温针灸联合小建中汤治疗脾胃虚寒型消化性溃疡疗效观察
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摘要
目的观察温针灸联合小建中汤治疗脾胃虚寒型消化性溃疡的临床疗效。方法 100例脾胃虚寒型消化性溃疡患者,随机分为对照组和观察组,每组50例。对照组采用小建中汤加减治疗,观察组在对照组基础上加用温针灸治疗。观察两组治疗后溃疡复发率、溃疡面积、胃幽门螺旋杆菌(Hp)清除率和生活质量评分,并检测外周血清和胃液表皮生长因子(EGF)、胃黏膜表皮生长因子受体(EGFR)的水平变化,并比较临床疗效。结果观察组总有效率为88.0%,对照组为66.0%,两组总有效率比较,差异有统计学意义(P<0.05)。观察组治疗后溃疡复发率、溃疡面积、Hp清除率优于对照组(P<0.05);观察组治疗后生活质量评分各维度优于对照组(P<0.05)。观察组治疗后血清、胃液EGF以及胃黏膜EGFR水平高于对照组(P<0.05)。结论运用温针灸联合小建中汤的方式治疗脾胃虚寒型消化性溃疡可以显著提高临床疗效,通过上调EGF、EGFR水平来促进胃黏膜修复和溃疡的愈合。
Objective To observe the clinical efficacy of warm needling plus Xiao Jian Zhong decoction in treating peptic ulcers due to deficiency cold in spleen-stomach. Method One hundred patients with peptic ulcers due to deficiency cold in spleen-stomach were randomized into a control group and an observation group, with 50 cases in each group. The control group was intervened by modified Xiao Jian Zhong decoction, while the observation group was additionally given warm needling treatment. The ulcer relapse rate, ulcer size, Helicobacter pylori (Hp) elimination rate and quality of life score in the two groups were observed after the treatment. The changes in the level of epidermal growth factor (EGF) in peripheral blood serum and gastric fluid, and the level of EGF receptor (EGFR) in gastric mucosa were detected. The clinical efficacies were also compared. Result The total effective rate was 88.0% in the observation group versus 66.0% in the control group, and the between-group difference in the total effective rate was statistically significant (P<0.05). After the treatment, the ulcer relapse rate, ulcer size and Hp elimination rate in the observation group were better than those in the control group (P<0.05); the observation group was superior to the control group in the score of each dimension in measuring the quality of life (P<0.05). The EGF levels in serum and gastric fluid and EGFR level in gastric mucosa in the observation group were higher than those in the control group after the intervention (P<0.05). Conclusion Warm needling plus Xiao Jian Zhong decoction can significantly enhance the clinical efficacy, boost the repair of gastric mucosa and the ulcer healing by up-regulating the level of EGF and EGFR in the treatment of peptic ulcers due to deficiency cold in spleen-stomach.
Objective To observe the clinical efficacy of warm needling plus Xiao Jian Zhong decoction in treating peptic ulcers due to deficiency cold in spleen-stomach. Method One hundred patients with peptic ulcers due to deficiency cold in spleen-stomach were randomized into a control group and an observation group, with 50 cases in each group. The control group was intervened by modified Xiao Jian Zhong decoction, while the observation group was additionally given warm needling treatment. The ulcer relapse rate, ulcer size, Helicobacter pylori (Hp) elimination rate and quality of life score in the two groups were observed after the treatment. The changes in the level of epidermal growth factor (EGF) in peripheral blood serum and gastric fluid, and the level of EGF receptor (EGFR) in gastric mucosa were detected. The clinical efficacies were also compared. Result The total effective rate was 88.0% in the observation group versus 66.0% in the control group, and the between-group difference in the total effective rate was statistically significant (P<0.05). After the treatment, the ulcer relapse rate, ulcer size and Hp elimination rate in the observation group were better than those in the control group (P<0.05); the observation group was superior to the control group in the score of each dimension in measuring the quality of life (P<0.05). The EGF levels in serum and gastric fluid and EGFR level in gastric mucosa in the observation group were higher than those in the control group after the intervention (P<0.05). Conclusion Warm needling plus Xiao Jian Zhong decoction can significantly enhance the clinical efficacy, boost the repair of gastric mucosa and the ulcer healing by up-regulating the level of EGF and EGFR in the treatment of peptic ulcers due to deficiency cold in spleen-stomach.
引文
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[17]官兴龙.小建中汤配合针刺治疗脾胃虚寒型胃痛60例[J].云南中医中药杂志,2009,30(7):85-86.
[18]蔡朝阳.温针灸疗法对胆囊切除术后胃肠功能恢复影响的临床观察[J].中外医学研究,2018,16(25):34-36.
[19]林深,刘燕娜,黄桂彬.温针灸配合调胃承气汤对功能性便秘患者胃肠激素的影响[J].深圳中西医结合杂志,2018,28(7):50-51.
[20]徐世芳.温针灸辅助治疗功能性消化不良的效果观察[J].内蒙古中医药,2017,36(18):104-105.
[21]王宝立.温针灸对脾胃气虚型功能性消化不良的临床效果分析[J].中国社区医师,2015,31(24):89-90.
[22]何慰慰,邓仁椿.温针灸联合独活寄生汤对膝骨性关节炎关节功能的改善作用[J].深圳中西医结合杂志,2018,28(20):54-55.
[23]李元,白妍,王顺.艾灸神阙穴结合温针灸治疗原发性痛经对症状积分及免疫功能的影响分析[J].中国妇幼保健,2018,33(20):4770-4773.
[24]吴光明.温针灸结合透明质酸注射治疗骨关节炎的疗效及对患者炎症因子水平的影响[J].光明中医,2018,33(18):2716-2718.
