温中和胃汤联合耳穴压豆对脾胃虚寒型慢性胃炎患者治疗疗效及对血清VIP、MTL水平的影响

Therapeutic Effect of Wenzhou Hewei Decoction(温中和胃汤)Combined with ear Acupoint Pressing Beans on Patients with Chronic Gastritis of Spleen and Stomach Deficiency Cold Type and Its Impact on Serum VIP and MTL

目的 温中和胃汤联合耳穴压豆对脾胃虚寒型慢性胃炎(CG)患者的治疗疗效及对血清VIP、MTL水平的影响。方法 选取2021年1月—2022年5月该院接收的脾胃虚寒型CG患者90例,采用随机数字表法分为观察组47例和对照组43例。所有患者均行常规治疗,同时对照组给予耳穴压豆治疗,观察组在对照组基础上联合温中和胃汤治疗。对比两组的治疗疗效、中医证候评分、不良反应发生情况。治疗前后,检测两组患者外周血胃肠功能指标[胃动素(MTL)、血管活性肽(VIP)]以及炎症指标[白细胞介素-1β(IL-1β)以及白细胞介素-6(IL-6)]表达水平。在患者停药3个月后,对其进行为期半年的跟踪随访调查,记录其复发情况。结果 观察组、对照组治疗总有效率分别为93.62%、76.74%,不良反应总共发生率分别为17.02%、9.30%,6个月内复发率分别为0.00%、13.95%。,观察组治疗总有效率较高、6个月复发率较低(P<0.05),两组不良反应发生率无差异(P>0.05)。治疗后中医证候对比,观察组胃隐痛、喜温喜按、劳累/受凉后症状加重和泛吐清水评分低于对照组(P<0.05),两组神疲倦怠、舌淡胖评分无差异(P>0.05)。治疗后,观察组血清MTL高于对照组(P<0.05),VIP、IL-1β低于对照组(P<0.05),两组IL-6浓度无差异(P>0.05)。结论 温中和胃汤联合耳穴压豆可有效提高脾胃虚寒型CG治疗疗效,降低VIP和IL-1β表达,同时提高MTL表达水平,降低短期内复发率。

Objective To observe the therapeutic effect of Wenzhou Hewei Decoction(温中和胃汤)combined with ear acupoint pressing on chronic gastritis(CG)patients with spleen and stomach deficiency cold type and its impact on the levels of serum VIP and MTL.Methods A total of 90 CG patients with spleen and stomach deficiency cold type admitted to the hospital between January 2021 and May 2022 were selected and divided into observation group(47 cases)and control group(43 cases)by random number table method.All patients received conventional treatment,while the control group was given ear acupoint pressing beans treatment,and the observation group on the basis of the control group combined with Wenzhou Hewei Decoction.The therapeutic effect,TCM syndrome scores and occurrence of adverse reactions were compared between the two groups.Before and after treatment,the expression levels of peripheral blood gastrointestinal function indicators[motilin(MTL),vasoactive peptide(VIP)]and inflammatory indicators[interleukin-1β(IL-1β)and interleukin-6(IL-6)]were detected in two groups.After 3 months of drug withdrawal,the patients were followed up for 6 months to record their recurrence.Results The total effective rates of the observation group and the control group were 93.62%and 76.74%,respectively.The total incidences of the observation group and the control group were 17.02%and 9.30%,while the recurrence rates within 6 months were 0.00%and 13.95%,respectively.The observation group had a higher total effective rate of treatment and a lower 6-month recurrence rate(P<0.05)and there was no difference in the incidence of adverse reactions between the two groups(P>0.05).The comparison of TCM syndromes after treatment showed that the scores of stomach dull pain,liking warm and press,symptom aggravation after fatigue/cold and excessive water spitting in the observation group were lower than those in the control group(P<0.05),and there were no difference between the two groups in the scores of mental fatigue or enlarged and pale tongue(P>0.05).After treatment,the serum MTL level in the observation group was higher than that in the control group(P<0.05),the levels of serum VIP and IL-1βwere lower than those in the control group(P<0.05),and the IL-6 level was not significantly different between the two groups(P>0.05).Conclusion Wenzhou Hewei Decoction combined with ear acupoint pressing bean can effectively improve the therapeutic effect of spleen and stomach deficiency cold type of CG,reduce the levels of VIP and IL-1β,increase the level of MTL and reduce the short-term recurrence rate.