清化和络剂治疗隆起糜烂性胃炎的临床观察及对循环炎症因子的影响
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摘要
目的:研究清化和络剂治疗隆起糜烂性胃炎的临床效果及对循环炎症因子的影响。方法:90例隆起糜烂性胃炎患者,根据数字表法随机分为3组,即中药组、西药组及联合组,每组各30例。中药组患者给予清化和络剂治疗,西药组患者给予奥美拉唑肠溶片、铝碳酸镁片治疗,联合组患者给予清化和络剂加奥美拉唑肠溶片、铝碳酸镁片治疗。对比3组患者治疗效果、治疗后症状评分、腺体萎缩、肠上皮化生、异型增生以及血清IL-8、TNF-α、IL-10变化情况。结果:联合组患者治疗总有效率(96.67%)明显高于中药组(73.33%)、西药组(66.67%),差异有统计学意义(P<0.05)。联合组患者胃脘疼痛、胃脘痞满、口苦口黏或口臭、纳呆食少、胃脘嘈杂不适、反酸、烧心、嗳气评分明显低于中药组、西药组,差异有统计学意义(P<0.05)。联合组患者治疗后腺体萎缩(3.33%)、肠上皮化生(3.33%)、异型增生发生率(3.33%)明显低于中药组(30.00%、23.33%、20.00%)、西药组(30.00%、33.33%、26.67%),差异有统计学意义(P<0.05)。联合组患者治疗后血清IL-8(7.56±1.68)ng/L、TNF-α(1.83±0.32)ng/mL、IL-10水平(6.36±1.25)μg/L明显低于中药组[(13.29±3.23)ng/L、(2.21±0.49)ng/mL、(13.13±3.44)μg/L]、西药组[(15.41±3.45)ng/L、(2.21±0.49)ng/mL、(14.87±3.56)μg/L],差异有统计学意义(P<0.05)。结论:清化和络剂联合西药治疗隆起糜烂性胃炎疗效显著,可改善临床症状,调节血清学指标水平,简便易行,不良反应较小,易于推广。
Objective: To study the clinical effect of Qinghua Heluoji in the treatment of erosive gastritis and effect on circulating inflammatory cytokines. Methods: Ninety patients with protuberant erosive gastritis were randomly divided into three groups, namely Chinese medicine group, western medicine group and combined group, 30 cases in each group. The Chinese medicine group were treated with Qinghua Heluoji and the western medicine group was given Omeprazole Enteric-coated Tablets and Hydrotalcite Tablets, and the combined group were given Omeprazole Enteric-coated Tablets, Hydrotalcite Tablets and Qinghua Heluoji. After treatment, the symptom score, gland atrophy, intestinal metaplasia, dysplasia and serum IL-8, TNF-alpha and IL-10 changes were compared among three groups. Results: The total effective rate of combined group(96.67%) was significantly higher than those of the Chinese medicine group(73.33%) and western medicine group(66.67%), and the difference was statistically significant(P<0.05). The combined group's epigastric pain, epigastric pain, sticky mouth or bad breath, poor appetite, stomach discomfort, noisy regurgitation, heartburn and belching score were significantly lower than those of the traditional Chinese medicine group and western medicine group. The difference was statistically significant(P<0.05). After treatment,the combined group's incidence of glandular atrophy(3.33%), intestinal metaplasia(3.33%) and dysplasia(3.33%) was significantly lower than those of the Chinese medicine group(30%, 23.33%, 20%) and western medicine group(30%, 33.33%, 26.67%), and the difference was statistically significant(P<0.05). After treatment,the combined group's IL-8(7.56±1.68)ng/L, TNF-alpha(1.83±0.32)ng/mL and IL-10(6.36±1.25)g/L were significantly lower than those of the Chinese medicine group [(13.29±3.23)ng/L,(2.21±0.49)ng/mL,(13.13±3.44)g/L] and western medicine group[(15.41±3.45)ng/L,(2.21±0.49)ng/mL,(14.87±3.56)g/L]. The difference was statistically significant(P<0.05). Conclusion: Qinghua Heluoji combined with western medicine treatment of erosive gastritis is significant, and can improve clinical symptoms and regulate the levels of serum markers, simple, with less side effects. It is easy to popularize.
