开胃进食汤加味治疗脾胃虚弱证幽门螺杆菌感染慢性萎缩性胃炎临床研究

Clinical Study on Modified Kaiwei Jinshi Tang for Chronic Atrophic Gastritis Infected by Helicobacter Pylori with Spleen-Stomach Weakness Syndrome

目的:观察开胃进食汤加味治疗幽门螺杆菌(Hp)感染慢性萎缩性胃炎(CAG)的临床疗效。方法:选择Hp感染CAG患者108例,随机分为治疗组与对照组各54例。2组均给予四联疗法治疗,对照组加用多潘立酮片口服,治疗组在对照组的基础上加用开胃进食汤加味内服。2组疗程均为12周。观察比较2组胃黏膜病理评分、脾胃虚弱证证候评分以及临床总体疗效。结果:治疗组总有效率为92.59%,对照组为77.78%,2组比较,差异有统计学意义(P<0.05)。治疗前,2组胃黏膜慢性炎性反应、活动性、萎缩、肠化生评分比较,差异无统计学意义(P>0.05);治疗后,2组胃黏膜慢性炎性反应、活动性、萎缩、肠化生评分均较治疗前显著降低(P<0.05),且治疗组上述各项评分均低于对照组(P<0.05)。治疗前,2组胃脘胀满、胃部喜按、食少纳呆、大便稀溏、倦怠乏力、气短懒言、食后脘闷等证候评分比较,差异无统计学意义(P>0.05);治疗后,2组上述各项中医证候评分均较治疗前降低(P<0.05),且治疗组各项评分均低于对照组(P<0.05)。结论:在西医常规治疗的基础上加用开胃进食汤加味治疗Hp感染CAG患者,可进一步改善脾胃虚弱证证候评分及胃黏膜病变,临床疗效肯定。

Objective:To observe the clinical effect of the therapy of modified Kaiwei Jinshi Tang on chronic atrophic gastritis(CAG) infected by helicobacter pylori(Hp) with spleen-stomach weakness syndrome.Methods:A total of 108 patients with CAG infected by Hp were randomly divided into the treatment group and the control group,with 54 cases in each group. Both groups were given quadruple therapy. The control group was additionally treated with domperidone tablets orally,and the treatment group was additionally treated with modified Kaiwei Jinshi tang based on the treatment of the control group. Both groups were treated for 12 weeks. The pathological scores of gastric mucosa, syndrome scores of spleen-stomach weakness and clinical effects in the two groups were observed and compared. Results:The total effective rate was 92.59% in the treatment group and 77.78% in the control group,the difference being significant(P<0.05). Before treatment, there was no significant difference being found in the comparisons of the scores of chronic inflammatory responses, activity, atrophy and intestinal metaplasia of gastric mucosa between the two groups(P>0.05). After treatment, the scores of chronic inflammatory responses,activity,atrophy and intestinal metaplasia of gastric mucosa were significantly decreased when compared with those before treatment(P<0.05),and the above four scores in the treatment group were lower than those in the control group(P<0.05). Before treatment,there was no significant difference being found in the comparisons of scores of stomach cavity fullness,preference to stomach compression,torpid intake,sloppy stool,fatigue and lack of strength,shortage of qi and unwillingness to talk and gastric stuffiness after eating between the two groups(P>0.05);after treatment, the above seven traditional Chinese medicine(TCM) syndrome scores in the two groups were decreased when compared with those before treatment,and the above seven scores in the treatment group were lower than those in the control group(P<0.05). Conclusion:The therapy of modified Kaiwei Jinshi Tang based on routine western medicine can further improve the gastric mucosa and TCM syndromes of patients with CAG infected by Hp,with a better effect.