芍药甘草汤加减治疗常见胃黏膜相关疾病研究进展

A review on Shaoyao Gancao decoction in the treatment of common gastric mucosa-related diseases

芍药甘草汤是经典的中药配伍方剂,源自中医经典古籍《伤寒论》,是经过长时间实践所得出的经验组方,由芍药和甘草组成,药简力宏。胃黏膜由胃腔表面覆盖的上皮层、固有层和黏膜肌层共同形成。生理情况下,胃黏膜的防御因子和侵袭因子处于动态平衡状态。当两者之间的平衡失调时,胃黏膜会受到损伤,从而出现胃黏膜相关疾病。临床研究表明芍药甘草汤加减能促进表皮生长因子、一氧化氮等保护因子合成,促进氧自由基清除剂超氧化物歧化酶的合成,降低丙二醛等攻击因子的损害,从而达到对胃黏膜的保护作用。慢性胃炎是由多种原因引起的胃黏膜的慢性炎性反应,胃溃疡是指在各种致病因子的作用下胃黏膜发生的炎性反应与坏死性病变,二者为临床常见胃黏膜相关疾病。西医治疗胃黏膜相关疾病的近期疗效较好,但也有易复发等不足,故临床在常见胃黏膜相关疾病的诊疗中,可在西医常规治疗的基础上结合中医理论,辨证配合使用芍药甘草汤加减,从而提高临床治疗有效率。文章就近年来芍药甘草汤及常见加减方如延附芍药甘草汤、一贯煎合芍药甘草汤等治疗慢性胃炎、胃溃疡的相关研究结果进行论述,为芍药甘草汤加减治疗胃黏膜相关疾病的进一步研究奠定基础。

Shaoyao Gancao decoction(芍药甘草汤)is a famous TCM prescription,originates from the classical TCM book Shanghan Lun(《伤寒论》).It is an experience prescription obtained from the practice for a long time,which is composed of Shaoyao(Radix Paeoniae)and Gancao(Radix Glycyrrhizae).Its composition is simple and its function is effective.The gastric mucosa is formed by the upper cortex,lamina propria and mucosal muscle covering the surface of the stomach cavity.Under physiological conditions,the defense factors and invasion factors of gastric mucosa are in a dynamic equilibrium state.When the balance between the two is interrupted,the gastric mucosa will be damaged,resulting in gastric mucosal related diseases.Clinical studies have shown that Shaoyao Gancao decoction and its modification can promote the synthesis of protective factors such as epidermal growth factor and nitric oxide,promote the synthesis of superoxide dismutase,and reduce the damage of attacking factors such as malondialdehyde,so as to achieve the protective effect on gastric mucosa.Chronic gastritis is a chronic inflammatory reaction of gastric mucosa caused by many reasons.Gastric ulcer refers to the inflammatory reaction and necrotizing lesion of gastric mucosa under the action of various pathogenic factors.Chronic gastritis and gastric ulcer are common diseases related to gastric mucosa.Western medicine has good short-term efficacy in the treatment of gastric mucosal related diseases,but there are some shortcomings such as easy recurrence of the disease.Therefore,in the clinical diagnosis and treatment of gastric mucosal related diseases,Shaoyao Gancao decoction can be used according to TCM syndrome differentiation on the basis of conventional Western medicine treatment,so as to improve the clinical treatment efficiency.This article discusses the relevant research results of Shaoyao Gancao decoction and its modification,such as Yanfu Shaoyao Gancao decoction(延附芍药甘草汤),Yiguan decoction(一贯煎)plus Shaoyao Gancao decoction in the treatment of chronic gastritis and gastric ulcer in recent years,laying a foundation for further research of Shaoyao Gancao decoction and its modification in the treatment of gastric mucosal related diseases.