正气散加减治疗慢性胃炎对患者生活质量、炎性因子水平的影响
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摘要
慢性胃炎是一种由多种病因导致的慢性胃黏膜炎症病变,肠化生是指胃黏膜上皮细胞转变成含有帕内特或杯状细胞的小/大肠黏膜上皮组织。慢性胃炎是胃发病率最高的疾病类型,而肠化生是慢性胃炎进展严重的表现。该实验通过探究正气散加减治疗慢性胃炎轻度肠上皮化生的疗效以及对患者生活质量和机体炎症反应的影响,分析中药方剂治疗的效果和作用机制。笔者抽选2016年4月—2017年4月收治的慢性胃炎轻度肠上皮化生患者120例作为实验对象,按照信封法分成2组,对照组患者(60例)使用法莫西丁治疗,观察组患者(60例)采用正气散加减治疗,连续治疗1个月后观察组患者治疗总有效率为93.3%,远高于对照组的80.0%;治疗后观察组患者证候积分、肠上皮化生、健康调查表(SF-36)、血清中C反应蛋白(CRP)、白细胞介素-8(IL-8)和肿瘤坏死因子-α(TNF-α)水平的变化均显著优于对照组,差异有统计学意义(P<0.05)。结果证实,正气散加减治疗慢性胃炎伴轻度肠化生效果显著,临床症状和肠化生病变改善明显,机体炎性因子清除效果显著,还能提升患者的生活质量,值得推广。
Chronic gastritis is a kind of chronic gastric mucosal inflammation caused by many factors.Intestinal metaplasia refers to the transformation of gastric mucosal epithelial cells into small/large intestinal mucosal epithelium containing Panette or goblet cells.Chronic gastritis has the highest incidence among stomach diseases,while intestinal metaplasia is the serious manifestation of chronic gastritis.In this experiment,the therapeutic effect of modified Zhengqi Powder on mild intestinal metaplasia in chronic gastritis and on patients' quality of life and inflammatory reaction was investigated to analyze the efficacy and mechanism of traditional Chinese medicine prescription.From April 2016 to April 2017,120 patients of chronic gastritis with mild intestinal metaplasia were selected and divided into two groups according to the envelope method.The control group(60 cases) was treated with famoxetine.After one month of continuous treatment,the total effective rate of treatment in the observation group was 93.3%,which was much higher than 80.0% in the control group.Health questionnaire(SF-36),serum C-reactive protein(CRP),interleukin-8(IL-8) and tumor necrosis factor-α(TNF-α) levels were significantly higher than those in the control group(P<0.05).The results showed that modified Zhengqi Powder has a significant efficacy in treat chronic gastritis with mild intestinal metaplasia,and can obviously alleviate clinical symptoms and intestinal metaplasia,remove inflammatory factors and improve the quality of life of patients,and is worth promotion.
Chronic gastritis is a kind of chronic gastric mucosal inflammation caused by many factors.Intestinal metaplasia refers to the transformation of gastric mucosal epithelial cells into small/large intestinal mucosal epithelium containing Panette or goblet cells.Chronic gastritis has the highest incidence among stomach diseases,while intestinal metaplasia is the serious manifestation of chronic gastritis.In this experiment,the therapeutic effect of modified Zhengqi Powder on mild intestinal metaplasia in chronic gastritis and on patients' quality of life and inflammatory reaction was investigated to analyze the efficacy and mechanism of traditional Chinese medicine prescription.From April 2016 to April 2017,120 patients of chronic gastritis with mild intestinal metaplasia were selected and divided into two groups according to the envelope method.The control group(60 cases) was treated with famoxetine.After one month of continuous treatment,the total effective rate of treatment in the observation group was 93.3%,which was much higher than 80.0% in the control group.Health questionnaire(SF-36),serum C-reactive protein(CRP),interleukin-8(IL-8) and tumor necrosis factor-α(TNF-α) levels were significantly higher than those in the control group(P<0.05).The results showed that modified Zhengqi Powder has a significant efficacy in treat chronic gastritis with mild intestinal metaplasia,and can obviously alleviate clinical symptoms and intestinal metaplasia,remove inflammatory factors and improve the quality of life of patients,and is worth promotion.
