Clinical Effect of Zhiwei Pill of Bile Reflux Gastritis with Symptoms of Disharmony of Liver and Stomach

Cui-zhu CAI; Qi WANG; Shao-jun HUANG; De-xi LIU

doi:10.13422/j.cnki.syfjx.20210434

您当前的位置：

首页 >

文章列表页 >

Clinical Effect of Zhiwei Pill of Bile Reflux Gastritis with Symptoms of Disharmony of Liver and Stomach

Clinic | 更新时间：2021-07-15

- Clinical Effect of Zhiwei Pill of Bile Reflux Gastritis with Symptoms of Disharmony of Liver and Stomach
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 27, Issue 15, Pages: 57-62(2021)
- 作者机构：
  
  1.三亚市中医院，海南三亚 572000
  2.广州中医药大学，广州 510006
  3.海口市中医院，海口 570216
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20210434
  CLC： R289;R256;R256.3;R256.4
- Received：18 November 2020，
  
  Published Online：04 January 2021，
  
  Published：05 August 2021
- 稿件说明：
移动端阅览
蔡翠珠,王奇,黄少君等.治胃丸治疗肝胃不和证胆汁反流性胃炎的临床疗效[J].中国实验方剂学杂志,2021,27(15):57-62.

CAI Cui-zhu,WANG Qi,HUANG Shao-jun,et al.Clinical Effect of Zhiwei Pill of Bile Reflux Gastritis with Symptoms of Disharmony of Liver and Stomach[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(15):57-62.
蔡翠珠,王奇,黄少君等.治胃丸治疗肝胃不和证胆汁反流性胃炎的临床疗效[J].中国实验方剂学杂志,2021,27(15):57-62. DOI： 10.13422/j.cnki.syfjx.20210434.

CAI Cui-zhu,WANG Qi,HUANG Shao-jun,et al.Clinical Effect of Zhiwei Pill of Bile Reflux Gastritis with Symptoms of Disharmony of Liver and Stomach[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(15):57-62. DOI： 10.13422/j.cnki.syfjx.20210434.

摘要

目的

采用三臂试验评价治胃丸治疗肝胃不和证胆汁反流性胃炎（BRG）的临床疗效与安全性，及对胃肠激素的调节作用。

方法

将180例患者按随机数字表法分为安慰剂组、对照组和观察组各60例。三组均给予非药物治疗的生活方式干预。对照组采用铝碳酸镁片，2片/次，3次/d，餐后1～2 h或睡前或胃部不适时服用；安慰剂组采用治胃丸模拟药，6 g/次，3次/d，餐后1 h口服；观察组采用治胃丸，6 g/次，3次/d，餐后1 h口服。三组疗程均为4周。进行治疗前后肝胃不和证各症状评分和慢性胃肠疾病患者报告临床结局评价量表（PRO）评分；治疗前后检查胃镜，进行胆汁反流程度和胃镜下黏膜评分；检测治疗前后胃泌素（GAS），胃动素（MTL），胆囊收缩素（CCK）和P物质（SP）等胃肠激素水平，比较中医证候疗效和胃镜疗效；进行安全性评价。

结果

治疗后观察组肝胃不和证各主要症状和7个次症状总分均低于对照组和安慰剂组（

0.01），观察组肝胃不和证积分和PRO积分均低于对照组和安慰剂组（

0.01）；治疗后观察组胆汁反流程度评分和胃镜下黏膜评分均低于对照组和安慰剂组（

0.01）；治疗后观察组CCK水平均低于对照组和和安慰剂组（

0.01），MTL，GAS和SP水平均高于对照组和安慰剂组（

0.01）；观察组中医证候疗效总有效率为（53/58）91.38%，高于对照组的（41/57）71.93%，安慰剂组的（18/52）34.62%（

=15.248，

0.01）；观察组的胃镜疗效总有效率为（54/58）93.10%，高于对照组的（45/57）78.95%，安慰剂组的（15/52）28.85%（

=27.581，

0.05，

0.01）。未发现服用治胃丸相关不良反应。

结论

治胃丸用于肝胃不和证（BRG）患者可改善胆汁反流，促进胃镜下黏膜的愈合，并能调节胃肠激素、改善胃肠运动功能，明显缓解临床症状，提高生活质量，有着较好的中医证候疗效和胃镜下黏膜疗效，且临床使用安全。

Abstract

Objective

To evaluate the clinical efficacy of Zhiwei pill for bile reflux gastritis （BRG） with symptoms of disharmony of liver and stomach， evaluate the safety after treatment by three-arm study， and investigate the regulatory action to gastrointestinal hormones.

