orally twice a day,20 mg once.Clarithromycin Sustained-Release Tablet was taken orally twice a day,0.5 g once.Amoxicillin Dispersible Tablet was taken orally once a day,0.25 g once.On the basis of the treatment in the control group,the study group was treated with Wenzhong Fuquyu Cuyu Decoction orally.The two groups were treated for 3 months.The changes of TCM syndrome scores of spleen and stomach deficiency cold syndrome were compared between the two groups before and after treatment.The therapeutic effect of the two groups was compared.The changes of endoscopic score,pathological tissue score and quality of life score were compared between the two groups before and after treatment.The changes of gastrointestinal hormone levels before and after treatment were compared between the two groups.Results The total effective rate of the study group was higher than that of the control group(P<0.05).After treatment,the symptoms of epigastric pain,warm and press,lack of food and tolerance,loose stools and weakness and shortness of breath decreased in the two groups,and the reduction of TCM symptoms in the study group was greater than that in the control group(P<0.05).After treatment,the endoscopic score and histopathological score were lower than those before treatment,while the quality of life score was higher in both groups.After treatment,the endoscopic score and pathological score of the study group were lower than those of the control group,and the quality of life score of the study group was higher than that of the control group(P<0.05).Gastrointestinal hormones(motilin,gastrin and somatostatin)increased in both groups after treatment compared with those before treatment,and the levels of motilin,gastrin and somatostatin in the study group were higher than those in the control group after treatment(P<0.05).Conclusion Wenzhong Fuquyu Cuyu Decoction has a definite curative effect on chronic atrophic gastritis,which can reduce the TCM syndrome scores,promote the recovery of gastric function,regulate gastrointestinal hormones,improve the quality of life of patients and the therapeutic effect.It is worthy of further studying.