中医沈元良用药组方治疗慢性萎缩性胃炎患者的效果观察

肖勇; 金少威; 董珍; 王天舒

doi:10.16766/j.cnki.issn.1674-4152.003757

中医沈元良用药组方治疗慢性萎缩性胃炎患者的效果观察

doi: 10.16766/j.cnki.issn.1674-4152.003757

肖勇¹,
金少威²,
董珍³,
王天舒^1, ,

1.
绍兴市中医院全科医学科，浙江绍兴 312000
2.
绍兴市中医院中医内科
3.
绍兴市中医院中医肿瘤内科

基金项目:

浙江省中医药科技计划项目 2023ZR135

详细信息

通讯作者:
王天舒，E-mail：xxyy618907@163.com

中图分类号: R573.32 R256.3
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- 文章访问数: 15
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- PDF下载量: 1
- 被引次数: 0
出版历程
- 收稿日期: 2024-05-22
- 网络出版日期: 2024-12-31

Observation on the effect of Shen Yuanliang's prescription in treating CAG patients

1.
General Practice Department, Shaoxing Hospital of Traditional Chinese Medicine, Shaoxing, Zhejiang 312000, China

摘要

摘要: 目的探讨名老中医沈元良用药组方治疗慢性萎缩性胃炎(CAG)对胃黏膜病变的改善作用及其机制。方法选取绍兴市中医院2020年9月—2023年9月收治的105例CAG患者，采用随机数字表法将患者分为A组(53例)和B组(52例)，B组患者采用西药治疗，A组在B组基础上同时服用沈元良用药组方。对比治疗前后患者胃黏膜组织病理学评分、血清成纤维细胞生长因子23(FGF-23)、胆碱酯酶(S-ChE)、胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、中医证候积分变化及临床效果差异。结果 A组患者治疗后的血清FGF-23低于B组，血清S-ChE、PGⅠ高于B组，差异有统计学意义(P＜0.05)；A组的胃脘胀痛、恶心呕吐、气滞积食、嗳气反酸积分均低于B组(P＜0.05)；治疗后，A组的胃黏膜萎缩程度评分、慢性炎症评分、肠上皮异常化生评分、肠上皮异常增生积分均低于B组(P＜0.05)；A组显效32例、有效18例、无效3例，B组显效20例、有效24例、无效8例，A组患者的总体疗效优于B组(Z=-2.402，P＜0.05)。结论采用名老中医沈元良用药组方治疗CAG患者，能更有效地改善胃黏膜组织病理学特征，改善血清S-ChE、FGF-23、PGⅠ及PGⅡ水平和临床症状，总体临床效果更好。
- 慢性萎缩性胃炎 /
- 名老中医 /
- 中医方剂 /
- 成纤维细胞生长因子 /
- 胆碱酯酶 /
- 胃蛋白酶原Ⅰ /
- 胃蛋白酶原Ⅱ
Abstract: Objective To explore the improvement effect and mechanism of Shen Yuanliang's prescription in treating chronic atrophic gastritis (CAG) on gastric mucosal lesions. Methods A total of 105 CAG patients admitted to Shaoxing Hospital of Traditional Chinese Medicine from September 2020 to September 2023 were selected and randomly divided into Group A (53 cases) and Group B (52 cases) using a random number table method. Patients in Group B were treated with Western medicine, while patients in Group A were administered Shen Yuanliang's traditional Chinese medicine prescription in addition to the Western medicine treatment received by Group B. Before and after treatment, the patients' gastric mucosal histopathology scores, serum fibroblast growth factor 23 (FGF-23), cholinesterase (S-ChE), pepsinogen Ⅰ (PG Ⅰ), pepsinogen Ⅱ (PG Ⅱ), changes in traditional Chinese medicine syndrome scores, and clinical effects were compared. Results After treatment, the serum FGF-23 level in Group A was lower than that in Group B, while the serum S-ChE and PG Ⅰ levels were higher than those in Group B, with statistically significant differences (P < 0.05). Group A had lower scores for epigastric distention and pain, nausea and vomiting, qi stagnation and indigestion, belching, and acid reflux than Group B (P < 0.05). After treatment, Group A had lower scores for gastric mucosal atrophy, chronic inflammation, intestinal metaplasia, and intestinal dysplasia than Group B (P < 0.05). There were 32 cases of marked effectiveness, 18 cases of effectiveness, and 3 cases of ineffectiveness in Group A, while Group B had 20 cases of marked effectiveness, 24 cases of effectiveness, and 8 cases of ineffectiveness. The overall therapeutic effect was better in Group A than in Group B (Z=-2.402, P < 0.05). Conclusion The treatment of CAG patients with Shen Yuanliang's prescription can improve the gastric mucosal histopathological features more effectively, improve the levels of S-ChE, FGF-23, PG Ⅰ, and PG Ⅱ in serum and clinical symptoms, and the overall clinical effect is better.
- Chronic atrophic gastritis /
- Famous old Chinese medicine /
- Traditional Chinese medicine prescriptions /
- Fibroblast growth factor /
- Cholinesterase /
- Pepsinogen Ⅰ /
- Pepsinogen Ⅱ