Objective: To study the clinical effect of Qinghua Heluoji in the treatment of erosive gastritis and effect on circulating inflammatory cytokines. Methods: Ninety patients with protuberant erosive gastritis were randomly divided into three groups, namely Chinese medicine group, western medicine group and combined group, 30 cases in each group. The Chinese medicine group were treated with Qinghua Heluoji and the western medicine group was given Omeprazole Enteric-coated Tablets and Hydrotalcite Tablets, and the combined group were given Omeprazole Enteric-coated Tablets, Hydrotalcite Tablets and Qinghua Heluoji. After treatment, the symptom score, gland atrophy, intestinal metaplasia, dysplasia and serum IL-8, TNF-alpha and IL-10 changes were compared among three groups. Results: The total effective rate of combined group(96.67%) was significantly higher than those of the Chinese medicine group(73.33%) and western medicine group(66.67%), and the difference was statistically significant(P<0.05). The combined group's epigastric pain, epigastric pain, sticky mouth or bad breath, poor appetite, stomach discomfort, noisy regurgitation, heartburn and belching score were significantly lower than those of the traditional Chinese medicine group and western medicine group. The difference was statistically significant(P<0.05). After treatment,the combined group's incidence of glandular atrophy(3.33%), intestinal metaplasia(3.33%) and dysplasia(3.33%) was significantly lower than those of the Chinese medicine group(30%, 23.33%, 20%) and western medicine group(30%, 33.33%, 26.67%), and the difference was statistically significant(P<0.05). After treatment,the combined group's IL-8(7.56±1.68)ng/L, TNF-alpha(1.83±0.32)ng/mL and IL-10(6.36±1.25)g/L were significantly lower than those of the Chinese medicine group [(13.29±3.23)ng/L,(2.21±0.49)ng/mL,(13.13±3.44)g/L] and western medicine group[(15.41±3.45)ng/L,(2.21±0.49)ng/mL,(14.87±3.56)g/L]. The difference was statistically significant(P<0.05). Conclusion: Qinghua Heluoji combined with western medicine treatment of erosive gastritis is significant, and can improve clinical symptoms and regulate the levels of serum markers, simple, with less side effects. It is easy to popularize.
引文
[1] 毛欣欣,柯晓,纪立金.隆起糜烂性胃炎病因及发病机制研究现况[J].辽宁中医药大学学报,2014,16(2),214-217.
[2] 张杰,徐进康.中医治疗糜烂性胃炎的Meta分析[J].中国医刊,2016,51(10):84-87.
[3] 杨亮,孟祥莉.疏肝健脾和胃通降法治疗胆汁反流性胃炎临床研究[J].四川中医,2017,35(6):86-88
[4] 孙克明,刘宪勇,毕文超,等.化浊解毒方联合兰索拉唑肠溶胶囊治疗浊毒内蕴证慢性糜烂性胃炎的临床观察[J].中医药导报,2016,22(19):97-98,101.
[5] 王相东,杨帆,方瑜.活血养胃汤加减治疗慢性萎缩性胃炎临床研究[J].山东中医药大学学报,2015,39(5):425-427.
[6] Takeichi Yoshida,Jun Kato,Izumi Inoue,et al.Comparative analysis of upper gastrointestinal endoscopy,doublecontrast upper gastrointestinal barium X-ray radiography and the titer of serum anti-Helicobacter pylori IgG focusing on the diagnosis of atrophic gastritis[J].Gastric Cancer,2016,19(2):670-675.
[7] 郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002.
[8] 朱永钦,朱永苹,黄连梅,等.慢性萎缩性胃炎中医病因病机和辨证分型的临床研究进展[J].中华中医药学刊,2017,35(2):322-325.
[9] 董兵轮,杜明.养胃配方颗粒组方对慢性萎缩性胃炎患者血清炎症指标及中医症状积分影响[J].辽宁中医药大学学报,2017,19(5):183-185.
[10] Fallahi P,Ferrari SM,Ruffilli I et al.Reversible normalisation of serum TSH levels in patients with autoimmune atrophic gastritis who received L-T4 in tablet form after switching to an oral liquid formulation:a case series[J].BMC Gastroenterol,2016,24(12):16-22.
[11] Rosa Ferreira,Rui Loureiro,Nuno Nunes.Role of endoscopic retrograde cholangiopancreatography in the management of benign biliary strictures:whats new[J].World Journal of Gastrointestinal Endoscopy,2016,1(4):220-231.
[12] 张声生,唐旭东.慢性胃炎中医诊疗专家共识意见[J].中华中医药杂志,2017,32(7):3060-3064.
[13] 张元忠,郭憬昱,郑丹.清胃祛湿汤联合奥美拉唑治疗脾胃湿热型慢性糜烂性胃炎的疗效分析[J].山西医药杂志,2017,46(13):1583-1585.
[14] Takeichi Yoshida,Jun Kato,Izumi Inoue,et al.Cancer development based on chronic active gastritis and resulting gastric atrophy as assessed by serum levels of pepsinogen and Helicobacter pylori antibody titer[J].International Journal of Cancer,2014,134(6):1445-1447.
