2023 年第 5 期 第 18 卷

鸡胵养胃散治疗慢性萎缩性胃炎的效果与作用机制探讨

The curative effect and mechanism of Jichi Yangwei powder on the treatment of chronic atrophic gastritis

作者：张娟1邱玉萍2罗晶1伊凡1

英文作者：Zhang Juan1 Qiu Yuping2 Luo Jing1 Yi Fan1

单位：1新疆维吾尔自治区乌鲁木齐市中医医院脾胃病科，乌鲁木齐830000；2新疆维吾尔自治区乌鲁木齐市中医医院南门分院针灸科，乌鲁木齐830000

英文单位：1Department of Spleen and Stomach Diseases Urumqi Traditional Chinese Medicine Hospital Xinjiang Uygur Autonomous Region Urumqi 830000 China; 2Department of Acupuncture Nanmen Branch of Urumqi Traditional Chinese Medicine Hospital Xinjiang Uygur Autonomous Region Urumqi 830000 China

关键词：慢性萎缩性胃炎；西北燥证；鸡胵养胃散；炎症因子；幽门螺杆菌

英文关键词：Chronicatrophicgastritis;Northwestdrynesssyndrome;JichiYangweipowder;Inflammatoryfactors;Helicobacterpylori

• 摘要：

• 目的 基于西北燥证理论探讨鸡胵养胃散治疗慢性萎缩性胃炎（CAG）的效果与作用机制。方法 选取新疆维吾尔自治区乌鲁木齐市中医医院2020年6月至2021年12月收治的100例CAG患者。按随机数字表法分为对照组与联合组，各50例。对照组采用常规西医治疗，联合组在对照组基础上加用鸡胵养胃散治疗，均治疗3个疗程（4周为1个疗程）。比较2组治疗前后的病理积分、中医症状评分与血清炎症因子［白细胞介素6（IL-6）、肿瘤坏死因子α（TNF-α）、IL-8］、胃泌素、胃动素以及血浆胃蛋白酶Ⅰ和Ⅱ水平，并比较2组临床疗效、幽门螺杆菌（Hp）根除率以及不良反应。结果  治疗后，2组患者的腺体萎缩、异体增生、肠上皮化生病理积分和中医症状评分以及血清IL-6、TNF-α、IL-8、胃泌素、胃动素水平均低于治疗前，且联合组低于对照组，差异均有统计学意义（均P＜0.05）；2组血浆胃蛋白酶Ⅰ及Ⅱ水平均高于治疗前、且联合组高于对照组，差异均有统计学意义（均P＜0.05）。联合组总有效率、Hp根除率高于对照组［92.0%（46/50）比72.0%（36/50）、95.6%（43/45）比76.7%（33/43）］，差异均有统计学意义（均P＜0.05）。2组总不良反应发生率差异无统计学意义（P>0.05）。结论   鸡胵养胃散能够提高CAG患者的临床疗效，明显改善其临床症状，降低炎症因子水平，调节血清胃泌素、胃动素以及血浆胃蛋白酶Ⅰ和Ⅱ水平，且安全性良好。

• Objective  To discuss the curative effect and mechanism of Jichi Yangwei powder on chronic atrophic gastritis(CAG) based on the theory of "Northwest Dryness Syndrome". Methods From June 2020 to December 2021, totally 100 CAG patients admitted to Urumqi Traditional Chinese Medicine Hospital, Xinjiang Uygur Autonomous Region were selected. According to the random number table method, they were divided into control group and combined group, with 50 cases each group. The control group was treated with conventional western medicine, and the combined group was treated with Jichi Yangwei powder on the basis of the control group, and all patients were treated for 3 courses(4 weeks was 1 course of treatment). The pathological score, traditional Chinese medicine symptom score, serum inflammatory factor［interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α), IL-8］, gastrin, motilin and plasma pepsin Ⅰ and Ⅱ levels were compared between the two groups before and after treatment. The clinical efficacy, clearance rate of Helicobacter pylori(Hp) and adverse reactions were compared between the two groups. ResultsAfter treatment, pathological scores of gland atrophy, allogeneic hyperplasia, pathological score of intestinal metaplasia, traditional Chinese medicine symptom score, levels of serum IL-6, TNF-α, IL-8 , gastrin and motilin in the two groups were lower than those before treatment, and those in the combined group were lower than those in the control group(all P<0.05). After treatment, the plasma pepsin Ⅰ and Ⅱ levels in the two groups were higher than those before treatment, and the levels in the combined group were higher than those in the control group(all P<0.05). The total effective rate and clearance rate of Hp in the combined group were higher than those in the control group［92.0%(46/50) vs 72.0%(36/50), 95.6%(43/45) vs 76.7%(33/43)］(both P<0.05). There was no significant difference in the incidence of total adverse reactions between the two groups(P>0.05). Conclusion Jichi Yangwei powder can improve the clinical curative efficacy of CAG patients, significantly improve their clinical symptoms, reduce the level of inflammatory factors, and regulate the levels of serum gastrin, motilin and plasma pepsin Ⅰ and Ⅱ, with good safety.