摘要
目的:评价乌芍散联合质子泵抑制剂(PPI)治疗胃内镜黏膜下剥离术(ESD)后溃疡的疗效。方法:将90例行胃ESD治疗的患者随机分为3组,对照组(30例)给予口服艾司奥美拉唑治疗,试验一组(30例)在此基础上联合铝镁加混悬液治疗,试验二组(30例)在对照组用药基础上联合乌芍散治疗,3组疗程均为8周。比较3组患者中医症状积分、人工溃疡临床愈合率以及治疗前后血清胃蛋白酶原水平变化。结果:胃ESD术后4周,试验一组与试验二组的总症状积分均低于对照组,疗效指数试验二组>试验一组>对照组,差异有统计学意义(P<0.05);胃ESD术后8周,试验二组的总症状积分低于对照组,差异有统计学意义(P<0.05)。术后8周复查胃镜,对照组临床愈合率为87.0%,试验一组临床愈合率为94.1%,试验二组临床愈合率为91.7%,3组间比较差异无统计学意义。在试验一组与试验二组中,ESD术后1周PGⅠ均比术前升高,术后8周PGⅠ均比术后1周明显降低,差异有统计学意义(P<0.05)。结论:乌芍散联合PPI可快速有效地改善患者胃ESD术后不适症状,提高患者生活质量,临床使用安全,可推广应用。
Objective: To study the clinical effect of Wushao Powder combined with proton pump inhibitors(PPI) on gastric ESD-induced ulcer. Methods: We made a analysis of 90 patients who underwent ESD at Jiangsu province hospital of Chinese Medicine between September 2018 and August 2019. They were randomLy divided into the control group(n=30), the first experimental group(n=30) and the second experimental group(n=30). The control group was given esomeprazole magnesium enteric-coated tablet, 40 mg once a day. The first experimental group was given Almgate Suspension combined with the same dose of esomeprazole. The second experimental group was given Wushao Powder combined with the same dose of esomeprazole. Three groups were treated for 8 weeks. All patients were followed up to evaluate the scores of clinical symptoms, ulcer healing rates under gastroscope and and levels of serum pepsinogen Ⅰ(PGⅠ) and pepsinogen ratio(PGR). Results: The total symptom score of the experimental groups were lower than the control group at 4 weeks after surgery(P<0.05). The efficacy index of the second experimental group at 4 weeks after ESD was higher than that of the control group, showing a statistically significant difference(P<0.05). The total symptom score of the second experimental group was lower than the control group at 8 weeks after surgery, the difference of which was statistically significant(P<0.05). The ulcer healing rate under gastroscope of the control group at 8 weeks is 87.0%,the first experimental group was 94.1%, and the second experimental group was 91.7 %,showing no statistically significant difference between the three groups.In the experimental groups, PGⅠ level increased at one week after ESD, and decreased significantly at 8 weeks(P<0.05). Conclusion: Wushao Powder combined with PPI can effectively improve uncomfortable symptoms and the quality of life of patients after gastric ESD, worthy to widely use.
作者
周婉
陈晶
韩树堂
肖君
张其德
李杨
ZHOU Wan;CHEN Jing;HAN Shutang;XIAO Jun;ZHANG Qide;LI Yang(Gastroenterology Endoscopy Center,Affiliated Hospital of Nanjing University of Chinese Medicine,Jiangsu Province Hospital of Chinese Medicine,Nanjing,210029,China)
出处
《中国中西医结合消化杂志》
CAS
2021年第8期540-544,549,共6页
Chinese Journal of Integrated Traditional and Western Medicine on Digestion
基金
江苏省中医院院级课题(No:Y2018CX03)。
