摘要
目的:探讨健脾愈胃汤联合四联方案治疗脾胃虚寒证胃溃疡患者的临床疗效。方法:选取2022年1月~2024年5月期间于某院门诊接受治疗的122例脾胃虚寒证胃溃疡患者作为研究对象,采用随机数字表法分为对照组和观察组,每组61例。对照组患者给予四联方案治疗,观察组患者在对照组治疗基础上加用健脾愈胃汤,连续用药4周。比较两组患者血液学指标[生长激素释放多肽(Ghrelin)、三叶因子1(TFF1)、三叶因子2(TFF2)、胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、PGⅠ/PGⅡ]、胃黏膜转化生长因子-β(TGF-β)、Smad3阳性例数、中医证候评分、临床疗效、幽门螺杆菌(Hp)根除率、溃疡愈合率、半年内复发率及不良反应发生情况。结果:治疗后,两组患者Ghrelin、TFF1、PGⅠ/PGⅡ均降低(P<0.05),且观察组低于对照组(P<0.05);TFF2均升高(P<0.05),且观察组高于对照组(P<0.05);胃黏膜TGF-β、Smad3阳性例数均降低(P<0.05),且观察组低于对照组(P<0.05);主症评分、次症评分及总评分均降低(P<0.05),且观察组低于对照组(P<0.05)。观察组患者治疗总有效率(93.22%)高于对照组(79.31%,P<0.05)。观察组患者溃疡愈合率(59.32%)高于对照组(39.66%,P<0.05),半年内复发率(2.86%)低于对照组(21.74%,P<0.05)。两组患者Hp根除率和不良反应总发生率比较均无统计学差异(P>0.05)。结论:健脾愈胃汤联合四联方案治疗脾胃虚寒证胃溃疡患者临床疗效较佳,可有效减轻临床症状,缓解胃黏膜损伤,抑制TGF-β、Smad3表达,减少复发率,且不会增加不良反应的发生风险。
Objective:To explore the clinical efficacy of Jianpi Yuwei decoction combined with quadruple therapy in treating gastric ulcer patients with spleen-stomach deficiency cold pattern.Methods:A total of 122 gastric ulcer patients with spleen-stomach deficiency cold pattern who visited outpatient department of hospital between January 2022 and May 2024 were selected and divided into the control group and the observation group by random number table method,with 61 patients in each group.The control group was treated with quadruple therapy,while the observation group was treated with Jianpi Yuwei decoction in addition to the control group,for 4 weeks.The hematological markers[growth hormone releasing polypeptide(Ghrelin),trefoil factor 1(TFF1),trefoil factor 2(TFF2),pepsinogen I(PG I),pepsinogenⅡ(PGⅡ),PGⅠ/PGⅡ],gastric mucosa transforming growth factor-β(TGF-β),Smad3 positive cases,traditional Chinese medicine symptom score,clinical efficacy,Helicobacter pylori(Hp)eradication rate,ulcer healing rate,recurrence rate within half a year and adverse reactions were compared between the two groups.Results:After treatment,Ghrelin,TFF1,PGⅠ/PGⅡwere decreased in both groups(P<0.05),and lower in the observation group than in the control group(P<0.05).TFF2 was increased in both groups(P<0.05),and higher in the observation group than in the control group(P<0.05).The positive cases of TGF-βand Smad3 in gastric mucosa were decreased in both groups(P<0.05),and lower in the observation group than in the control group(P<0.05).The main symptom score,secondary symptom score and total score were decreased in both groups(P<0.05),and lower in the observation group than in the control group(P<0.05).The total effective rate in the observation group(93.22%)was higher than that in the control group(79.31%,P<0.05).The ulcer healing rate in the observation group(59.32%)was higher than that in the control group(39.66%,P<0.05),and the recurrence rate with half a year(2.86%)was lower than that in the control group(21.74%,P<0.05).No statistically significant difference was observed in Hp eradication rate and the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:Following treatment with Jianpi Yuwei decoction combined with quadruple therapy,favorable clinical efficacy was observed as well as reduced clinical symptoms,alleviated gastric mucosal damage and downregulation of TGF-βand Smad3 expression,reduced recurrence without increasing the risk of adverse reactions.
作者
程涛
安秀丽
李凯
CHENG Tao;AN Xiu-li;LI Kai(Shangqiu Traditional Chinese Medicine Hospital,Shangqiu 476000,China)
出处
《中国合理用药探索》
2025年第4期134-140,共7页
Chinese Journal of Rational Drug Use
基金
河南省医学科技攻关计划项目(LHGJ20220405)。
关键词
健脾愈胃汤
四联方案
脾胃虚寒证
胃溃疡
疗效
复发
Jianpi Yuwei decoction
quadruple scheme
spleen-stomach deficiency cold pattern
gastric ulcer
efficacy
recurrence
作者简介
程涛,男,副主任医师,专业方向:脾胃肝胆、脾胃虚寒的诊治。E-mail:zxmmm2023@163.com。
