化浊解毒治萎方对Hp阳性慢性萎缩性胃炎患者血清PGⅠ/PGⅡ的影响-《环球中医药》

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Title:: Influence of Huazhuo Jiedu Zhiwei formula on PGⅠ/PGⅡ in patients of chronic atrophic gastritis with HP

作者:: 郭敏李佃贵; 450000 郑州,河南中医学院第一附属医院脾胃肝胆病科(郭敏); 河北省中医院脾胃病科(李佃贵)

Author(s):: GUO Min; LI Dian-gui.; The First Affliated Hospital of HeNan University of TCM, Zhengzhou 450000, China; Traditional Chinese Medicine Hospital of HeBei Province, ShiJiaZhuang 050011, China

关键词:: 化浊解毒治萎方; 萎缩性胃炎; 胃蛋白酶原

Keywords:: Huazhuo Jiedu Zhiwei formula; Atrophic gastritis; Pepsinogen

分类号:: R573.3+2

DOI:: 10.3969/j.issn.1674-1749.2016.11.002

文献标志码:: A

摘要:: 目的观察化浊解毒治萎方对幽门螺旋杆菌(helicobacter pylori,Hp)阳性慢性萎缩性胃炎血清胃蛋白酶原(pepsinogen,PG)的影响。方法根据随机数字表法将Hp阳性的慢性萎缩性胃炎患者分为试验组和对照组,每组各54例。对照组给予常规四联疗法根除幽门螺旋杆菌(奥硝唑片0.5 g、克拉霉素0.5 g、雷贝拉唑片20 mg、枸橼酸铋钾胶囊0.6 g,每天两次,早晚各1次)连服用14天后停用; 试验组在四联用药基础上应用化浊解毒健脾方,疗程3个月。观察两组患者的幽门螺杆菌清除率、胃镜、病理组织学改变,PGⅠ/PGⅡ的变化。结果(1)总有效率:试验组90%,对照组52.9%,两组比较差异有统计学意义(P<0.05),试验组总有效率高于对照组;(2)Hp根除率:试验组90%,对照组41.1%,两组比较差异有统计学意义(P<0.05),试验组Hp根除率高于对照组;(3)胃黏膜病理:在改善胃黏膜萎缩程度方面试验组优于治疗组,两组比较差异有统计学意义(P<0.05);(4)PG Ⅰ/PG Ⅱ的变化:治疗后试验组PG Ⅰ/PG Ⅱ为(12.92±1.31),对照组(8.03±0.98),试验组明显提高了PG Ⅰ/PG Ⅱ比值,两组比较有统计学意义(P<0.05)。结论化浊解毒治萎方联合四联疗法可提高Hp根除率,减轻Hp对胃黏膜的损害; 有效减轻胃黏膜萎缩程度,甚至可以逆转萎缩性胃炎,其作用可能与提高胃蛋白酶原尤其是PGⅠ水平,促进胃黏膜对营养物质的吸收利用,利于胃黏膜修复,恢复腺体功能。

Abstract:: Objective To observe the effect of Huazhuo JieDu Zhiwei formula on the expression of pepsinogen in chronic atrophic gastritis(CAG)with HP. Methods CAG patients with positive HP were assigned to a treatment group and a control group according to the random digital table, 54 in each group. Patients in both groups took ornidazole tablets(0.5 g,bid,po), rabeprazole(20 mg,bid,po), bismuth potassium citrate capsules(0.6 g,bid,po), and clarithromycin(0.5 g,bid,po)for 14 days. Additionally, patients in the treatment group took Huazhuo Jiedu Zhiwei formula for 3 months. The HP eradication rate was observed, and the expression of serum PGⅠ/PGⅡ in CAG patients was determined. The findings of gastroscopy and histology of gastric mucosa were recorded. Results(1)Total effective rate: 90% in the treatment group and 52.9% in the control group, there was significant difference between two groups(P<0.05);(2)HP eradication rate: the HP eradicate rate was 90% in the treatment group, and 41.1% in the control group, with significant difference between two groups(P<0.05);(3)Gastric mucosa pathological morphology: the improvement of the degree of gastric mucosal atrophy in experimental group was better than that in the treatment group(P<0.05);(4)PGⅠ/PGⅡ ratio:after the treatment, the expression of PGⅠ/PGⅡ increased significantly, the ratio of PGⅠ/PGⅡ was(12.92±1.31)in the treatment group, and(8.03±0.98)in the control group(P<0.05). Conclusion Huazhuo Jiedu Zhiwei formula combined with quadruple therapy could increase the HP eradicate rate, diminish the injury of gastric mucosa, reduce the degree of gastric mucosal atrophy, even reverse the atrophic gastritis, and its mechanism might be related to increasing levels of pepsinogen, especially the PGⅠ Level, promoting gastric mucosa to absorb and utilize nutrients, repairing the gastric mucosal and recovering the gland function.

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《环球中医药》[ISSN:1006-6977/CN:61-1281/TN]

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