化痰消瘀方治疗慢性萎缩性胃炎伴胆汁反流的临床疗效及对胃肠激素和炎症、氧化应激相关因子水平的影响
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摘要
目的观察化痰消瘀方对慢性萎缩性胃炎(CAG)伴胆汁反流的临床疗效及对胃肠激素和炎症、氧化应激相关因子水平的影响。方法将98例CAG伴胆汁反流患者按照随机数字表法分为2组。对照组49例采用常规对症治疗;治疗组49例在对照组治疗基础上予化痰消瘀方治疗。2组均连续治疗4周,比较2组治疗前后临床症状和体征评分、胃肠激素[胃动素(MTL)、胃泌素(GAS)、胃蛋白酶原Ⅰ(PGⅠ)]及血清表皮生长因子(EGF)、肿瘤坏死因子α(TNF-α)、超氧化物歧化酶(SOD)、丙二醛(MDA)水平变化情况,以及24 h反流次数、最长反流时间。结果治疗后2组胃脘灼痛、口苦烧心、胃窦糜烂评分均降低(P<0.05),且治疗组各项评分均低于对照组(P<0.05)。治疗后2组MTL水平均升高(P<0.05),GAS、PGⅠ水平均降低(P<0.05);治疗组治疗后MTL水平均高于对照组(P<0.05),GAS、PGⅠ水平均低于对照组(P<0.05)。治疗后2组EGF、SOD水平均升高(P<0.05),TNF-α、MDA水平均降低(P<0.05);治疗组治疗后EGF、SOD水平均高于对照组(P<0.05),TNF-α、MDA水平均低于对照组(P<0.05)。治疗后2组24 h反流次数、最长反流时间均降低(P<0.05);且治疗组24 h反流次数及最长反流时间均低于对照组(P<0.05)。结论化痰消瘀方治疗CAG伴胆汁反流可改善胃肠激素水平,降低机体炎症、氧化应激相关因子水平,改善临床相关症状。
Objective To observe the clinical efficacy of Huatan Xiaoyu prescription on chronic atrophic gastritis(CAG) with bile reflux and its influence on gastrointestinal hormone and inflammatory and oxidative stress related factors. Methods 98 CAG patients with bile reflux were divided into two groups according to random number table method. 49 cases in control group were treated by routine symptomatic treatment. 49 cases in treatment group were treated by Huatan Xiaoyu prescription on the basis of the control group. Both groups were treated for 4 weeks. The clinical symptoms and signs scores, gastrointestinal hormones [motilin(MTL), gastrin(GAS), pepsinogen Ⅰ(PGⅠ) ], serum epidermal growth factor(EGF), tumor necrosis factor-α(TNF-α), superoxide dismutase(SOD), malondialdehyde(MDA) levels, 24-hour reflux times and the longest reflux time were compared between the two groups before and after treatment. Results After treatment, the scores of stomach burning pain, bitter mouth, heartburn and erosion of antrum in the two groups were all decreased(P<0.05), and the scores in the treatment group were lower than those in the control group(P<0.05). After treatment, MTL level in both groups were increased(P<0.05), GAS and PGⅠ levels were decreased(P<0.05); the MTL level in the treatment group was higher than that in the control group(P<0.05), and GAS and PGⅠ levels were lower than those in the control group(P<0.05). After treatment, the levels of EGF and SOD in both groups were increased(P<0.05), TNF-α and MDA were decreased(P<0.05), and the levels of EGF and SOD in the treatment group were higher than those in the control group(P<0.05), while the levels of TNF-α and MDA were lower than those in the control group(P<0.05). The 24-hour reflux times and the longest reflux time in the two groups were decreased after treatment(P<0.05), and the 24-hour reflux times and longest reflux time in the treatment group were lower than those in the control group(P<0.05). Conclusion Huatan Xiaoyu prescription in treating CAG with bile reflux can improve the level of gastrointestinal hormones, reduce the levels of inflammatory and oxidative stress related factors, and improve clinical symptoms.
Objective To observe the clinical efficacy of Huatan Xiaoyu prescription on chronic atrophic gastritis(CAG) with bile reflux and its influence on gastrointestinal hormone and inflammatory and oxidative stress related factors. Methods 98 CAG patients with bile reflux were divided into two groups according to random number table method. 49 cases in control group were treated by routine symptomatic treatment. 49 cases in treatment group were treated by Huatan Xiaoyu prescription on the basis of the control group. Both groups were treated for 4 weeks. The clinical symptoms and signs scores, gastrointestinal hormones [motilin(MTL), gastrin(GAS), pepsinogen Ⅰ(PGⅠ) ], serum epidermal growth factor(EGF), tumor necrosis factor-α(TNF-α), superoxide dismutase(SOD), malondialdehyde(MDA) levels, 24-hour reflux times and the longest reflux time were compared between the two groups before and after treatment. Results After treatment, the scores of stomach burning pain, bitter mouth, heartburn and erosion of antrum in the two groups were all decreased(P<0.05), and the scores in the treatment group were lower than those in the control group(P<0.05). After treatment, MTL level in both groups were increased(P<0.05), GAS and PGⅠ levels were decreased(P<0.05); the MTL level in the treatment group was higher than that in the control group(P<0.05), and GAS and PGⅠ levels were lower than those in the control group(P<0.05). After treatment, the levels of EGF and SOD in both groups were increased(P<0.05), TNF-α and MDA were decreased(P<0.05), and the levels of EGF and SOD in the treatment group were higher than those in the control group(P<0.05), while the levels of TNF-α and MDA were lower than those in the control group(P<0.05). The 24-hour reflux times and the longest reflux time in the two groups were decreased after treatment(P<0.05), and the 24-hour reflux times and longest reflux time in the treatment group were lower than those in the control group(P<0.05). Conclusion Huatan Xiaoyu prescription in treating CAG with bile reflux can improve the level of gastrointestinal hormones, reduce the levels of inflammatory and oxidative stress related factors, and improve clinical symptoms.
