摘要
【目的】观察益气养阴法改善气阴两虚型慢性萎缩性胃炎(chronic atrophic gastritis,CAG)临床症状及胃黏膜萎缩伴肠上皮化生的疗效。【方法】将62例气阴两虚型CAG患者随机分为对照组和治疗组,每组各31例。对照组给予中成药摩罗丹口服治疗,治疗组给予中药白贝益胃汤(香砂六君子汤合乌贝汤的基础上加滋养胃阴及清热解毒药物组方而成)口服治疗,疗程均为12周。观察2组患者治疗前和治疗8周、12周后的中医证候积分、胃镜组织学积分及病理组织学积分的变化情况,并评价2组患者的临床疗效和安全性。【结果】(1)脱落情况:研究过程中,对照组脱落1例,治疗组无脱落病例,最终共有61例患者完成全部疗程的治疗,其中治疗组31例,对照组30例。(2)疗效情况:治疗12周后,治疗组的总有效率为90.32%(28/31),对照组为63.33%(19/30),组间比较(χ^(2)检验),治疗组的疗效明显优于对照组(P<0.05)。(3)中医证候积分改善情况:治疗8周后,2组患者的胃脘胀满、胃脘灼痛、喜按、胃中嘈杂、口干口苦、乏力倦怠、大便异常(大便干燥)等中医证候积分均较治疗前有所下降,但差异均无统计学意义(P>0.05);治疗12周后,2组患者的各项中医证候积分均较治疗前明显下降(P<0.05);组间比较,治疗组在治疗12周后对各项中医证候积分的下降幅度均明显优于对照组(P<0.05)。(4)胃镜组织学积分改善情况:治疗8周后,治疗组的胃镜组织学积分较治疗前明显下降(P<0.05),而对照组较治疗前有所下降,但差异无统计学意义(P>0.05);治疗12周后,2组患者的胃镜组织学积分均较治疗前明显下降(P<0.05);组间比较,治疗组在治疗8周、12周后对胃镜组织学积分的下降幅度均明显优于对照组(P<0.05)。(5)病理组织学积分改善情况:治疗8周后,2组患者的腺体萎缩、肠上皮化生、慢性炎症、病变活动度等各项病理组织学积分均较治疗前有所下降,但差异均无统计学意义(P>0.05);治疗12周后,除对照组的慢性炎症外,2组患者的各项病理组织学积分均较治疗前明显下降(P<0.05);组间比较,治疗组在治疗12周后对腺体萎缩、肠上皮化生、病变活动度等病理组织学积分的降低幅度均明显优于对照组(P<0.05)。(6)安全性评价:治疗过程中,2组患者均未发生明显不良反应,且2组患者的血常规、心电图、肝肾功能等安全性指标也均未出现异常,具有较高的安全性。【结论】基于益气养阴法的中药白贝益胃汤治疗气阴两虚型CAG患者疗效确切,可起到改善慢性炎症、缓解症状及逆转肠上皮化生的作用。
Objective To observe the efficacy of therapy for replenishing qi and nourishing yin(abbreviated as Yiqi Yangyin method)on improving the clinical symptoms and gastric atrophy complicated with intestinal metaplasia in chronic atrophic gastritis(CAG)patients of qi and yin deficiency type.Methods Sixty-two patients with CAG of qi and yin deficiency type were randomly divided into the control group and the treatment group,with 31 cases in each group.The control group was given oral use of Chinese patent medicine Moluodan,and the treatment group was given oral use of Baibei Yiwei Decoction(a combination of Xiangsha Liujunzi Decoction and Wubei Decoction with the addition of herbs for nourishing stomach yin and clearing heat and toxins),and the course of treatment covered 12 weeks.The changes of traditional Chinese medicine(TCM)syndrome scores,gastroscopic histological scores and pathological histological scores of the two groups were observed before treatment and after 8 and 12 weeks of treatment.After treatment,the clinical efficacy and safety of the two groups were evaluated.Results(1)During the trial,there was one case falling off from the control group while none case falling off from the treatment group.Eventually,a total of 61 patients completed the full course of treatment,including 31 cases in the treatment group and 30 cases in the control group.(2)After 12 weeks of treatment,the total effective rate of the treatment group was 90.32%(28/31),and that of the control group was 63.33%(19/30).The intergroup comparison(tested by chisquare test)showed that the therapeutic efficacy of the treatment group was significantly superior to that of the control group(P<0.05).(3)After 8 weeks of treatment,the decrease of the scores in the two groups were shown in the TCM symptoms of epigastric distension,burning pain in the gastric epigastrium,preference of pressing,gastric discomforts,dry mouth and bitterness in the mouth,fatigue and tiredness,and abnormal stools(dry stools),but the difference was not statistically significant in comparison with the pre-treatment period(P>0.05).After 12 weeks of treatment,the scores of each of the TCM symptoms in the two groups were significantly decreased compared with the pre-treatment period(P<0.05),and the intergroup comparison showed that the decrease of the scores of each of the TCM symptoms in the treatment group after 12 weeks of treatment was significantly superior to that of the control group(P<0.05).(4)After 8 weeks of treatment,the gastroscopic histological scores of the treatment group were significantly decreased compared with the pre-treatment period(P<0.05),while those of the control group declined to some extent,but the difference was not statistically significant(P>0.05).After 12 weeks of treatment,the gastroscopic histological scores in the two groups were significantly decreased compared with the pre-treatment period(P<0.05),and the intergroup comparison showed that the decrease of gastroscopic histological scores in the treatment group after 8 and 12 weeks of treatment was significantly superior to that in the control group(P<0.05).(5)After 8 weeks of treatment,the pathological histological scores of glandular atrophy,intestinal metaplasia,chronic inflammation,and activities of the disease in the two groups were decreased compared with the pre-treatment period,but the difference was not statistically significant(P>0.05).After 12 weeks of treatment,all pathological histological scores in the two groups except for chronic inflammation in the control group were significantly decreased compared with those before treatment(P<0.05).The intergroup comparison showed that the decrease of pathological histological scores of glandular atrophy,intestinal metaplasia,and activities of the disease in the treatment group after 12 weeks of treatment was significantly superior to that in the control group(P<0.05).(6)During the treatment process,no obvious adverse reactions occurred in the two groups of patients,and the safety indexes such as blood routine test,electrocardiogram,liver and kidney functions of the two groups were all normal,which had a high safety.Conclusion The treatment of Chinese medicine Baibei Yiwei Decoction based on the Yiqi Yangyin method exerts certain effect in treating patients with CAG of qi and yin deficiency type.It can improve chronic inflammation,relieve symptoms,and reverse the intestinal metaplasia in CAG patients.
作者
白娜
颜桂林
刘文华
郭思远
郭耀荣
陶杨
BAI Na;YAN Gui-Lin;LIU Wen-Hua;GUO Si-Yuan;GUO Yao-Rong;TAO Yang(College of Traditional Chinese Medicine,Chongqing Medical University,Chongqing 400016,China;Beibei Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine,Chongqing 400700,China;Graduate School of Guangzhou University of Chinese Medicine,Guangzhou 510006 Guangdong,China)
出处
《广州中医药大学学报》
CAS
2023年第12期3019-3025,共7页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
重庆市科技计划项目(编号:2021-27)
全国中医临床特色技术传承骨干人才培训项目(编号:国中医办人教函[2018]224号)。
关键词
慢性萎缩性胃炎
气阴两虚
益气养阴
白贝益胃汤
摩罗丹
chronic atrophic gastritis
deficiency of qi and yin
replenishing qi and nourishing yin
Baibei Yiwei Decoction
Moluodan
