理中汤加减联合针灸调治慢性糜烂性胃炎的临床效果

Clinical Effect on the Treatment of Chronic Atrophic Gastritis with Modified Lizhong Decoction combined withAcupunctureand Moxibustion

目的 探讨理中汤加减联合针灸调治慢性糜烂性胃炎(CEG)的临床效果。方法 选取2020年4月至2021年4月于辽宁中医药大学附属第四医院脾胃科病房就诊的84例CEG患者作为研究对象,根据住院病历号随机分为对照组与观察组,每组42例。两组患者入院后均给予对症治疗,对照组在基础治疗上给予硫糖铝混悬凝胶、泮托拉唑肠溶胶囊治疗,观察组给予理中汤加减口服,同时给予患者针灸治疗。比较两组患者中医证候评分、胃黏膜组织病理情况、表皮生长因子(EGF)、胃蛋白酶原Ⅰ(PGⅠ)、胃泌素(GAS)、治疗有效率和不良反应发生率。结果 观察组治疗有效率为97.62%(41/42),高于对照组的90.48%(38/42),差异有统计学意义(P<0.05);对照组不良反应发生率为7.14%,观察组不良反应发生率为9.52%,观察组略高于对照组,但差异无统计学意义(P>0.05);治疗后两组中医证候积分、胃黏膜组织病理情况评分有所降低,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后,对照组及观察组EGF水平较治疗前降低,GAS、PGⅠ水平较治疗前升高,且观察组各指标改善程度更显著,差异有统计学意义(P<0.05)。结论 理中汤加减联合针灸治疗CEG具有确切的疗效,其可以通过改善患者胃黏膜损伤,使胃分泌激素及蛋白酶水平升高,最终改善胃消化功能,使患者的临床症状得到明显改善。

Objective To explore the clinical effect of Lizhong Decoction plus acupuncture and moxibustion on chronic erosive gastritis(CEG).Methods 84 CEG patients who visited the Spleen and Stomach Department of the Fourth Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from April 2020 to April 2021 were selected as the research subjects.They were randomly divided into a control group and an observation group based on their hospitalization records,with 42 patients in each group.Both groups of patients were given symptomatic treatment after admission.The control group was given sucralfate suspension gel and pantoprazole enteric coated capsule on the basis of basic treatment.The observation group was given Lizhong Decoction plus or minus oral administration,and the patients were given acupuncture and moxibustion treatment.The TCM syndrome score,histopathology of gastric mucosa,epidermal growth factor(EGF),pepsinogen I(PG I),Gastrin(GAS),treatment efficiency and adverse reaction rate were compared between the two groups.Results The effective rate of treatment in the observation group was 97.62%(41/42),which was higher than 90.48%(38/42)in the control group,with a statistically significant difference(P<0.05);The incidence of adverse reactions in the control group was 7.14%,while the incidence of adverse reactions in the observation group was 9.52%,the observation group was slightly higher than the control group,but the difference was not statistically significant(P>0.05);After treatment,TCM syndrome scores and gastric mucosa histopathological scores in the two groups were decreased,and the observation group was lower than the control group,and the difference was statistically significant(P<0.05);After treatment,the levels of EGF in the control group and observation group decreased,while the levels of GAS and PG I increased,the improvement of various indicators in the observation group was more significant,and the difference was statistically significant(P<0.05).Conclusion Modified Lizhong Decoction combined with acupuncture and moxibustion has a definite curative effect in the treatment of CEG.It can improve the gastric mucosal damage,restore the levels of gastric hormones and pepsin,and finally improve the gastric digestive function,so that the patient's clinical symptoms can be significantly improved.