黄芪建中汤对慢性萎缩性胃炎(脾胃虚弱证)患者胃镜指标和胃蛋白酶原变化的影响

Analysis on the changes in the gastroscopy indicators and pepsinogen in patients with chronic atrophic gastritis(syndrome of the spleen-stomach weakness)before and after a treatment with the Huangqi Jianzhong decoction

目的 分析慢性萎缩性胃炎(脾胃虚弱证)患者黄芪建中汤治疗前后胃镜指标和胃蛋白酶原变化。方法2019年1月-2022年1月海南医学院第一附属医院收治的慢性萎缩性胃炎(脾胃虚弱证)患者110例,分为对照组与研究组,各55例,方法为随机数字表法。对照组接受西医常规治疗,研究组在此基础上接受黄芪建中汤治疗,2组均治疗2个月。分析2组治疗2个月后疗效,治疗前、治疗2个月后内镜病理评分、胃蛋白酶原及胃肠道激素,治疗期间不良反应发生情况。结果 治疗2个月后,研究组总有效率为94.55%,高于对照组的81.82%(P <0.05)。与治疗前比较,治疗2个月后2组萎缩、慢性炎性反应、肠腺上皮化生、胃窦部小弯、胃窦部大弯、胃角评分均降低,且研究组更低(P <0.05);2组血清胃泌素(GAS)、胃蛋白酶原Ⅰ(PGⅠ)、PGⅠ/胃蛋白酶原Ⅱ(PGⅡ)水平升高,且研究组更高(P <0.05)。治疗期间,2组不良反应发生率比较均衡(12.73%vs 7.27%,P> 0.05)。结论 慢性萎缩性胃炎(脾胃虚弱证)患者接受黄芪建中汤治疗的疗效确切,可促进胃蛋白酶原及胃肠道激素分泌,进而改善胃镜指标,安全性良好。

Objective To analyze the changes in the gastroscopy indicators and pepsinogen in patients with chronic atrophic gastritis(syndrome of the spleen-stomach weakness)before and after a treatment with the Huangqi Jianzhong decoction.Methods From January 2019 to January 2022,110 patients with chronic atrophic gastritis(syndrome of the spleen-stomach weakness)admitted to the First Affi liated Hospital of Hainan Medical College were randomly divided into the control group and the study group,with 55 cases in each group.The control group received a routine western medicine treatment,while the study group was treated with the Huangqi Jianzhong decoction on that basis,both for 2 months.The efficacy after 2 months of treatment,the endoscopic pathological scores and the levels of pepsinogen and gastrointestinal hormones before and after 2 months of treatment,and the incidence of adverse reactions during treatment were analyzed.Results After 2 months of treatment,the total eff ective rate of the study group(94.55%)was higher than that of the control group(81.82%)(P<0.05).Compared with before treatment,the scores of atrophy,chronic infl ammatory reaction,intestinal gland metaplasia,lesser curvature of antrum,greater curvature of antrum,and gastric angle in both groups were decreased,and the scores were much lower in the study group(P<0.05).Compared with before treatment,the serum levels of gastrin(GAS),pepsinogen I(PG I)and PG I/pepsinogen II(PG II)in the two groups increased after 2 months of treatment,and the levels were much higher in the study group(P<0.05).During the treatment,there was no significant difference in the incidence of adverse reactions between the study group and the control group(12.73%vs 7.27%,P>0.05).Conclusion The Huangqi Jianzhong decoction is eff ective in the treatment of patients with chronic atrophic gastritis(syndrome of the spleen-stomach weakness),which can promote the secretion of pepsinogen and gastrointestinal hormones,and improve the indexes of gastroscopy,with a good safety.