半夏泻心汤联合胃复春对慢性萎缩性胃炎患者血清表皮生长因子及血清胃蛋白酶原、胃泌素表达影响
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摘要
目的:研究半夏泻心汤联合胃复春对慢性萎缩性胃炎患者血清表皮生长因子(EGF)及血清胃蛋白酶原(PG)、胃泌素(GS)表达的影响。方法:选择我院2016年9月—2017年9月收治的慢性萎缩性胃炎患者100例,随机分成两组。所有患者均给予常规三联治疗(阿莫西林+克拉霉素+枸橼酸铋钾),对照组50例同时给予胃复春,观察组50例在此基础上联合半夏泻心汤治疗,所有患者均连续治疗3个月。比较治疗前后患者血清EGF、胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、GS、症状评分、不良反应和疗效。结果:治疗3个月后,对照组症状疗效总有效率和病理疗效总有效率均低于观察组,差异具有统计学意义(P<0.05)。两组患者治疗后EGF含量均低于治疗前,差异有统计学意义(P<0.05);与对照组相比,观察组EGF含量降低更明显,差异有统计学意义(P<0.05)。两组患者治疗后PGⅠ含量均高于治疗前,差异有统计学意义(P<0.05);与对照组相比,观察组PGⅠ含量升高更明显,差异有统计学意义(P<0.05);两组PGⅡ含量治疗前后无显著变化(P>0.05)。观察组患者血清GS含量明显升高,且显著高于对照组,差异有统计学意义(P<0.05)。治疗后,观察组症状评分为(2.47±0.35)分,对照组症状评分为(4.87±0.69)分,两组比较差异有统计学意义(P<0.05)。结论:半夏泻心汤能够明显改善慢性萎缩性胃炎患者症状及镜下表现,可能的作用机制是调节EGF、PGⅠ和GS的表达,对临床有一定指导意义。
Objective :To analyse the effect of Banxia Xiexin Decoction combined with Weifuchun in the treatment of serum EGF,PG and GS in patients with chronic atrophic gastritis. Methods :100 patients with chronic atrophic gastritis treated in our hospital in September 2016—September 2017 were randomly divided into two groups. All patients were given conventional triple therapy,while 50 cases in control group were given Weifuchun simultaneously,while 50 cases in the observation group were treated with Banxia Xiexin Decoction,and all patients were treated for 3 months continuously. The serum serum EGF,PG I,PG II,GS,symptom score,adverse reaction and efficacy were compared before and after comparison. Results :After 3 months of treatment,the effective rate and the pathological efficiency of the control group were lower than the observation group(P<0.05);The content of EGF in the two groups were lower than before treatment(P<0.05);Compared with the control group,the content of EGF in the observation group decreased more obviously(P<0.05). After treatment,the content of PGI in the two groups were higher than before treatment(P<0.05);Compared with the control group,the content of PGI in the observation group increased more significantly(P<0.05).There was no significant change in the two groups of PGII before and after treatment(P>0.05). The level of serum GS in the observation group was significantly higher than the control group(P<0.05). After treatment,the symptom score of the observation group was(2.47 + 0.35)points,and the score of the control group was(4.87 + 0.69)points,there was significant difference between the two groups(P<0.05). Conclusion :Banxia Xiexin Decoction can significantly improve symptoms and microscopic manifestations of patients with chronic atrophic gastritis. The possible mechanism is to regulate the expression of EGF,PG I and GS,and has certain guiding significance for clinical practice.
