摘要
[目的]观察自拟柴龙逆萎汤联合多潘立酮片改善慢性萎缩性胃炎(CAG)患者胃黏膜病理组织学的临床效果及对血清中白细胞介素-32(IL-32)、降钙素基因相关肽(CGRP)、人表皮生长因子(EGF)水平的影响。[方法]选择2017年1月~2018年9月于我院消化内科门诊收治的慢性萎缩性胃炎患者112例为研究对象,随机分为对照组(n=56例)和观察组(n=56例)。对照组患者给予多潘立酮片口服;观察组患者则在对照组基础上加用自拟柴龙逆萎汤治之。比较2组治疗的临床效果,观察胃黏膜病理组织学结果:胃黏膜腺体萎缩、肠上皮化生(IM)、异型增生(ATP)变化,检测胃蛋白酶原、血清中IL-32、CGRP、EGF水平,统计复发率,评价用药安全性。[结果]观察组临床疗效更好,治愈33例,有效率92.86%(52/56);对照组治愈20例,有效率78.57%(44/56)(P<0.05);随访半年,复发率3.03%明显低于对照组的复发率30.00%(P<0.05);与治疗前比较,2组患者的胃镜下病理结果改善明显,且观察组胃镜下病理结果所示腺体萎缩、IM、ATP等改善优于对照组(P<0.05);血清PGⅠ、PGⅠ/PGⅡ水平较治疗前明显升高,PGⅡ水平则明显降低,血清中IL-32、EGF水平均低于治疗前,CGRP水平高于治疗前,且观察组变化程度较对照组明显(P<0.05);观察组用药安全性更高,不良反应率3.57%(2/56)明显低于对照组的不良反应发生率17.86%(10/56)(P<0.05)。[结论]自拟柴龙逆萎汤联合多潘立酮片利于改善胃黏膜病理,调节PG分泌量,其机制与调控血清中IL-32、CGRP、EGF水平,以减轻胃黏膜的炎性损伤,促进损伤胃黏膜的愈合有关,且复发率低,用药安全性高。
[Objective]To observe the clinical effect of self-designed chailongniwei decoction combined with doperidone tablets on the gastric mucosa histopathology in patients with chronic atrophic gastritis and the influence on the serum levels of interleukin-32(IL-32),calcium gene related peptide(CGRP)and epidermal growth factor(EGF).[Methods]112 patients with chronic atrophic gastritis admitted to the department of gastroenterology of our hospital from January 2017 to September 2018 were selected as study subjects,and were randomly divided into the control group(n=56 cases)and the observation group(n=56 cases).Patients in the control group were given doperidone orally.Patients in the observation group were treated with the self-made chailong niwei decoction on the basis of the control group.The purpose of this study was to compare the clinical effects of the two groups,observe the gastric mucosal glands atrophy,intestinal metaplasia(IM)and atypicalhyperplasia(ATP)changes in the gastric mucosa by pathological histopathology,detect the changes of pepsinogen,IL-32,CGRP and EGF in serum,and evaluate the recurrence rate and the drug safety.[Results]The clinical effect of observation group was better,33 cases were cured,and the effective rate was 92.86%(52/56).The effective rate of control group was 78.57%(44/56)(P<0.05).The recurrence rate of 3.03%was significantly lower than that of the control group(30.00%)(P<0.05).Compared with before treatment,the pathological results of patients in the two groups were significantly improved under gastroscopy,and the pathological results of glands atrophy,IM,ATP and other improvements in the observation group were better than those in the control group(P<0.05).The serum PGⅠ,PGⅠ/PGⅡlevels in the two groups were significantly higher than before treatment,while PGⅡlevels were significantly lower than before treatment,the serum IL-32 and EGF levels were lower than before treatment,and the CGRP levels were higher than before treatment,the degree of change in the observation group was more obvious than that in the control group(P<0.05).The observation group had higher drug safety,and the adverse reaction rate of 3.57%(2/56)was significantly lower than that of the control group 17.86%(10/56)(P<0.05).[Conclusion]The self-designed chailongniwei decoction combined with doperidone tablets is beneficial to improve gastric mucosa pathology,and regulate PG level.The mechanism is related to inhibiting the levels of IL-32,CGRP and EGF in serum to reduce the inflammatory injury of gastric mucosa and promote the healing of injured gastric mucosa,with low recurrence rate and high drug safety.
作者
梅莉
潘淑波
MEI Li;PAN Shu-ho(Department of Internal Medicine,Hai'an Hospital of Traditional Chinese Medicine,Hai'an 226600,China;Department of Gastroenterology,Suzhou Science and Technology City Hospital,Suzhou 215000,China)
出处
《中国中西医结合消化杂志》
CAS
2019年第6期420-425,共6页
Chinese Journal of Integrated Traditional and Western Medicine on Digestion
基金
苏州高新区医疗卫生科技计划项目(No:2016Q011)
