黄芪建中汤联合常规西药治疗慢性非萎缩性胃炎脾胃虚寒证患者的效果

Effects of Huangqi Jianzhong decoction combined with conventional Western medicine in treatment of chronic non-atrophic gastritis with spleen and stomach deficiency cold syndrome

目的:观察黄芪建中汤联合常规西药治疗慢性非萎缩性胃炎(CNG)脾胃虚寒证患者的效果。方法:选取2018年1月至2021年12月德化县中医院收治的140例CNG脾胃虚寒证患者进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各70例。对照组予以常规西药治疗,观察组在对照组基础上联合黄芪建中汤治疗,两组均连续治疗2个月。比较两组临床疗效、治疗前后中医证候积分、胃黏膜内镜分型分级、血清炎性因子[前列腺素E_(2)(PGE_(2))、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]水平和不良反应发生率。结果:观察组治疗总有效率为98.57%(69/70),高于对照组的88.57%(62/70),差异有统计学意义(P<0.05);治疗后,观察组胃部隐痛、泛吐清水、神倦纳差、大便溏薄等中医证候积分均低于对照组,胃黏膜内镜分型分级优于对照组,差异有统计学意义(P<0.05);观察组PGE_(2)水平高于对照组,TNF-α、IL-6水平均低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:黄芪建中汤联合常规西药治疗CNG脾胃虚寒证患者可提高治疗总有效率,改善胃黏膜内镜分型分级和血清炎性因子水平,降低中医证候积分,效果优于单纯常规西药治疗。

Objective:To observe effects of Huangqi Jianzhong decoction combined with conventional Western medicine in treatment of chronic non-atrophic gastritis(CNG)patients with spleen and stomach deficiency cold syndrome.Methods:A prospective study was conducted on 140 CNG patients with spleen and stomach deficiency cold syndrome admitted to the hospital from January 2018 to December 2021.According to the random number table method,they were divided into control group and observation group,70 cases in each group.The control group was treated with conventional Western medicine,while the observation group was treated with Huangqi Jianzhong decoction on the basis of that of the control group.Both groups were treated for 2 months.The clinical efficacy,the TCM syndrome scores before and after the treatment,the endoscopic classification of gastric mucosa,the serum inflammatory factor levels[prostaglandin E_(2)(PGE_(2)),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)],and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of treatment in the observation group was 98.57%(69/70),which was higher than 88.57%(62/70)in the control group,and the difference was statistically significant(P<0.05).After the treatment,the scores of TCM syndromes such as gastric dull pain,vomiting clear water,fatigue and anorexia,and loose stools in the observation group were lower than those in the control group,the endoscopic classification of gastric mucosa was better than that in the control group,and the differences were statistically significant(P<0.05).The level of PGE_(2) in the observation group was higher than that in the control group,the levels of TNF-αand IL-6 were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Huangqi Jianzhong decoction combined with conventional western medicine can improve the total effective rate of treatment,improve the endoscopic classification of gastric mucosa and the levels of serum inflammatory factors,and reduce the score of TCM syndromes in the patients with CNG spleen and stomach deficiency cold syndrome.Moreover,it is superior to single conventional western medicine treatment.