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表 1 2组CAG患者各项基线资料比较

Table 1. Comparison of the baseline data of CAG patients between the two groups

组别	例数	年龄(x±s，岁)	BMI(x±s)	性别[例(%)]		吸烟[例(%)]	饮酒[例(%)]	Hp阳性[例(%)]	腺体萎缩程度[例(%)]
组别	例数	年龄(x±s，岁)	BMI(x±s)	男性	女性	吸烟[例(%)]	饮酒[例(%)]	Hp阳性[例(%)]	轻度	中度	重度
A组	53	49.2±7.4	23.84±1.90	33(62.26)	20(37.74)	26(49.06)	24(45.28)	41(77.36)	16(30.19)	28(52.83)	9(16.98)
B组	52	47.5±8.2	23.66±1.75	28(53.85)	24(46.15)	22(42.31)	18(34.62)	37(71.15)	21(40.38)	25(48.08)	6(11.54)
统计量		1.116^a	0.505^a	0.764^b		0.482^b	1.245^b	0.529^b	-1.193^c
P值		0.267	0.615	0.382		0.488	0.265	0.467	0.233
注：^a为t值，^b为χ²值，^c为Z值。

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表 2 2组CAG患者治疗前后血清S-ChE、FGF-23、PGⅠ及PGⅡ比较(x±s)

Table 2. Comparison of serum S-ChE, FGF-23, PG-Ⅰ, and PG-Ⅱ before and after treatment between two groups (x±s)

组别	例数	S-ChE(mg/mL)		t值	P值	FGF-23(pg/mL)		t值	P值	PGⅠ(μg/L)		t值	P值	PGⅡ(μg/L)		t值	P值
组别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
A组	53	5.34±1.16	7.48±1.32	-8.829	＜0.001	54.83±5.92	45.38±4.72	9.033	＜0.001	79.6±18.4	120.5±23.7	-9.888	＜0.001	4.67±1.20	4.80±1.32	-0.528	0.598
B组	52	5.60±1.21	6.64±1.40	-4.075	＜0.001	56.30±5.58	48.41±5.00	7.626	＜0.001	83.8±17.8	110.0±24.4	-6.294	＜0.001	4.50±1.14	4.69±1.46	-0.744	0.459
统计量		-1.124^a	6.109^b			-1.309^a	9.012^b			-1.188^a	7.882^b			0.744^a	1.290^b
P值		0.264	＜0.001			0.194	＜0.001			0.237	0.027			0.459	0.311
注：^a为t值，^b为F值。

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表 3 2组CAG患者治疗前后的中医临床症状积分比较(x±s，分)

Table 3. Comparison of TCM clinical symptom scores of CAG patients before and after treatment between the two groups (x±s, points)

组别	例数	胃脘胀痛		t值	P值	恶心呕吐		t值	P值	气滞积食		t值	P值	嗳气反酸		t值	P值
组别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
A组	53	2.20±0.58	0.81±0.19	16.437	＜0.001	1.84±0.42	0.79±0.15	16.994	＜0.001	1.98±0.41	0.85±0.26	16.829	＜0.001	2.00±0.43	0.91±0.28	15.361	＜0.001
B组	52	2.14±0.62	1.33±0.24	8.796	＜0.001	1.67±0.48	1.05±0.27	8.136	＜0.001	2.14±0.48	1.22±0.31	11.642	＜0.001	2.12±0.50	1.26±0.34	10.287	＜0.001
统计量		0.512^a	9.181^b			1.932^a	7.491^b			-1.838^a	7.110^b			-1.319^a	6.201^b
P值		0.610	＜0.001			0.056	＜0.001			0.069	＜0.001			0.190	＜0.001
注：^a为t值，^b为F值。

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表 4 2组CAG患者胃黏膜病理组织学改善情况比较(x±s，分)

Table 4. Comparison of gastric mucosal histopathological improvement between two groups of CAG patients (x±s, points)

组别	例数	胃黏膜萎缩		t值	P值	肠上皮异常化生		t值	P值	慢性炎症		t值	P值	肠上皮异常增生		t值	P值
组别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
A组	53	2.30±0.43	1.41±0.38	11.230	＜0.001	1.91±0.37	1.40±0.28	7.953	＜0.001	2.19±0.47	0.98±0.25	16.424	＜0.001	1.90±0.51	1.28±0.32	7.445	＜0.001
B组	52	2.14±0.47	1.78±0.43	4.093	＜0.001	1.85±0.40	1.58±0.31	3.861	＜0.001	2.08±0.50	1.32±0.31	9.340	＜0.001	1.83±0.48	1.43±0.39	4.681	＜0.001
统计量		1.821^a	6.910^b			0.798^a	5.442^b			1.162^a	7.481^b			0.724^a	4.461^b
P值		0.072	＜0.001			0.427	0.002			0.248	＜0.001			0.471	0.014
注：^a为t值，^b为F值。

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表 5 2组CAG患者疗效比较[例(%)]

Table 5. Comparison of clinical efficacy of CAG patients between two groups [cases(%)]

组别	例数	显效	有效	无效
A组	53	32(60.38)	18(33.96)	3(5.66)
B组	52	20(38.46)	24(46.15)	8(15.38)
注：2组疗效比较，Z=-2.402, P=0.016。

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