Objective :To analyse the effect of Banxia Xiexin Decoction combined with Weifuchun in the treatment of serum EGF,PG and GS in patients with chronic atrophic gastritis. Methods :100 patients with chronic atrophic gastritis treated in our hospital in September 2016—September 2017 were randomly divided into two groups. All patients were given conventional triple therapy,while 50 cases in control group were given Weifuchun simultaneously,while 50 cases in the observation group were treated with Banxia Xiexin Decoction,and all patients were treated for 3 months continuously. The serum serum EGF,PG I,PG II,GS,symptom score,adverse reaction and efficacy were compared before and after comparison. Results :After 3 months of treatment,the effective rate and the pathological efficiency of the control group were lower than the observation group(P<0.05);The content of EGF in the two groups were lower than before treatment(P<0.05);Compared with the control group,the content of EGF in the observation group decreased more obviously(P<0.05). After treatment,the content of PGI in the two groups were higher than before treatment(P<0.05);Compared with the control group,the content of PGI in the observation group increased more significantly(P<0.05).There was no significant change in the two groups of PGII before and after treatment(P>0.05). The level of serum GS in the observation group was significantly higher than the control group(P<0.05). After treatment,the symptom score of the observation group was(2.47 + 0.35)points,and the score of the control group was(4.87 + 0.69)points,there was significant difference between the two groups(P<0.05). Conclusion :Banxia Xiexin Decoction can significantly improve symptoms and microscopic manifestations of patients with chronic atrophic gastritis. The possible mechanism is to regulate the expression of EGF,PG I and GS,and has certain guiding significance for clinical practice.
引文
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[11]申兰国,曹志群.苦参碱联合胃复春片治疗慢性萎缩性胃炎患者的疗效研究[J].实用药物与临床,2016,19(7):883-885.
[12]郑逢民,郑乐乐,郑中坚,等.消痞愈萎汤联合胃复春片治疗慢性萎缩性胃炎伴胃黏膜肠上皮化生或异型增生64例临床观察[J].中医杂志,2015,56(4):311-314.
[13]邵雪辉,王建国,韩志宏,等.红外线照射对萎缩性胃炎大鼠胃黏膜表皮生长因子及其受体表达的影响[J].中华物理医学与康复杂志,2016,38(2):92-95.
[14] CHEN TS,LUO JC,CHANG FY. Prevalence of Helicobacter pylori infection in duodenal ulcer and gastro-duodenal ulcer diseases in Taiwan[J]. J Gastroenterol Hepatol,2010,25(2):919-922.
[15]李文利,钮自宇,张鸣鸣,等.大蒜素对幽门螺杆菌阴性的慢性萎缩性胃炎患者血清表皮生长因子和胃黏膜病理、表皮生长因子受体的影响[J].中华实验和临床感染病杂志(电子版),2014,8(6):796-799.
[16]何智超,尹丕发,林楠,等.血府逐瘀胶囊对幽门螺杆菌阳性慢性萎缩性胃炎患者氧化-抗氧化系统及血清表皮生长因子的影响[J].现代中西医结合杂志,2017,26(15):1617-1620.
[17]刘烈辉,李捷壮,陈健,等.黄连素对老年慢性萎缩性胃炎患者血清胃蛋白酶原及胃泌素表达的影响研究[J].中国生化药物杂志,2014,34(8):139-141.
[18]王雪萍,徐耀华.阿莫西林联合铋剂对慢性萎缩性胃炎患者血清胃泌素-17及胃蛋白酶原水平影响研究[J].中国生化药物杂志,2016,36(3):64-66.
[19]孙雪飞,何旭.血清胃蛋白酶原与胃泌素检测对慢性萎缩性胃炎的诊断价值[J].湖南师范大学学报(医学版),2016,13(5):115-116,117.
[20]杨勤,姚玉玲.胃蛋白酶原与胃泌素检测对慢性萎缩性胃炎的诊断价值探讨[J].实用临床医药杂志,2012,16(23):23-24,31.
[21]闫建锋.半夏泻心汤加减治疗慢性萎缩性胃炎的临床观察[J].中医药学报,2015,43(5):101-104.
[2]吴欣欣.半夏泻心汤治疗幽门螺杆菌相关性慢性萎缩性胃炎[J].长春中医药大学学报,2013,29(2):286-287.