[15] 金烨,张士敏,韦婧,等.幽门螺杆菌相关性胃炎患者中医证型及其与中医体质的相关性研究[J].陕西中医,2017,38(10):1380-1381.
[16] Benedetto Mangiavillano,Nico Pagano,Todd H Baron.Outcome of stenting in biliary and pancreatic benign and malignant diseases:A comprehensive review[J].World Journal of Gastroenterology,2015,14(30):9038-9054.
[17] 于永强,程秀莲.柴胡疏肝散加减治疗60例慢性萎缩性胃炎的安全性及可行性分析[J].世界中医药,2015,10(10):486-487.
[18] 肖贵容,汪开洋.健脾通络汤治疗慢性萎缩性胃炎疗效观察[J].陕西中医,2017,38(1):45-46.
[19] 谢建寰.加味六君子汤治疗脾胃虚弱型慢性萎缩性胃炎37例[J].世界中西医结合杂志,2015,10(11):1545-1548.
[20] 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.
[2] 张杰,徐进康.中医治疗糜烂性胃炎的Meta分析[J].中国医刊,2016,51(10):84-87.
[3] 杨亮,孟祥莉.疏肝健脾和胃通降法治疗胆汁反流性胃炎临床研究[J].四川中医,2017,35(6):86-88
[4] 孙克明,刘宪勇,毕文超,等.化浊解毒方联合兰索拉唑肠溶胶囊治疗浊毒内蕴证慢性糜烂性胃炎的临床观察[J].中医药导报,2016,22(19):97-98,101.
[5] 王相东,杨帆,方瑜.活血养胃汤加减治疗慢性萎缩性胃炎临床研究[J].山东中医药大学学报,2015,39(5):425-427.
[6] Takeichi Yoshida,Jun Kato,Izumi Inoue,et al.Comparative analysis of upper gastrointestinal endoscopy,doublecontrast upper gastrointestinal barium X-ray radiography and the titer of serum anti-Helicobacter pylori IgG focusing on the diagnosis of atrophic gastritis[J].Gastric Cancer,2016,19(2):670-675.
[7] 郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002.
[8] 朱永钦,朱永苹,黄连梅,等.慢性萎缩性胃炎中医病因病机和辨证分型的临床研究进展[J].中华中医药学刊,2017,35(2):322-325.
[9] 董兵轮,杜明.养胃配方颗粒组方对慢性萎缩性胃炎患者血清炎症指标及中医症状积分影响[J].辽宁中医药大学学报,2017,19(5):183-185.
[10] Fallahi P,Ferrari SM,Ruffilli I et al.Reversible normalisation of serum TSH levels in patients with autoimmune atrophic gastritis who received L-T4 in tablet form after switching to an oral liquid formulation:a case series[J].BMC Gastroenterol,2016,24(12):16-22.
[11] Rosa Ferreira,Rui Loureiro,Nuno Nunes.Role of endoscopic retrograde cholangiopancreatography in the management of benign biliary strictures:whats new[J].World Journal of Gastrointestinal Endoscopy,2016,1(4):220-231.
[12] 张声生,唐旭东.慢性胃炎中医诊疗专家共识意见[J].中华中医药杂志,2017,32(7):3060-3064.
[13] 张元忠,郭憬昱,郑丹.清胃祛湿汤联合奥美拉唑治疗脾胃湿热型慢性糜烂性胃炎的疗效分析[J].山西医药杂志,2017,46(13):1583-1585.
[14] Takeichi Yoshida,Jun Kato,Izumi Inoue,et al.Cancer development based on chronic active gastritis and resulting gastric atrophy as assessed by serum levels of pepsinogen and Helicobacter pylori antibody titer[J].International Journal of Cancer,2014,134(6):1445-1447.
[15] 金烨,张士敏,韦婧,等.幽门螺杆菌相关性胃炎患者中医证型及其与中医体质的相关性研究[J].陕西中医,2017,38(10):1380-1381.
[16] Benedetto Mangiavillano,Nico Pagano,Todd H Baron.Outcome of stenting in biliary and pancreatic benign and malignant diseases:A comprehensive review[J].World Journal of Gastroenterology,2015,14(30):9038-9054.
[17] 于永强,程秀莲.柴胡疏肝散加减治疗60例慢性萎缩性胃炎的安全性及可行性分析[J].世界中医药,2015,10(10):486-487.
[18] 肖贵容,汪开洋.健脾通络汤治疗慢性萎缩性胃炎疗效观察[J].陕西中医,2017,38(1):45-46.
[19] 谢建寰.加味六君子汤治疗脾胃虚弱型慢性萎缩性胃炎37例[J].世界中西医结合杂志,2015,10(11):1545-1548.
[20] 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.