痛泻要方加减联合雷贝拉唑对肝郁脾虚证胃溃疡患者IL-2、IL-6的影响及临床观察

发布时间：2018-04-13 14:37

本文选题：痛泻要方加减 + 雷贝拉唑　；参考：《贵阳中医学院》2015年硕士论文

【摘要】：目的：观察痛泻要方加减联合雷贝拉唑治疗肝郁脾虚证胃溃疡患者的疗效和血清IL-2、IL-6的变化,探讨其可能作用机制和IL-2、IL-6在肝郁脾虚证胃溃疡发病中的作用及临床意义。方法：将60例肝郁脾虚证胃溃疡患者随机分为治疗组和对照组。对照组采用根除Hp标准三联疗法2周后,继服雷贝拉唑4周；治疗组则在采用对照组治疗方案的同时联合痛泻要方加减治疗,疗程亦为6周。治疗结束后观察临床疗效、证候积分变化、Hp根除情况、溃疡半年复发率及不良反应。并在治疗前后检测患者血清IL-2、IL-6,与15名体检正常人对比,观察其变化。结果：1、胃镜疗效：治疗组与对照组比较,差异无显著意义(P0.05)。2、中医证候疗效：治疗组愈显率、总有效率均高于对照组,差异有显著意义(P0.05)。3、中医证候积分比较：组内比较,各组总积分,各证积分均较治疗前明显降低,差异有显著意义(P0.05)。组间比较,治疗后治疗组总积分、各证积分(舌脉除外)均低于对照组,差异有显著意义(P0.05)。4、根除Hp疗效：治疗后,治疗组与对照组Hp根除率比较,差异无显著意义(P0.05)；半年后治疗组复发率明显低于对照组,差异有显著意义(P0.05)。5、患者血清IL-2、IL-6的变化：两组患者治疗前IL-2明显降低,IL-6明显升高,较之正常组差异有显著意义(P0.05)。治疗后治疗组接近正常组,差异无统计意义(P0.05)；而对照组在治疗后,较之正常组和治疗组,差异仍有显著意义(P0.05)。6、溃疡复发率：治疗组低于对照组,但差异无显著意义(P0.05)。结论痛泻要方加减联合雷贝拉唑治疗肝郁脾虚证胃溃疡疗效显著,复发率低,毒副作用小,安全可靠。其作用机制可能是通过调节细胞因子水平而发挥治疗作用。
[Abstract]:Objective: to observe the therapeutic effect of Tongxieyao decoction plus or minus rabeprazole in treating gastric ulcer of liver stagnation and spleen deficiency syndrome and the change of serum interleukin-6 (IL-6), and to explore the possible mechanism of the effect and the role and clinical significance of IL-2P IL-6 in the pathogenesis of gastric ulcer of liver stagnation and spleen deficiency syndrome.Methods: 60 patients with gastric ulcer of liver stagnation and spleen deficiency syndrome were randomly divided into treatment group and control group.The control group was treated with standard triple therapy for eradication of HP for 2 weeks, followed by rabeprazole for 4 weeks, while the treatment group was treated with the combination of Tongxie decoction and Tongxie decoction for 6 weeks.After the treatment, the clinical effect, symptom score, ulcer recurrence rate and adverse reaction were observed.The serum levels of IL-2 and IL-6 were measured before and after treatment, and compared with 15 normal controls.Results: there was no significant difference between the treatment group and the control group in the effect of gastroscopy. There was no significant difference between the treatment group and the control group. The curative effect of TCM syndromes: the total effective rate of the treatment group was higher than that of the control group, and the difference was significant (P0.05 路3). The comparison of TCM syndromes integral: comparison within the group,The total score of each group and the integral of each syndrome were significantly lower than those before treatment, and the difference was significant (P 0.05).After treatment, the total score and every syndrome score (except tongue pulse) in the treatment group were lower than those in the control group, and the difference was significant (P 0.05. 4). The curative effect of HP eradication: after treatment, the eradication rate of HP in the treatment group and the control group was higher than that in the control group.After treatment, the treatment group was close to the normal group, the difference was not statistically significant (P 0.05), while that in the control group was still significantly higher than that in the normal group and the treatment group. The recurrence rate of ulcer in the treatment group was lower than that in the control group, but there was no significant difference between the treatment group and the control group.Conclusion Tongxieyao decoction combined with rabeprazole in the treatment of gastric ulcer with liver stagnation and spleen deficiency syndrome has significant curative effect, low recurrence rate, small toxic side effect and safe and reliable.Its mechanism may be to regulate cytokine levels and play a therapeutic role.
【学位授予单位】：贵阳中医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R573.1

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