[3]唐旭东,王萍,李振华,等.慢性萎缩性胃炎中医诊疗共识意见[C]//中华中医药学会.中华中医药学会脾胃病分会第二十三次全国脾胃病学术交流会论文集.北京:中华中医药学会,2011:8-14.
[4]中华人民共和国卫生部.中药新药临床研究指导原则(第一辑)[M].北京:中国医药科技出版社,1993:93-94.
[5]李思颖.半夏泻心汤治疗慢性萎缩性胃炎临床研究[J].河南中医,2015,35(1):26-27.
[6]宫晶书.柴胡疏肝散合半夏泻心汤加减治疗慢性萎缩性胃炎肝胃郁热证临床研究[J].河南中医,2016,36(11):1981-1983.
[7]王秀萍,张来春.半夏泻心汤加减治疗慢性萎缩性胃炎60例[J].河南中医,2016,36(10):1697-1699.
[8]杨辉,毛艳琨,商娟娟,等.益气养阴化瘀法治疗慢性萎缩性胃炎临床疗效观察[J].辽宁中医药大学学报,2018,20(8):139-141.
[9]杨伟钦,蒋凯林,杨浩宇,等.基于数据挖掘的刘凤斌教授治疗慢性萎缩性胃炎组方规律探究[J].辽宁中医药大学学报,2018,20(8):81-84.
[10]董安山,潘兆宝,吉华青,等.四联疗法联合胃复春在慢性萎缩性胃炎治疗中的效果观察[J].重庆医学,2017,46(9):1257-1258.
[11]申兰国,曹志群.苦参碱联合胃复春片治疗慢性萎缩性胃炎患者的疗效研究[J].实用药物与临床,2016,19(7):883-885.
[12]郑逢民,郑乐乐,郑中坚,等.消痞愈萎汤联合胃复春片治疗慢性萎缩性胃炎伴胃黏膜肠上皮化生或异型增生64例临床观察[J].中医杂志,2015,56(4):311-314.
[13]邵雪辉,王建国,韩志宏,等.红外线照射对萎缩性胃炎大鼠胃黏膜表皮生长因子及其受体表达的影响[J].中华物理医学与康复杂志,2016,38(2):92-95.
[14] CHEN TS,LUO JC,CHANG FY. Prevalence of Helicobacter pylori infection in duodenal ulcer and gastro-duodenal ulcer diseases in Taiwan[J]. J Gastroenterol Hepatol,2010,25(2):919-922.
[15]李文利,钮自宇,张鸣鸣,等.大蒜素对幽门螺杆菌阴性的慢性萎缩性胃炎患者血清表皮生长因子和胃黏膜病理、表皮生长因子受体的影响[J].中华实验和临床感染病杂志(电子版),2014,8(6):796-799.
[16]何智超,尹丕发,林楠,等.血府逐瘀胶囊对幽门螺杆菌阳性慢性萎缩性胃炎患者氧化-抗氧化系统及血清表皮生长因子的影响[J].现代中西医结合杂志,2017,26(15):1617-1620.
[17]刘烈辉,李捷壮,陈健,等.黄连素对老年慢性萎缩性胃炎患者血清胃蛋白酶原及胃泌素表达的影响研究[J].中国生化药物杂志,2014,34(8):139-141.
[18]王雪萍,徐耀华.阿莫西林联合铋剂对慢性萎缩性胃炎患者血清胃泌素-17及胃蛋白酶原水平影响研究[J].中国生化药物杂志,2016,36(3):64-66.
[19]孙雪飞,何旭.血清胃蛋白酶原与胃泌素检测对慢性萎缩性胃炎的诊断价值[J].湖南师范大学学报(医学版),2016,13(5):115-116,117.
[20]杨勤,姚玉玲.胃蛋白酶原与胃泌素检测对慢性萎缩性胃炎的诊断价值探讨[J].实用临床医药杂志,2012,16(23):23-24,31.
[21]闫建锋.半夏泻心汤加减治疗慢性萎缩性胃炎的临床观察[J].中医药学报,2015,43(5):101-104.