健脾益胃汤治疗慢性糜烂性胃炎并发癌前病变临床研究

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目的:观察健脾益胃汤治疗慢性糜烂性胃炎并发癌前病变的临床疗效.方法:选取2014年1月~ 2016年1月于我院接受治疗的慢性糜烂性胃炎并发癌前病变患者84例,按照随机数表将患者分为两组,每组各42例患者,观察组采用中药健脾益胃汤方进行治疗,口服煎剂由制剂室制备,每日1剂,分早晚2次服用;对照组采用常规药物进行干预,给予胃复春片口服治疗,每日3次,4片1次.对两组患者的胃镜检查疗效进行评定并进行比较;根据患者的临床特征计算患者的中医证候积分,对两组患者的中医症候疗效进行对比;统计并对比两组患者治疗前后的幽门螺旋杆菌感染情况,并统计感染率;统计患者治疗前后的血清IL-8、IL-11、TNF-α、GH水平,对比两组患者以上指标的改善情况.结果:比较两组患者的胃镜检查疗效,对照组总有效率为66.7%,观察组患者总有效率为83.3%,差异具有统计学意义(P<0.05);观察组患者镜检查疗效的总有效率明显大于对照组.治疗前两组患者的中医证候无统计学差异,治疗后观察组患者的总有效率为97.6%,明显高于对照组的85.7%,差异具有统计学意义(P<0.05).治疗前观察组患者和对照组患者的的Hp感染率分别为87.9%和88.3%,治疗后观察组患者的感染率为66.7%,明显小于对照组的76.2%,两组差异具有统计学意义(P<0.05).对两组患者治疗后的TNF-α、GH、IL-8和IL-11水平进行统计,观察组的TNF-α、IL-8、IL-11水平分别为45.69±5.92ng/L、7.63±1.25ng/L、47.32±3.26ng/L,均明显低于对照组,观察组患者的GH水平为1.24±0.23μg/L,高于对照组的0.71±0.39.μg/L,差异具有统计学意义(P<0.05).结论健脾益胃汤治疗慢性糜烂性胃炎并发癌前病变疗效非常显著,在患者的胃镜检查疗效、中医症候方面的疗效、减少胃黏膜的炎性反应和患者hp的根除等方面均优于对照组组,值得推广应用.“,”Objective:To explore the clinical effect of using Jianpi Yiwei Decoction in treating chronic erosive gastritis with precancerous lesions.Methods:84cases of patients with chronic erosive gastritis cancer from January 2014to January 2016in our hospital for treatment of patients with precancerous lesions according to the random number table method,the patients were divided into two groups,42patients in each group,the observation group was given Jianpi Yiwei Decoction for treatment,oral decoction agent prepared by the hospital preparation room,1 daily dose,2times a day sooner or later.The controlled group was given routine drug intervention that was Weifuchun orally,4tablets once,3times a day.To evaluate the gastroscopy efficacy of the two groups were compared,the calculation of the syndrome integral according to the clinical characteristics of the patients,to compare the curative effect of TCM syndrome of the two groups of patients.Statistics and infection of Helicobacter pylori before and after treatment were compared between the two groups,and the statistics of infection rate of patients before and after treatment.The serum statistics of IL-8,IL-11,TNF-alpha,GH level,the improvement of the above indexes were compared between the two groups.Results:Comparing the two groups of patients with gastroscopy efficacy,the total effective rate of the patients in the controlled group was 66.7%.The total effective rate of the observation group was 83.3%;the curative effect of the observation group microscopic examination of patients with total efficiency was significantly higher than the controlled group.Before treatment,there was no statistical difference between the two groups of TCM syndromes,the total effective rate of the observation group was 97.6%,the total effective rate of the controlled group was 85.7%,treatment control and Hp group of patients with the infection rate were 87.9% and 88.3% groups of patients after treatment,the rate of observation group was 66.7%,significantly less than 76.2% in the controlled group,with significant difference between the two groups (P<0.05).The statistics of the two groups of patients after treatment,IL-8,IL-11,TNF-α and GH levels of the observation group were 45.69±5.92ng/L,7.63± 1.25ng/L,47.32±3.26ng/L,were significantly lower than the controlled group,the observation group of patients with GH levels of 1.24 ± ±0.23g/L was higher than that in the controlled group of 0.71 ±0.39g/L.Conclusion:Using Jianpi Yiwei Decoction in the treatment of patients with chronic erosive gastritis and precancerous lesions has significantly effect on TCM syndromes and gastroscopy efficacy,reduces in patients with inflammatory reaction and gastric mucosa in patients with HP eradication therapy,it is worthy of popularization and application.
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