芪参益胃汤治疗慢性萎缩性胃炎伴胃癌前病变疗效及其机制探讨

发布时间：2018-06-05 15:02

本文选题：芪参益胃汤 + 萎缩性胃炎　；参考：《中药药理与临床》2017年02期

【摘要】：目的:观察芪参益胃汤治疗慢性萎缩性胃炎伴胃癌前病变临床疗效,并初步探讨其治疗机制。方法:选择河北省中医院脾胃科门诊2014年1月至2016年1月收治的萎缩性胃炎伴胃癌前病变患者170例,按照数字随机表法分为2组,每组85例,治疗组给予中药组方芪参益胃汤口服,对照组给予对照组给予胃复春片口服,两组均连续治疗24周,比较两组治疗前后中医证候评分、病理积分和血清白细胞介素(IL)-2、IL-4、IL-6和干扰素-γ(INF-γ)水平,并比较两组治疗中有效率。结果:治疗后治疗组胃脘痛[(0.58±0.21)分比(1.06±0.37)分]、痞满[(0.84±0.36)分比(1.49±0.81)分]、纳呆[(0.68±0.22)分比(0.92±0.45)分]积分低于对照组(P0.01),炎症[(0.79±0.32)分比(1.08±0.45)分]、萎缩[(0.94±0.41)分比(1.26±0.54)分]、肠化生[(0.75±0.34)分比(1.22±0.53)分]、异型增生[(0.65±0.26)分比(0.79±0.30)分]积分均明显低于对照组,血清IL-2[(9.44±1.74)pg/ml比(5.81±1.49)pg/ml]、INF-γ[(20.48±5.17)pg/ml比(15.78±5.44)pg/ml]水平明显高于对照组,IL-4[(6.04±1.51)pg/ml比(8.23±1.95)pg/ml]、IL-6[(59.64±12.77)pg/ml比(76.38±12.80)pg/ml]水平明显低于对照组,治疗总有效率高于对照组(95.18%比81.71%)。结论:芪参益胃汤可有效改善症状,缓解胃黏膜炎症,阻断和逆转肠上皮化生、异型增生,治疗萎缩性胃炎伴胃癌前病变疗效显著,其机制可能与调节Th1/Th2免疫失衡有关。
[Abstract]:Objective: to observe the clinical effect of Qishen Yiwei decoction on chronic atrophic gastritis with gastric precancerous lesion and to explore its therapeutic mechanism. Methods: 170 cases of atrophic gastritis with precancerous lesions were selected from January 2014 to January 2016 in the Department of spleen and stomach, Hebei traditional Chinese Medicine Hospital. According to the method of digital random table, 170 patients were divided into two groups, 85 cases in each group. The treatment group was treated with Qishen Yiwei decoction and the control group was treated with Weifuchun tablet for 24 weeks. The scores of TCM syndromes before and after treatment were compared between the two groups. The pathological score and the serum levels of IL-4 IL-6 and IFN- 纬 INF- 纬 were compared between the two groups. Results: after treatment, the scores of epigastric pain [0.58 卤0.21) vs 1.06 卤0.37], fullness [0.84 卤0.36) vs 1.49 卤0.81], nardine [0.68 卤0.22 vs 0.92 卤0.45] of the treatment group were lower than those of the control group (P 0.011, inflammation 0.79 卤0.32 vs 1.08 卤0.45), atrophy [0.94 卤0.41 vs 1.26 卤0.54], intestinal metaplasia [0.75 卤0.34 vs 1.22 卤0.53], dysplasia [0.94 卤0.41] and intestinal metaplasia [0.75 卤0.34 vs 1.22 卤0.53]. The score of health [0.65 卤0.26] score was significantly lower than that of control group (0.79 卤0.30). The level of serum IL-2 [9.44 卤1.74)pg/ml vs 5.81 卤1.49)pg/ml] INF- 纬 [20.48 卤5.17)pg/ml vs 15.78 卤5.44)pg/ml] was significantly higher than that of control group [6.04 卤1.51)pg/ml 8.23 卤1.95)pg/ml] IL-6 [59.64 卤12.77)pg/ml vs 76.38 卤12.80)pg/ml], and the total effective rate was 95.18% higher than that of control group (95.18% vs 81.71%). Conclusion: Qishen Yiwei decoction can effectively improve symptoms, relieve inflammation of gastric mucosa, block and reverse intestinal metaplasia and dysplasia, and have a significant effect on atrophic gastritis with gastric precancerous lesion. The mechanism of Qishen Yiwei decoction may be related to the regulation of Th1 / Th2 immune imbalance.
【作者单位】：河北省中医院脾胃病3科;河北省优抚医院消化内科;
【基金】：河北省中医药管理局科研计划项目(2015111)
【分类号】：R259

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