血清胃蛋白酶原在中医药治疗慢性萎缩性胃炎疗效量化评估的应用价值与可行性分析
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摘要
[目的]探讨血清胃蛋白酶原(PG)在中医药治疗慢性萎缩性胃炎(CAG)疗效量化评估的应用价值与可行性。[方法]选取肇庆市中医院2016年1月~2017年12月住院的36例慢性萎缩性胃炎患者采用中药四君子汤加减治疗并跟踪随访。使用本研究建立的PGⅠ、PGⅡ定量检测技术并结合胃镜及病理检查,每3个月对治疗患者进行疗效评价,以期建立中药治疗CAG疗效的量化评价模式,筛选疗效更快、更好的中药治疗CAG的方案。[结果]治疗前,患者血清都呈现PGⅠ低水平和PGⅡ高水平;中医治疗3个月后中成药治疗组PGⅠ水平明显上升,PGⅡ水平明显下降,PGⅠ/PGⅡ值升高(P<0.05);治疗6个月后检测到PGⅠ水平的明显升高和PGⅡ水平的明显降低(P<0.05),胃镜和病理结果也显示胃萎缩现象有缓解趋势;9个月后监测显示实验组血清PGⅠ水平和PGⅠ/PGⅡ比值持续升高,PGⅡ水平持续下降(P<0.05);治疗12个月后胃镜和病理检查结果显示中成药治疗组胃萎缩现象基本消失,腺体泌酸机能也明显恢复,PGⅠ水平和PGⅠ/PGⅡ比值上升,PGⅡ水平下降(P<0.05)。患者治疗有效率可达94.4%;随治疗疗程的增加患者病理积分逐渐下降,差异明显(P<0.05)。[结论]与传统胃镜和病理检查相比,本研究建立的血清PGⅠ、PGⅡ定量分析系统可以在3个月内有效量化评估中药治疗慢性萎缩性胃炎(CAG)的疗效,而且有效避免了传统方法中取样部位不同造成的结果差异,也更容易被患者所接受。
[Objective]To investigate the availability and application value of serum pepsinogen when treating the chronic atrophic gastritis using Chinese medicine quantitatively.[Methods]36 hospitalized patients from Traditional Chinese Medicine Hospital of Zhaoqing from January 2016 to December 2017 were involved into research.The observation group was treated with Chinese medicine.Meanwhile,PGI and PGII were measured with TRFIA every three months,accompanied with calculating the value of PGI/PGII.[Results]Before treatment,the level of PGI keeps high,while PGII keeps low.3 months later,PGI rose obviously while PGII declined badly,which resulted in the growing of PGI/PGII(P<0.05).And the control group did not change.Observations after 6 and 9 months' treatment showed similar changes on PGI and PGII.Results were confirmed by the relief of lipogastry observed via gastroscope and pathological means.Results on the final observing point demonstrated that patients were almost recovered,and PGI,PGI/PGII rose dramatically.The effective rate of treatment was 94.4%.With the increase of the course oftreatment,the pathological score of patients decreased gradually,the difference was significant(P<0.05).[Conclusion]Compared with traditional gastroscope and pathological means,the newly established PG1\PG2-TRFIA system can value the treatment of Chinese medicine on the CAG quantitatively.Also it is more acceptable to patients.
[Objective]To investigate the availability and application value of serum pepsinogen when treating the chronic atrophic gastritis using Chinese medicine quantitatively.[Methods]36 hospitalized patients from Traditional Chinese Medicine Hospital of Zhaoqing from January 2016 to December 2017 were involved into research.The observation group was treated with Chinese medicine.Meanwhile,PGI and PGII were measured with TRFIA every three months,accompanied with calculating the value of PGI/PGII.[Results]Before treatment,the level of PGI keeps high,while PGII keeps low.3 months later,PGI rose obviously while PGII declined badly,which resulted in the growing of PGI/PGII(P<0.05).And the control group did not change.Observations after 6 and 9 months' treatment showed similar changes on PGI and PGII.Results were confirmed by the relief of lipogastry observed via gastroscope and pathological means.Results on the final observing point demonstrated that patients were almost recovered,and PGI,PGI/PGII rose dramatically.The effective rate of treatment was 94.4%.With the increase of the course oftreatment,the pathological score of patients decreased gradually,the difference was significant(P<0.05).[Conclusion]Compared with traditional gastroscope and pathological means,the newly established PG1\PG2-TRFIA system can value the treatment of Chinese medicine on the CAG quantitatively.Also it is more acceptable to patients.
引文
[1]伊凡,曾韦苹,郭红梅,等.中医药治疗慢性萎缩性胃炎的临床研究进展[J].新疆医科大学学报,2015,38(2):148-152.
