目的 探讨滋胃饮联合西药治疗慢性萎缩性胃炎胃阴亏虚证的临床疗效.方法 选取慢性萎缩性胃炎胃阴亏虚证患者68例,随机分为对照组33例和治疗组35例.对照组采用阿莫西林胶囊、克拉霉素缓释片、奥美拉唑肠溶胶囊、枸橼酸铋钾胶囊等西药治疗,治疗组在对照组基础上加服滋胃饮,2组疗程均为6周.比较2组患者的临床疗效、中医证候积分、胃黏膜组织病理评分及胃黏膜炎症指标[白介素-11 (IL-11)、白介素-12(IL-12)、C反应蛋白(CRP)和肿瘤坏死因子-α(TNF-α)]和胃黏膜免疫功能指标(CD4+、CD8+和CD4 +/CD8+).结果 治疗组总有效率为94.29％,显著高于对照组的75.76％(P＜o.05).治疗6周,2组中医证候积分均较治疗前显著降低(P＜0.05),且治疗组主要中医症状积分如胃脘隐痛、食后脘闷、纳呆少食和次要中医症状积分如恶心呕吐及总积分均显著低于对照组(P＜0.05).2组胃黏膜组织病理评分均较治疗前显著降低(P＜0.05),且治疗组显著低于对照组(P＜0.05).2组胃黏膜炎症指标和胃黏膜免疫功能指标均较治疗前显著降低(P＜0.05),且治疗组显著低于对照组(P＜0.05).结论 滋胃饮联合西医常规治疗慢性萎缩性胃炎胃阴亏虚证患者疗效显著,可以显著改善患者的临床症状,降低胃黏膜炎症反应程度,值得临床推广.%Objective To explore the clinical effect of stomach-tonifying decoction combined with western medicine on the treatment of patients with yin deficiency syndrome of stomach of chronic atrophic gastritis.Methods Totally 68 patients with yin deficiency syndrome of stomach of chronic atrophic gastritis were randomly divided into control group (n =33) and treatment group (n =35).The control group was treated with western medicines such as amoxicillin capsules,clarithromycin sustained release tablets,omeprazole enteric-coated capsules and bismuth potassium citrate capsules.The treatment group was treated with stomach-tonifying decoction on the basis of the control group.Both groups were treated for 6 weeks.The clinical efficacy,score of TCM syndromes,gastric mucosa pathological score and gastric mucosal inflammation indexes [interleukin-11 (IL-11),interleukin-12 (IL-12),C reactive protein (CRP) and tumor necrosis factor-α (TNF-α)] and gastric mucosal immune function indexes (CD4 +,CD8 + and CD4 +/CD8 +).Results The total effective rate of the treatment group was 94.29％,which was significantly higher than 75.76％ of the control group (P ＜0.05).After treatment of 6 weeks,the scores of TCM syndromes in both groups were significantly lower than those before treatment (P ＜ 0.05),and the scores of main TCM symptom such as epigastric pain,abdominal nausea after eating,loss of appetite and score of minor TCM symptom such as nausea and vomiting and total score in the treatment group were significantly lower than those in the control group (P ＜ 0.05).After 6 weeks of treatment,the gastric mucosa pathological score in both groups was significantly lower than that before treatment (P ＜ 0.05),and the score of the treatment group was significantly lower than that of the control group (P ＜ 0.05).After treatment of 6 weeks,the gastric mucosal inflammation indexes and gastric mucosal immune function indexes in both groups were significantly lower than those before treatment (P ＜ 0.05),and these indexes in the treatment group were significantly lower than those in the control group (P ＜ 0.05).Conclusion Stomach-tonifying decoction combined with western medicine is effective in treating patients with yin deficiency syndrome of stomach of chronic atrophic gastritis,which can significantly improve the clinical symptoms and reduce the degree of inflammatory reactions of gastric mucosa,so it is worthy of clinical application.
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