Method

One hundred and eighty patients were randomly divided into placebo group （60 cases）， control group （60 cases） and observe group （60 cases） by random number table. Patients in three groups got lifestyle intervention of non-drug therapy. Patients in control group got hydrotalcite tablets 1-2 hours after meal or untimely bedtime or in case of stomach pain， 2 tablets/time， 3 times/day. Patients in placebo group got simulated medicine of Zhiwei pill 1 hour after meal， 6 g/time， 3 times/day. Patients in observe group got Zhiwei pill 1 hour after meal， 6 g/time， 3 times/day. The treatment continued for 4 weeks in all 3 groups. Before and after treatment， scores were graded for symptoms of disharmony of liver and stomach and patient reported outcome （PRO） scale for patients with chronic gastrointestinal diseases. Gastroscopy was taken to grade the scores of bile reflux and mucosa under gastroscope. Levels of gastrin （GAS）， motilin （MTL）， cholecystokinin （CCK）， substance P （SP） and gastrointestinal hormones were detected. Efficacy for traditional Chinese medicine（TCM） syndrome and efficacy under gastroscope were compared， and safety after treatment was evaluated.

Result

After treatment， the total scores of the main symptoms and 7 secondary symptoms of disharmony of liver and stomach in observe group were all lower than those in placebo group and control group （

0.01）， and scores of symptoms of disharmony of liver and stomach and PRO were all lower than those in control group and placebo group （

0.01）. After treatment， scores of degree of bile reflux and mucosa under gastroscope in observe group were all lower than those in placebo group and control group （

0.01）. Level of CCK was lower than that in placebo group and control group （

0.01）， while levels of MTL， GAS and SP were higher than those in placebo group and control group （

0.01）. Total effective rate of TCM syndrome was 91.38%（53/58）， higher than 71.93%（41/57） in control group and 34.62%（18/52） in placebo group. The total effective rate in gastroscopy was 93.10%（54/58）， higher than 78.95%（45/57） in control group and 28.85%（15/52） in placebo group （

0.05 or

0.01）. No adverse reactions related to Zhiwei pill were found.

Conclusion

Zhiwei pill can improve bile reflux， promote the healing of mucosa under gastroscope， regulate gastrointestinal hormones， improve gastrointestinal motor function， significantly alleviate clinical symptoms， and improve quality of life， with better efficacy for TCM syndrome and efficacy in gastroscopy， and it is safe for clinical use.

关键词

Keywords

references

赵亚男，许翠萍 . 胆汁反流性胃炎病因病机及诊治进展［J］. 世界华人消化杂志， 2018 ， 26 （ 32 ）： 1886 - 1892 .

SHENOUDA M M ， HARB S E ， MIKHAIL S A A ， et al . Bile gastritis following laparoscopic single anastomosis gastric bypass： pilot study to assess significance of bilirubin level in gastric aspirate ［J］. Obes Surg ， 2018 ， 28 （ 2 ）： 389 - 395 .

柳鹏飞，张伟，田耀洲 . 田耀洲教授治疗胆汁反流性胃炎经验撷英［J］. 辽宁中医药大学学报， 2020 ， 22 （ 2 ）： 140 - 143 .

肖淑红，刘建浩，刘德喜，等 . 治胃丸治疗Hp相关性胃炎肝胃气滞证的临床观察［J］. 中国实验方剂学杂志， 2020 ， 26 （ 6 ）： 91 - 96 .

李建平，蔡翠珠 . 刘德喜运用“脾胃转枢理论”论治脾胃病经验［J］. 湖南中医杂志， 2016 ， 32 （ 6 ）： 25 - 26 .

蔡翠珠，王磊，刘德喜 . 刘德喜运用治胃汤治疗脾胃病临床经验［J］. 河南中医， 2015 ， 35 （ 10 ）： 2334 - 2336 .