引文
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[17] 郝婷婷,马晓鹏,温彦丽,等.幽门螺杆菌感染慢性胃炎患者血清TNF-α、IL-8和VEGF水平及其与胃炎严重程度的相关性研究[J].胃肠病学和肝病学杂志,2016,25(7):769-772.
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[19] 叶玉枝,王昕,刘明辉,等.一贯煎对卵巢早衰大鼠模型脂质过氧化状态的影响[J].中华中医药学刊,2016,34(10):2431-2434.
[20] 李宁宁,郭海,雷延飞.半夏厚朴汤加味对慢性萎缩性胃炎大鼠胃黏膜血流量及脂质过氧化损伤的影响研究[J].现代中西医结合杂志,2016,25(20):2170-2171.
[2] 丁士刚,王晔.胆汁反流性胃病的诊断[J].中华消化杂志,2016,36(6):365-368.
[3] 侯叶廷,苏秉忠,闫文全.胆汁反流性胃炎胃动力及幽门螺杆菌感染情况的临床研究[J].现代消化及介入诊疗,2016,21(5):753-755.
[4] 朱永钦,罗昭琼,朱永苹,等.中医药治疗胆汁反流性胃炎临床研究概况[J].山东中医药大学学报,2017,41(2):189-192.
[5] 王吉耀.内科学[M].北京:人民卫生出版社,2001:404-407.
[6] 郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:124-128.
[7] Szarszewski A,Korzon M,Kamiska B,et al.Duodenogastric reflux:clinical and therapeutic aspects[J].Arch Dis Child,1999,81(1):16-20.
[8] 王玉富.铝碳酸镁联合胃炎康胶囊治疗胆汁反流性胃炎疗效评价[J].中国药业,2017,26(15):32-34.
[9] Yamada S,Tomatsuri N,Kawakami T,et al.Helicobacter pylori Eradication Therapy Ameliorates Latent Digestive Symptoms in Chronic Atrophic Gastritis[J].Digestion,2018,97(4):333-339.
[10] 黄璠,朱云清.熊去氧胆酸对原发性胆汁反流性胃炎的疗效观察[J].西南国防医药,2017,27(11):1218-1220.
[11] 张丹,曾志,魏睦新.化痰消瘀方加减治疗萎缩性胃炎伴胆汁反流疗效观察[J].中国中西医结合消化杂志,2016,24(5):383-386.
[12] 熊利红.自拟调脾养胃汤对胆汁反流性胃炎患者胃肠激素及血清炎症因子的影响[J].现代中西医结合杂志,2018,27(8):889-891.
[13] Teruel C,Jesús de Higes M,Luengo P,et al.Symptomatic Non-acidic Reflux in a Patient With Chronic Autoimmune Atrophic Gastritis Successfully Treated With Anti-reflux Surgery[J].J Neurogastroenterol Motil,2018,24(1):159-160.
[14] 黄铭涵,王文荣,黄健,等.中药复方清化饮对慢性萎缩性胃炎大鼠血清IL-10、NO、GAS及血浆MTL的影响[J].西安交通大学学报(医学版),2018,39(1):116-120.
[15] 陈伟军,郑献敏,梁建华.健胃消痞汤配合针刺治疗对慢性萎缩性胃炎患者血清表皮生长因子、一氧化氮的影响[J].河北中医,2017,39(2):194-198.
[16] 朱旭刚.越鞠丸配合熊去氧胆酸对肝气犯胃型胆汁反流性胃炎患者疗效及血浆MTL、VIP的影响[J].中国初级卫生保健,2017,31(12):85-87.
[17] 郝婷婷,马晓鹏,温彦丽,等.幽门螺杆菌感染慢性胃炎患者血清TNF-α、IL-8和VEGF水平及其与胃炎严重程度的相关性研究[J].胃肠病学和肝病学杂志,2016,25(7):769-772.
[18] 王丽梅.中西医结合疗法对慢性萎缩性胃炎患者效果及血清炎症因子的影响[J].甘肃科技,2017,33(3):105-106.
[19] 叶玉枝,王昕,刘明辉,等.一贯煎对卵巢早衰大鼠模型脂质过氧化状态的影响[J].中华中医药学刊,2016,34(10):2431-2434.
[20] 李宁宁,郭海,雷延飞.半夏厚朴汤加味对慢性萎缩性胃炎大鼠胃黏膜血流量及脂质过氧化损伤的影响研究[J].现代中西医结合杂志,2016,25(20):2170-2171.
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