摘要
目的本研究旨在基于中医土壅木郁理论,探索明析和中降逆汤对胆汁反流性胃炎(Bile Reflux Gastritis,BRG)肝胃不和证的临床医治成效及其作用机制。方法收集2020年9月~2023年9月期间收治的80例患有胆汁反流性胃炎且属肝胃不和证患者,将其随机划分成治疗组与对照组,每组各有40例。对照组运用常规西医治疗手段,治疗组则在常规西医治疗的前提下加用和中降逆汤进行医治,治疗周期为8周。研究观察两组患者治疗前后多项指标变化,包括中医证候积分(胃脘胀满、疼痛、嗳气、反酸等症状评分)、胃内胆汁反流程度(通过胃镜下胆汁反流分级评估)、胃镜观察胃黏膜损伤程度,采用生活质量评分量表评估患者生活质量,采用酶联免疫吸附试验检测血清炎症小体NLRP3水平以评估炎症状态,并记录两组患者治疗期间的并发症发生率。结果治疗后,治疗组中医证候总有效率显著高于对照组(P<0.05)。治疗组胃内胆汁反流程度明显减轻,胃镜下胆汁反流分级较对照组显著改善(P<0.05)。在接受治疗后,治疗组患者胃镜观察胃黏膜损伤程度改善更明显,该差异具有统计学意义(P<0.05)。针对生活质量评分提升情况而言,治疗组的提升幅度明显超过对照组(P<0.05)。在血清炎症小体NLRP3水平上,治疗组相较于治疗前显著下降,且该水平低于对照组,差异同样具有统计学意义(P<0.05)。治疗组的并发症发生概率显著低于对照组,组间差异有统计学意义(P<0.05)。结论基于中医土壅木郁理论的和中降逆汤联合常规西医治疗胆汁反流性胃炎肝胃不和证,在改善患者临床症状、减轻胆汁反流、缓解胃黏膜炎症、提升生活质量、抑制炎症反应以及降低并发症发生率等方面效果显著,优于单纯西医治疗,为胆汁反流性胃炎的治疗提供了新的有效方案。
Objective Based on the theory of soil obstructing wood depression in traditional Chinese medicine,the purpose of this study was to explore the clinical effect and mechanism of Hezhongjiangni Decoction in the treatment of liver and stomach disharmony syndrome of bile reflux gastritis.Methods From September 2020 to September 2023,80 patients with bile reflux gastritis and liver and stomach disorder were collected and randomly divided into treatment group and control group,with 40 cases in each group.The control group was treated with conventional Western medicine,and the treatment group was treated with Hezhongjiangni Decoction in addition to conventional Western medicine.The treatment cycle was 8 weeks.The study observed the changes of a number of indicators in the two groups before and after treatment,including TCM syndrome scores(scores of symptoms such as stomach fullness,pain,belching,and acid reflux),the degree of bile reflux in the stomach(assessed by the bile reflux classification under gastroscopy),the degree of gastric mucosa injury observed by gastroscopy,and the quality of life rating scale was used to evaluate the quality of life of patients.Serum inflammasome NLRP3 levels were measured by enzyme-linked immunosorbent assay(ELISA)to assess inflammation status,and complication rates during treatment were recorded in both groups.Results After treatment,the total effective rate of TCM syndrome in the treatment group was significantly higher than that in the control group(P<0.05).The degree of bile reflux in the stomach of the treatment group was significantly reduced,and the grade of bile reflux under gastroscopy was significantly improved compared with that of the control group(P<0.05).After receiving treatment,the gastric mucosa injury degree of patients in the treatment group improved more significantly,and the difference was statistically significant(P<0.05).The improvement of quality of life score in the treatment group was significantly higher than that in the control group(P<0.05).The level of serum inflammasome NLRP3 in the treatment group was significantly decreased compared with that before treatment,and the level was lower than that in the control group,the difference was also statistically significant(P<0.05).The probability of complications in the treatment group was significantly lower than that in the control group,and the difference between groups was statistically significant(P<0.05).Conclusion Based on the theory of soil obstructing wood depression in traditional Chinese medicine,Hezhongjiangni Decoction combined with conventional Western medicine in the treatment of liver and stomach disharmony syndrome of bile reflux gastritis has significant effects in improving patients'clinical symptoms,alleviating bile reflux,alleviating gastric mucosal inflammation,regulating gastrointestinal hormone levels,improving quality of life,inhibiting inflammatory response and reducing the incidence of complications,etc.,which is superior to Western medicine alone.It provides a new and effective scheme for the treatment of bile reflux gastritis.
作者
李静
任小军
罗云
LI Jing;REN Xiaojun;LUO Yun(Department of Gastroenterology,Dazhou Hospital of Integrated Traditional Chinese and Western Medicine,Dazhou 635000,China)
出处
《四川中医》
2025年第8期150-155,共6页
Journal of Sichuan of Traditional Chinese Medicine
基金
四川省中医药管理局科学技术专项课题(2020LC0101)。
关键词
土壅木郁理论
和中降逆汤
胆汁反流性胃炎
肝胃不和证
胃肠激素
Theory of soil obstructing and wood depression
Hezhongjiangni Decoction
Bile reflux gastritis
Liver and stomach disharmony syndrome
Gastrointestinal hormone
