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三亚市中医院,海南 三亚 572000
褚雪菲,硕士,副主任医师,从事中医内科疾病的临床工作,E-mail:123344393@qq.com
* 刘道龙,硕士,副主任医师,从事老年疾病的临床工作,E-mail:27992824@qq.com
收稿日期:2020-10-16,
网络出版日期:2020-12-04,
纸质出版日期:2021-09-20
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褚雪菲,刘道龙,韩广明.芍药甘草汤合一贯煎加减治疗慢性萎缩性胃炎胃阴不足证的影响[J].中国实验方剂学杂志,2021,27(18):107-112.
CHU Xue-fei,LIU Dao-long,HAN Guang-ming.Influence Modified of Shaoyao Gancaotang Combined with Yiguanjian on Chronic Atrophic Gastritis with Deficiency of Stomach Yin[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(18):107-112.
褚雪菲,刘道龙,韩广明.芍药甘草汤合一贯煎加减治疗慢性萎缩性胃炎胃阴不足证的影响[J].中国实验方剂学杂志,2021,27(18):107-112. DOI: 10.13422/j.cnki.syfjx.20210232.
CHU Xue-fei,LIU Dao-long,HAN Guang-ming.Influence Modified of Shaoyao Gancaotang Combined with Yiguanjian on Chronic Atrophic Gastritis with Deficiency of Stomach Yin[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(18):107-112. DOI: 10.13422/j.cnki.syfjx.20210232.
目的
2
观察芍药甘草汤合一贯煎加减治疗慢性萎缩性胃炎(CAG)胃阴不足证的临床疗效及对预后风险的影响。
方法
2
将110例患者按随机数字表法分为对照组54例和观察组56例。两组均给予根除幽门螺杆菌(Hp)治疗措施。对照组口服养胃舒胶囊,3粒/次,2次/d;观察组口服芍药甘草汤合一贯煎加减,1剂/d。两组疗程均为16周。进行治疗前后胃镜病理评估,进行萎缩程度(OLGA)及肠化程度(OLGIM)分级评价,对萎缩程度,肠化程度,Hp感染,慢性炎性反应,活动性进行评分,并进行胃镜黏膜征象评分;进行治疗前后消化不良症状和胃肠病患者报告的结局指标(PRO)评分;检测治疗前后胃蛋白酶原Ⅰ(PG Ⅰ),PGⅡ,促胃液素-17(G-17),细胞毒素相关蛋白(CagA)和空泡细胞毒素(VacA)。
结果
2
观察组临床疗效高于对照组(
Z
=2.068,
P
<
0.05);观察组萎缩程度、肠化程度、慢性炎性反应和活动性评分均低于对照组(
P
<
0.01);观察组OLGA(
Z
=2.037,
P
<
0.05)和OLGIM(
Z
=2.014,
P
<
0.05)评估均高于对照组;观察组PGⅠ,G-17水平和PG Ⅰ/PG Ⅱ均高于对照组(
P
<
0.01);观察组CagA和VacA阳性率均低于对照组(
P
<
0.05);观察组胃镜黏膜征象、消化不良症状和PRO评分均低于对照组(
P
<
0.01)。
结论
2
在根除Hp的基础上,给予芍药甘草汤合一贯煎加减内服治疗CAG胃阴不足证患者,可减轻临床症状,提高患者生活质量,促进黏膜修复,改善了病理组织学病变,缩小了胃黏膜萎缩程度和范围,有利于延缓病变进展和降低癌变风险,有着较好的临床疗效,值得进一步深入研究。
Objective
2
To observe clinical effect on chronic atrophic gastritis (CAG) with deficiency of stomach Yin when modified Shaoyao Gancaotang combined with Yiguanjian used on patients, and to study influence to prognostic risk.
Method
2
One hundred and ten cases patients were randomly divided into control group 54 cases and observation group 56 cases. Two groups got treatment of eradication of
Helicobacter pylori
(Hp). Patients in control group got Yangweishu capsules, 3 grains/time, 2 times/day. Patients in observation groups when Shaoyao Gancaotang combined with Yiguanjian modified, 1 dose/day. The treatment continued for 16 weeks. Before and after treatment, gastroscope was discussed and operative link for gastritis assessment (OLGA) and operative link on intestinal-metaplasia assessment (OLGIM) were recorded, scores of atrophic degree, intestinal metaplasia degree, Hp infection, chronic inflammatory reaction, activity, endoscopic mucosal signs, dyspepsia symptoms, reported outcome patients reported outcomes (PRO) of patients with gastrointestinal diseases were graded. And to test levels of pepsinogenⅠ (PG Ⅰ),PGⅡ, gastrin-17 (G-17), cytotoxin associated gene A (CagA) and vacuolar cytotoxin (VacA).
Result
2
The effect of patients treated in observation group was better than the effect of patients received measures in control group (
Z
=2.068,
P
<
0.05). Scores of atrophic degree, intestinal metaplasia degree, chronic inflammatory reaction and activity were lower than the scores of patients received measures in control group (
P
<
0.01). Levels of OLGA (
Z
=2.037,
P
<
0.05) and OLGIM (
Z
=2.014,
P
<
0.05) of patients treated in observation group were better than the levels of patients received measures in control group. And levels of PGⅠ, G-17 and PG Ⅰ/PGⅡ of patients treated in observation group were higher than the dates of patients received measures in control group (
P
<
0.01). Positive rates of CagA and VacA were all lower than the dates in control group (
P
<
0.05). And gastroscopic mucosal signs and dyspepsia symptoms and scores of PRO were all lower than dates of patients received measures in control group (
P
<
0.01).
Conclusion
2
On the basis of eradicating Hp, treatment of Shaoyao Gancaotang with Yiguanjian modified can relieve the clinical symptoms, improve the quality of life of patients, promote mucosal repair, improve the pathological changes, reduce the degree and scope of gastric mucosal atrophy, which is conducive to delay the progression of lesions and reduce the risk of canceration when it used on CAG. It has good clinical efficacy and was worthy of further study
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