健脾愈胃汤联合奥美拉唑对胃溃疡脾胃虚寒证患者溃疡面积、胃肠道症状及血清TFF2水平的影响

Influence of Jianpi Yuwei Decoction Combined with Omeprazole on Ulcer Area,Gastrointestinal Symptoms,and Serum TFF2 Level in Patients with Gastric Ulcer of Symptom of Deficiency-cold in Spleen and Stomach

目的:分析健脾愈胃汤联合奥美拉唑对胃溃疡脾胃虚寒证患者溃疡面积、胃肠道症状及血清三叶因子2(TFF2)的影响。方法:选择2020年5月至2022年4月黑龙江中医药大学附属第二医院收治的100例脾胃虚寒证胃溃疡患者为研究对象,按照随机数字表法分为两组,对照组50例给予奥美拉唑治疗,中药组50例在对照组的基础上选择健脾愈胃汤治疗,比较两组患者临床疗效、周期性胃肠道症状评分、血清细胞因子、胃泌素指标及溃疡面积情况。结果:治疗后,中药组的总治疗效率为94.00%(47/50),对照组的总有效率为76.00%(38/50),中药组的总有效率高于对照组(χ^(2)=6.353,P<0.05)。与本组治疗前比较,两组患者治疗后的周期性上腹疼痛、腹胀、反酸、嗳气症状评分均下降(P<0.05);治疗后与对照组比较,中药组周期性上腹疼痛、腹胀、反酸、嗳气症状评分下降更明显(P<0.05)。与本组治疗前比较,两组患者治疗后TFF2水平升高(P<0.05),C反应蛋白(CRP)和肿瘤坏死因子-α(TNF-α)水平均降低(P<0.05);治疗后与对照组比较,中药组TFF2水平升高更明显(P<0.05),CRP和TNF-α水平均降低更明显(P<0.05)。与本组治疗前比较,两组患者治疗后的胃动素(MTL)、胃泌素(GAS)、胆囊收缩素(CCK)-33水平及溃疡面积均下降(P<0.05);治疗后与对照组比较,中药组MTL、GAS、CCK-33水平及溃疡面积均下降更明显(P<0.05)。结论:健脾愈胃汤联合奥美拉唑能减少脾胃虚寒证胃溃疡患者溃疡面积,缓解周期性胃肠道症状,提高血清TFF2水平,治疗效果显著。

Objective:To analyze the influence of Jianpi Yuwei decoction combined with omeprazole on ulcer area,gastrointestinal symptoms,and serum trefoil factor family 2(TFF2)in patients with gastric ulcer(symptom of deficiency-cold in spleen and stomach).Method:A total of 100 patients with gastric ulcer of symptom of deficiency-cold in spleen and stomach admitted to the Second Affiliated Hospital of Heilongjiang University of Chinese Medicine from May 2020 to April 2022 were regarded as the research subjects.They were randomly grouped into two groups according to the number table method.50 cases in the control group received omeprazole treatment,while 50 cases in the traditional Chinese medicine(TCM)group received Jianpi Yuwei decoction treatment on the basis of the control group.The clinical efficacy,periodic gastrointestinal symptom score,serum cytokines,gastrin indexes,and ulcer area of the two groups were compared.Result:After treatment,the total treatment efficiency of the TCM group was 94.00%(47/50),while the total effective rate of the control group was 76.00%(38/50).The total effective rate of the TCM group was higher than that of the control group(χ^(2)=6.353,P<0.05).After treatment,the scores of periodic upper abdominal pain,bloating,acid reflux,and belching symptoms in both groups decreased(P<0.05).Compared with that in the control group after treatment,the score of periodic upper abdominal pain,bloating,acid reflux,and belching symptoms in the TCM group decreased more significantly(P<0.05).After treatment,the levels of TFF2 increased in both groups(P<0.05),and C-reactive protein(CPR)and tumor necrosis factor(TNF-α)decreased(P<0.05).Compared with the control group after treatment,the TCM group showed a more significant increase in TFF2 levels(P<0.05),and CRP and TNF-α levels decreased more significantly(P<0.05).After treatment,the levels of motilin(MTL),gastrin(GAS),cholecystokinin(CCK)-33,and ulcer area decreased in both groups(P<0.05).Compared with those in the control group after treatment,the levels of MTL,GAS,CCK-33,and ulcer area in the TCM group decreased more significantly(P<0.05).Conclusion:Jianpi Yuwei decoction combined with omeprazole can reduce the ulcer area,alleviate periodic gastrointestinal symptoms,and increase serum TFF2 level in patients with gastric ulcer of symptom of deficiency-cold in spleen and stomach,with remarkable effects.