姚乃礼经验方治疗慢性非萎缩性胃炎的效果观察

Observation on the clinical efficacy of Yao Naili's empirical formula in the treatment of chronic non-atrophic gastritis

目的观察姚乃礼经验方治疗慢性非萎缩性胃炎的临床疗效。方法采用前瞻性病例系列研究设计,连续入组并观察自2018年12月1日-2021年10月31日在中国中医科学院广安门医院姚乃礼门诊就诊的慢性非萎缩性胃炎患者的就诊情况,收集并统计门诊患者的一般情况及疗效评价资料(主要症状积分、主要症状治疗情况、炎症指标、胃肠激素指标、胃肠道症状分级评分表、汉密尔顿焦虑量表、自评医疗成效MYMOP量表、不良事件统计)。结果共206例患者完成研究,其中男性99例,女性107例,年龄23~83岁,中位数41.5岁,病程范围为3~372个月,中位数为13个月;治疗后胃胀、胃痛、嗳气、反酸、腹胀、烧心、嘈杂等主要症状的症状积分较治疗前均有不同程度的减低,差异具有统计学意义(P<0.01);与治疗前相比,患者白细胞介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死细胞因子-α(TNF-α)、胃泌素(GAS)水平及胃肠道症状分级评分表(GSRS)、汉密尔顿焦虑量表(HAMA)评分均显著下降,胃动素(MTL)、表皮生长因子(EGF)水平显著上升,差异具有统计学意义(P<0.01)。主要症状治疗总有效率均>75%;患者的自评医疗成效问卷(MYMOP)治疗前后总得分比较,差异具有统计学意义(P<0.01);本次临床研究期间患者均未出现不良反应。结论姚乃礼使用经验方辨证治疗慢性非萎缩性胃炎,可显著改善胃痛、胃胀、嘈杂、嗳气等临床症状,使患者炎症指标、胃肠激素指标水平恢复正常状态,改善胃肠道症状及焦虑心理状态,且未见肝、肾功能等指标的异常及不良反应。

Objective To observe the clinical efficacy of Professor Yao Naili's empirical formula in the treatment of chronic nonatrophic gastritis.Methods The prospective case series study design was used,and the patients with chronic non-atrophic gastritis who went to Professor Yao Naili's outpatient clinic in Guang'anmen Hospital,China Academy of Chinese Medical Sciences for medical treatment from December 1,2018 to October 31,2021 were continuously enrolled and observed.The general conditions and efficacy evaluation data of outpatients[major symptom score,major symptom treatment,inflammation index,gastrointestinal hormone index,gastrointestinal symptom rating scale,Hamilton Anxiety scale,Measure Yourself Medical Outcome Profile(MYMOP)scale of self-rated medical outcomes,adverse event statistics]were collected and statistically analyzed.Results A total of 206 patients completed the study,including 99 males and 107 females.The age range of the subjects was 23-83 years old,with a median of 41.5 years old.The course of disease ranged from 3 months to 372 months,with a median of 13 months.Compared with before treatment,scores of major symptoms such as distension,stomachache,belching,acid regurgitation,abdominal distension,heartburn and gastric upset were decreased to different degrees after treatment,and there was statistically significant difference(P<0.01).Compared with before treatment,the levels of interleukin-6(IL-6),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and gastrin(GAS),and the scoes of Gastrointestinal Symptom Rating Scale(GSRS)and Hamilton Anxiety Scale(HAMA)were significantly decreased,and the levels of motilin(MTL)and epidermal growth factor(EGF)were significantly increased,and there were statistically significant differences(P<0.01).The total effective rate of the main symptoms treatment was more than 75%.There was statistically significant difference in the total score of MYMOP before and after treatment(P<0.01).There were no adverse reactions observed among the patients during this clinical study.Conclusion Professor Yao Naili uses the empirical formula to treat chronic non-atrophic gastritis with syndrome differentiation,which can significantly improve the clinical symptoms such as stomach pain,distension,gastric upset and belching,restore the normal levels of inflammatory indicators and gastrointestinal hormone indicators,and improve the gastrointestinal symptoms and anxiety of the patients.This treatment method has no abnormal liver and kidney function indicators and adverse reactionas observed.