中华医学会消化病学分会 . 中国慢性胃炎共识意见（2017年，上海）［J］. 中华消化杂志， 2017 ， 37 （ 11 ）： 721 - 738 .

张亚历 . 实用消化病学［M］. 北京：清华大学出版社， 2009 ： 120 - 123 .

中华中医药学会脾胃病分会 . 慢性胃炎中医诊疗专家共识意见（2017）［J］. 中华中医药杂志， 2017 ， 32 （ 7 ）： 3060 - 3064 .

中华医学会消化内镜学分会 . 慢性胃炎的内镜分型分级标准及治疗的试行意见［J］. 中华消化内镜杂志， 2004 ， 21 （ 2 ）： 77 - 78 .

中国中西医结合学会消化系统疾病专业委员会 . 胃肠疾病中医证候评分表［J］. 世界华人消化杂志， 2004 ， 12 （ 11 ）： 2701 - 2703 .

MCCABE M E ， DILLY C K . New causes for the old problem of bile reflux gastritis ［J］. Clin Gastroenterol Hepatol ， 2018 ， 16 （ 9 ）： 1389 - 1392 .

罗昭琼，朱永钦，朱永苹，等 . 安胃汤联合茴三硫胶囊治疗胆汁反流性胃炎寒热错杂证临床观察［J］. 辽宁中医药大学学报， 2018 ， 20 （ 5 ）： 180 - 183 .

国家食品药品监督管理局药品评审中心 . 中药新药临床研究指导原则［M］. 北京：中国医药科技出版社， 2015 ： 5 - 10 .

黄志明 . 铝碳酸镁片联合熊去氧胆酸治疗胆汁反流性胃炎的临床疗效［J］. 临床和实验医学杂志， 2014 ， 13 （ 20 ）： 1698 - 1701 .

PASQUER A ， PELASCINI E ， PONCET G ， et al . Laparoscopic treatment of gastro-gastric fistula after RYGB： technical points ［J］. Obes Surg ， 2018 ， 28 （ 5 ）： 1452 - 1453 .

RHUE K E ， BIDDICK A A ， FOLTZ K M ， et al . Emphysematous gastritis in a cat ［J］. J Vet Emerg Crit Care （San Antonio）， 2018 ， 28 （ 6 ）： 596 - 602 .

SCHUBERT M L . Functional anatomy and physiology of gastric secretion ［J］. Curr Opin Gastroenterol ， 2015 ， 31 （ 6 ）： 479 - 485 .

ZHANG J ， WANG H . Morroniside protects against chronic atrophic gastritis in rat via inhibiting inflammation and apoptosis ［J］. Am J Transl Res ， 2019 ， 11 （ 9 ）： 6016 ‐ 6023 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Correlation Between Quality of Life and Traditional Chinese Medicine Syndromes in Patients with Myasthenia Gravis

Clinical Efficacy of Modified Yigongsan Combined with Multi-enzyme Tablets and Bifidobacterium Triple Live Powder in Treatment of Infantile Anorexia with Spleen-Stomach Qi Deficiency Syndrome

Effect of Modified Qilang Prescription on Drug-dependent Constipation of Qi-Yin Deficiency Type

Clinical Observation of Bupi Qingfei Decoction in Treatment of Bronchiectasis Colonized by Pseudomonas aeruginosa

Clinical Evaluation and Mechanism of Xuesusheng Granule for Patients with Cancer Related Fatigue

Related Author

ZHANG Yibin

LU Qi

WANG Baitong

QI Yixun

XU Hanying

XU Peng

SONG Meijin

ZHAO Peixi

Related Institution

Changchun University of Chinese Medicine

The Third Affiliated Clinical Hospital of Changchun University of Chinese Medicine

The Affiliated Hospital of Changchun University of Chinese Medicine

Hebei University of Chinese Medicine

The Fourth Hospital of Shijiazhuang

AI问答

Postal code：100700
Tel：010-84076882 Email：syfjx_2010@188.com
Technical support is provided by Beijing Founder electronics co., LTD 京ICP备11006657号-10 京公网安备11010802024621
It is recommended to read the content of this site in Chrome&IE9+. Please switch to extreme mode in browser 360.
Cookies We use cookies to help provide and enhance our service and tailor content. By continuing, you agree to the use of cookies.

⁰