引文
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[14]郎振翼.不换金正气散加减治疗慢性胃炎脾胃湿热证疗效观察[J].中国医药导报,2011,8(25):91.
[15]Fehér J,Kovács I,Balacco G C.Role of gastrointestinal inflammations in the development and treatment of depression[J].Orv Hetil,2011,152(37):1477.
[16]张岩,张焱.中医从湿论治慢性胃炎研究进展[J].辽宁中医药大学学报,2015(8):115.
[17]李良霄,刘彦洁,王朝阳,等.慢性胃炎患者幽门螺杆菌感染的临床治疗及血脂与炎性因子变化[J].中华医院感染学杂志,2014,24(13):3267.
[18]刘志清,艾耀伟.胃苏颗粒联合三联疗法对慢性胃炎患者血清炎症因子的影响[J].湖北中医药大学学报,2017,19(4):24.
[19]郭平,张琼.香砂养胃丸与胃复春片对慢性萎缩性胃炎患者炎性因子水平的影响[J].检验医学与临床,2018(3):389.
[2]盛浩.黄连平胃汤治疗慢性胃炎脾胃湿热证的临床实验研究[D].济南:山东中医药大学,2005.
[3]中华医学会消化病学分会.中国慢性胃炎共识意见(下)(2006,上海)[J].现代消化及介入诊疗,2007,5(1):44.
[4]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002.
[5]危北海,陈治水,张万岱.胃肠疾病中医证候评分表[J].世界华人消化杂志,2004,12(11):2701.
[6]吴秀霞,李鲜,党中勤,等.资生汤加减治疗慢性萎缩性胃炎伴肠上皮化生的临床研究[J].中国中药杂志,2017,41(24):4882.
[7]金晓峰,王剑,李永金,等.简体中文版本嗅觉障碍生活质量量表的信度和效度分析[J].临床耳鼻咽喉头颈外科杂志,2016(18):1423.
[8]Zhao J,Cheng H,Ding Y.Research progress of fire needling for chronic gastritis[J].Chin Acupunct Moxibust,2018,38(2):223.
[9]李志茹,王滨,杨巧芳.中医诊治慢性萎缩性胃炎的研究概况及进展[J].内蒙古医科大学学报,2016,38(4):370.
[10]张永生,朱飞叶,邓建平.徐珊治疗慢性胃炎伴肠上皮化生经验[J].中医杂志,2014,55(1):15.
[11]Eun C S,Kim B K,Han D S,et al.Differences in gastric mucosal microbiota profiling in patients with chronic gastritis,intestinal metaplasia,and gastric cancer using pyrosequencing methods[J].Helicobacter,2014,19(6):407.
[12]刘小发,刘建平,杜艳茹,等.李佃贵治疗慢性萎缩性胃炎伴肠上皮化生用药特点[J].中医杂志,2017,58(7):559.
[13]杨靖,孔文霞,李培,等.李培教授治疗慢性胃炎之经验总结[J].成都中医药大学学报,2017,40(1):71.
[14]郎振翼.不换金正气散加减治疗慢性胃炎脾胃湿热证疗效观察[J].中国医药导报,2011,8(25):91.
[15]Fehér J,Kovács I,Balacco G C.Role of gastrointestinal inflammations in the development and treatment of depression[J].Orv Hetil,2011,152(37):1477.
[16]张岩,张焱.中医从湿论治慢性胃炎研究进展[J].辽宁中医药大学学报,2015(8):115.
[17]李良霄,刘彦洁,王朝阳,等.慢性胃炎患者幽门螺杆菌感染的临床治疗及血脂与炎性因子变化[J].中华医院感染学杂志,2014,24(13):3267.
[18]刘志清,艾耀伟.胃苏颗粒联合三联疗法对慢性胃炎患者血清炎症因子的影响[J].湖北中医药大学学报,2017,19(4):24.
[19]郭平,张琼.香砂养胃丸与胃复春片对慢性萎缩性胃炎患者炎性因子水平的影响[J].检验医学与临床,2018(3):389.