[2]李靖,杨立宏,曾斌芳.慢性萎缩性胃炎中医证候与分子生物学理论研究[J].中医药导报,2014,20(7):1-3.
[3]Kuipers E J,Klinkenberg-Knol E C,VandenbrouckeGrauls C M,et al.Role of Helicobacter pylori in the pathogenesis of atrophic gastritis[J].Scand J Gastroenterol Suppl,1997,223:28-34.
[4]Weck M N,Brenner H.Prevalence of chronic atrophic gastritis in different parts of the world[J].Cancer Epidemiol Biomarkers Prev,2006,15(6):1083-1094.
[5]路敏敏,金世禄,刘宝珍,等.慢性萎缩性胃炎的诊断进展[J].中华全科医学,2015,5(13):823-825.
[6]高峰,李文晓.尿素呼气试验假阴性原因探讨[J].胃肠病学,2015,20(3):151-154.
[7]Broutet N,PlebaniM,Sakarovitch C,et al.Pepsinogen A,pepsinogen C,and gastrin as markers of atrophic chonic gastritis in European dyspeptics[J].Br J Cancer,2003,88(8):1239-1247.
[8]徐倩菲,陆喜荣,戴彦苗,等.“健脾活血方”治疗脾虚络阻型慢性萎缩性胃炎36例临床研究[J].江苏中医药,2017,49(10):35-37.
[9]梅成义,孙树怀.内镜在慢性萎缩性胃炎诊断中的应用价值[J].中外医疗,2015,23(41):181-183
[10]李学军,吴婧,陈亮亮,等.脾胃培源方对脾胃虚弱型慢性萎缩性胃炎的临床疗效及理化指标的影响[J].中国中西医结合消化杂志,2016,24(7):541-544.
[11]刘淑玮,程胜平.胃舒散对慢性萎缩性胃炎患者血清胃蛋白酶原、生存质量及疗效的影响[J].中医药导报,2015,21(22):58-60.
[12]韩冬.益气化瘀解毒方对HP相关性慢性萎缩性胃炎临床疗效及胃蛋白酶原的影响[J].中国中西医结合消化杂志,2017,12(1):23-26.
[13]陈洁,朱明辉,彭岚,等.血清胃蛋白酶原水平与慢性萎缩性胃炎的相关性分析[J].中国卫生检验杂志,2015,25(21):3649-3650.
[2]李靖,杨立宏,曾斌芳.慢性萎缩性胃炎中医证候与分子生物学理论研究[J].中医药导报,2014,20(7):1-3.
[3]Kuipers E J,Klinkenberg-Knol E C,VandenbrouckeGrauls C M,et al.Role of Helicobacter pylori in the pathogenesis of atrophic gastritis[J].Scand J Gastroenterol Suppl,1997,223:28-34.
[4]Weck M N,Brenner H.Prevalence of chronic atrophic gastritis in different parts of the world[J].Cancer Epidemiol Biomarkers Prev,2006,15(6):1083-1094.
[5]路敏敏,金世禄,刘宝珍,等.慢性萎缩性胃炎的诊断进展[J].中华全科医学,2015,5(13):823-825.
[6]高峰,李文晓.尿素呼气试验假阴性原因探讨[J].胃肠病学,2015,20(3):151-154.
[7]Broutet N,PlebaniM,Sakarovitch C,et al.Pepsinogen A,pepsinogen C,and gastrin as markers of atrophic chonic gastritis in European dyspeptics[J].Br J Cancer,2003,88(8):1239-1247.
[8]徐倩菲,陆喜荣,戴彦苗,等.“健脾活血方”治疗脾虚络阻型慢性萎缩性胃炎36例临床研究[J].江苏中医药,2017,49(10):35-37.
[9]梅成义,孙树怀.内镜在慢性萎缩性胃炎诊断中的应用价值[J].中外医疗,2015,23(41):181-183
[10]李学军,吴婧,陈亮亮,等.脾胃培源方对脾胃虚弱型慢性萎缩性胃炎的临床疗效及理化指标的影响[J].中国中西医结合消化杂志,2016,24(7):541-544.
[11]刘淑玮,程胜平.胃舒散对慢性萎缩性胃炎患者血清胃蛋白酶原、生存质量及疗效的影响[J].中医药导报,2015,21(22):58-60.
[12]韩冬.益气化瘀解毒方对HP相关性慢性萎缩性胃炎临床疗效及胃蛋白酶原的影响[J].中国中西医结合消化杂志,2017,12(1):23-26.
[13]陈洁,朱明辉,彭岚,等.血清胃蛋白酶原水平与慢性萎缩性胃炎的相关性分析[J].中国卫生检验杂志,2015,25(21):3649-3650.