摘要
目的评价安中复元方联合四联疗法治疗 H.pylori 阳性慢性萎缩性胃炎(chronic atrophicgastritis, CAG)的疗效。方法将符合入选标准的 110 例 H.pylori 阳性 CAG 患者按随机数字表法分为 2组,每组 55 例。对照组采用四联疗法,研究组在对照组基础上加用安中复元方。 2 组均连续治疗 40 d。采用 ELISA 法检测血清胃蛋白酶原Ⅰ(Pepsinogen Ⅰ, PG Ⅰ)、胃蛋白酶原Ⅱ(Pepsinogen Ⅱ, PGⅡ)、促胃液素、内皮素及 CRP、 IL-6、 TNF-α水平,采用 14C 尿素呼气试验检测 H.pylori 根除率,评价临床疗效。结果研究组总有效率为 92.7%(51/55)、对照组为 78.2%(43/55), 2 组比较差异有统计学意义(χ2=4.681,P=0.031)。研究组 H.pylori 根除率为 89.1%(49/55)、对照组为 76.4%(42/55), 2 组比较差异有统计学意义(χ2=3.911, P=0.048)。治疗后,研究组血清 PGⅠ水平[(84.87±13.95)μg/L 比(78.05±12.69)μg/L, t=3.434]与 PGⅠ/PGⅡ比值[(6.71±1.26)比(5.86±1.13), t=2.861]均高于对照组(P<0.05), PGⅡ[(12.64±1.94)μg/L 比(13.31±2.10)μg/L , t = 3.725]水平低于对照组(P < 0.01);血清促胃液素[(10.76±3.06)mmol/L 比(8.11±2.84)mmol/L, t=4.707]水平高于对照组(P<0.01),内皮素[(56.64±4.42)ng/L 比(60.42±5.13)ng/L,t=4.140]水平低于对照组(P<0.01)。研究组治疗后血清 CRP、IL-6、TNF-?水平均低于对照组(t 值分别为 11.100、 9.571、 8.687, P 值均<0.001)。结论安中复元方联合四联疗法可促进 H.pylori 阳性 CAG 患者胃黏膜修复与再生,降低炎性细胞因子水平。
Objective To evaluate the efficacy of Anzhong-Fuyuan decoction combined with western routine therapy in the treatment of helicobacter pylori(H.pylori)-positive chronic atrophic gastritis (CAG). Methods A total of 110 H.pylori positive CAG patients who met the inclusion criteria were divided into two groups according to random number table method, 55 in each group. The control group was treated with quadruple therapy. On the basis of the control group, the study group was treated with Anzhong-Fuyuan decoction. Both groups were treated continuously for 40 days. The serum level of pepsinogen I (Pepsinogen ,Ⅰ PG ), pepsinogen (PG ), gastri ⅠⅡⅡ n (GAS), endothelin (ET), CRP, IL-6 and TNF-? were detected by ELISA. The eradication rate of H.pylori was measured by 14C urea breath test, and the clinical efficacy was evaluated. Results The total effective rate was 92.7%(51/55) in the study group and 78.2%(43/55) in the control group. There were significant differences between the two groups (χ2=4.681, P=0.031). The eradication rate of H.pylori was 89.1%(49/55) in the study group and 76.4%(42/55) in the control group. There was significant difference between the two groups (χ2=3.911, P=0.048). After treatment, the level of serum PG (84.87 ± 13.95 g/L Ⅰ vs. 78.05 ± 12.69 g/L, t=3.434) and PG /PG (6.71 ± 1.26 ⅠⅡ vs. 5.86 ± 1.13, t=2.861) in the study group was significantly higher than those in the control group (P<0.05), and PG (12.64 ± 1.94 g/L Ⅱ vs. 13.31 ± 2.10 g/L, t=3.725) was significantly lower than those in the control group (P<0.01). The serum level of gastrin (10.76 ± 3.06 mmol/L vs. 8.11 ± 2.84 mmol/L, t=4.707) was higher than that of control group (P<0.01), endothelin (56.64 ± 4.42 ng/L vs. 60.42 ± 5.13 ng/L, t=4.140) was significantly lower than that of control group (P<0.01). After treatment, the level of CRP, IL-6 and TNF-? in the study group was significantly lower than those in the control group (t=11.100, 9.571 and 8.687, respectively, all Ps< 0.001). Conclusions The Anzhong-Fuyuan decoction combined with routine therapy can significantly enhance the gastric mucosal secretion ability of H.pylori positive CAG patients, increase the ratio of PGⅠ/PGⅡ, promote the repair and regeneration of gastric mucosa, reduce the level of inflammatory cytokines.
作者
王静
孙玉凤
李宽红
东艳蕊
邵翠翠
王文正
Wang Jing;Sun Yufeng;Li Kuanhong;Dong Yanrui;Shao Cuicui;Wang Wenzheng(Department of Digestive Hematology, People's Hospital of Nanpi County, Cangzhou 061500, China;Department of Digestive Medicine, Second Hospital of Hebei Medical University, Shijiazhuang 050000, China)
出处
《国际中医中药杂志》
2019年第6期556-560,共5页
International Journal of Traditional Chinese Medicine
基金
河北省医学科学研究重点课题计划(20171477).
关键词
幽门螺杆菌
胃炎
萎缩性
安中复元方
四联疗法
临床应用
Helicobacter pylori
Gastritis, atrophic
Anzhong-Fuyuan decoction
Quadruple therapy
Clinical application
