黄芪建中汤加减联合肝胃百合汤对老年胃溃疡患者胃运动功能和溃疡愈合的影响

Effects of Huangqi Jianzhong Decoction combined with Ganwei Baihe Decoction on gastric motor function and ulcer healing in elderly patients with gastric ulcer

目的观察黄芪建中汤加减联合肝胃百合汤治疗老年胃溃疡对患者胃运动功能和溃疡愈合情况的影响。方法选取老年胃溃疡患者106例,随机分为两组,每组53例。对照组给予常规西医对症治疗,观察组在对照组基础上给予黄芪建中汤加减联合肝胃百合汤治疗,连续治疗6 w。记录两组治疗前后溃疡愈合指标、胃运动功能指标、核转录因子(NF)-κB、白细胞介素(IL)-8、IL-4、三叶因子(TFF)2及中医症候积分的变化,并统计两组幽门螺旋杆菌(Hp)阴性率和不良反应率。结果治疗后两组溃疡底部的厚苔面积、溃疡周围黏膜充血面积及溃疡周围再生上皮面积较治疗前显著下降(P<0.05),观察组上述指标均显著低于对照组(P<0.05)。观察组Hp阴性率(88.68%)显著高于对照组(73.58%,P<0.05)。治疗后两组胃窦收缩幅度及胃窦、十二指肠协调性较治疗前显著上升(P<0.05),胃排空时间、胃窦收缩频率较治疗前显著下降(P<0.05),观察组胃运动功能显著优于对照组(P<0.05)。治疗后两组胃脘隐痛、空腹病重、神疲乏力、面色无华、手足不温及大便溏薄积分均较治疗前显著下降(P<0.05),观察组各项中医症候积分显著低于对照组(P<0.05)。治疗后两组IL-4、TFF2治疗前显著上升(P<0.05),NF-κB、IL-8较治疗前显著下降(P<0.05),观察组IL-4、TFF2显著高于对照组(P<0.05),NF-κB、IL-8显著低于对照组(P<0.05)。治疗期间,观察组总不良反应率为7.55%,与对照组的11.32%进行组间比较发现,差异无统计学意义(P>0.05)。结论黄芪建中汤加减联合肝胃百合汤治疗老年胃溃疡可调节相关因子的表达,改善胃运动功能,促进溃疡愈合。

Objective To observe the effect of Huangqi Jianzhong Decoction combined with Ganwei Baihe Decoction on gastric motor function and ulcer healing in elderly patients with gastric ulcer.Methods 106 elderly patients with gastric ulcer were radomly divided into two groups,with 53 cases in each group.The control group was treated with routine western medicine,and the observation group was treated with Huangqi Jianzhong Decoction combined with Ganwei Baihe Decoction on the basis of the control group for 6 weeks.The changes of ulcer healing index,gastric motor function index,nuclear transcription factor(NF)-κB,interleukin(IL)-8,IL-4,trifoliate factor(TFF)2 and TCM symptom score before and after treatment were recorded,and the negative rate and adverse reaction rate of helicobacter pylori(Hp)were counted in two groups.Results The area of thick moss at the bottom of the ulcer,the area of mucosal congestion around the ulcer and the area of regenerated epithelium around the ulcer in two groups were significantly decreased after treatment compared with before treatment(P<0.05),the above indexes in the observation group were significantly lower than those in the control group(P<0.05).The negative rate(88.68%)of Hp in the observation group was significantly higher than that in the control group(73.58%,P<0.05).The amplitude of antral contraction,the coordination of antral and duodenum were significantly increased(P<0.05),the time of gastric emptying and the frequency of antral contraction were significantly decreased(P<0.05)in the two groups after treatment compared with before treatment,the gastric motor function in the observation group was significantly better than that in the control group(P<0.05).After treatment,the epigastric pain,serious illness on empty stomach,lethargy,pale face,warm hands and feet and thin stool sugar score were significantly decreased in two groups compared with before treatment(P<0.05),the scores of TCM symptoms in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the IL-4,TFF2 of the two groups were significantly increased compared with before treatment(P<0.05),and the levels of NF-κB,IL-8 were significantly decreased compared with before treatment(P<0.05),the levels of IL-4,TFF2 of the observation group were significantly higher than those of the control group(P<0.05),and the levels of NF-κB,IL-8 of the observation group were significantly lower than those of the control group(P<0.05).During the treatment period,the adverse reaction rate of the observation group was 7.55%,which was not statistically significant compared with 11.32%of the control group(P>0.05).Conclusions Huangqi Jianzhong Decoction combined with Ganwei Baihe Decoction to treat senile gastric ulcer could regulate the expression of related factors,improve gastric motor function and promote ulcer healing.