[25]孙晴,管玉珍,张伟.温针灸治疗老年冠状动脉粥样硬化性心脏病并高同型半胱氨酸44例[J].环球中医药,2018,11(9):1436-1438.
[26]黄慧.加味小建中汤治疗消化性溃疡25例临床观察[J].中医药导报,2007,13(6):38-39,43.
[27]刘振杰,喻斌.加味左金丸联合埃索美拉唑肠溶片治疗胃溃疡的效果及对COX-2、EGF表达的影响[J].解放军预防医学杂志,2018,36(7):843-846.
[28]周建红,胡玲,邢海伦,等.Hp相关胃病不同中医证候型EGF、TFF1及ICAM-1蛋白水平的表达[J].时珍国医国药,2013,24(12):3064-3067.
[29]王中东,黄麦华.幽门螺杆菌感染者胃液及血液表皮生长因子和前列腺素E2含量研究[J].社区医学杂志,2013,11(14):15-16.
[2]李素红,魏海燕,李晓燕,等.小建中汤加味治疗脾胃虚寒型消化性溃疡68例[J].世界中医药,2013,8(11):1303-1304,1308.
[3]王高云,时昭红,张介眉.促愈颗粒对胃溃疡患者胃液EGF含量和胃粘膜组织PGE2含量的影响[J].湖北中医杂志,2012,31(7):6-8.
[4]李刚,崔桂娟.黄芪建中汤合良附丸加减治疗脾胃虚寒型消化性溃疡100例疗效观察[J].河北中医,2011,33(1):66-67.
[5]陈灏珠.实用内科学[M].第12版.北京:人民卫生出版社,2005:1861-1866.
[6]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:6.
[7]杨宇玲,耿萍,杨立春.建中愈疡散联合西药治疗消化性溃疡脾胃虚寒证疗效观察[J].实用中西医结合临床,2014,14(7):22-23,28.
[8]古学文,廖永州.疏肝健脾活血法对胃溃疡患者胃黏膜表皮生长因子及受体表达的影响[J].广州中医药大学学报,2010,27(2):113-115,118.
[9]McHorney CA,Ware JE Jr,Raczek AE.The MOS36-Item Short-Form Health Survey(SF-36):Ⅱ.Psychometric and clinical tests of validity in measuring physical and mental health constructs[J].Med Care,1993,31(3):247-263.
[10]廖琴,陶英.中医辨证施护脾胃虚寒胃痛临床观察[J].中国当代医药,2009,16(21):184-185.
[11]万毓华,付勇.小建中汤治疗脾胃虚寒型消化性溃疡的临床研究[J].当代医学,2013,19(34):155-156.
[12]余波.小建中汤合良附丸联合西药治疗脾胃虚寒型消化性溃疡的临床研究[J].中国医药指南,2013,11(32):518-519.
[13]李秀英.小建中汤配合食疗治疗脾胃虚寒型胃脘痛临床疗效观察[J].中国当代医药,2012,19(4):107-108.
[14]金蛟君,楼巧勤,叶育双.中西医结合治疗脾胃虚寒型消化性溃疡临床研究[J].新中医,2015,47(4):91-92.
[15]李谖.小建中汤治疗脾胃虚寒型消化性溃疡随机平行对照研究[J].实用中医内科杂志,2015,29(5):100-101.
[16]李日德,柯俊.小建中汤联合西药治疗消化性溃疡的疗效观察[J].临床医学工程,2012,19(1):67-68.
[17]官兴龙.小建中汤配合针刺治疗脾胃虚寒型胃痛60例[J].云南中医中药杂志,2009,30(7):85-86.
[18]蔡朝阳.温针灸疗法对胆囊切除术后胃肠功能恢复影响的临床观察[J].中外医学研究,2018,16(25):34-36.
[19]林深,刘燕娜,黄桂彬.温针灸配合调胃承气汤对功能性便秘患者胃肠激素的影响[J].深圳中西医结合杂志,2018,28(7):50-51.
[20]徐世芳.温针灸辅助治疗功能性消化不良的效果观察[J].内蒙古中医药,2017,36(18):104-105.
[21]王宝立.温针灸对脾胃气虚型功能性消化不良的临床效果分析[J].中国社区医师,2015,31(24):89-90.
[22]何慰慰,邓仁椿.温针灸联合独活寄生汤对膝骨性关节炎关节功能的改善作用[J].深圳中西医结合杂志,2018,28(20):54-55.
[23]李元,白妍,王顺.艾灸神阙穴结合温针灸治疗原发性痛经对症状积分及免疫功能的影响分析[J].中国妇幼保健,2018,33(20):4770-4773.
[24]吴光明.温针灸结合透明质酸注射治疗骨关节炎的疗效及对患者炎症因子水平的影响[J].光明中医,2018,33(18):2716-2718.
[25]孙晴,管玉珍,张伟.温针灸治疗老年冠状动脉粥样硬化性心脏病并高同型半胱氨酸44例[J].环球中医药,2018,11(9):1436-1438.
[26]黄慧.加味小建中汤治疗消化性溃疡25例临床观察[J].中医药导报,2007,13(6):38-39,43.
[27]刘振杰,喻斌.加味左金丸联合埃索美拉唑肠溶片治疗胃溃疡的效果及对COX-2、EGF表达的影响[J].解放军预防医学杂志,2018,36(7):843-846.
[28]周建红,胡玲,邢海伦,等.Hp相关胃病不同中医证候型EGF、TFF1及ICAM-1蛋白水平的表达[J].时珍国医国药,2013,24(12):3064-3067.
[29]王中东,黄麦华.幽门螺杆菌感染者胃液及血液表皮生长因子和前列腺素E2含量研究[J].社区医学杂志,2013,11(14):15-16.