加味黄芪建中汤联合瑞巴派特三联疗法治疗脾胃虚寒型消化性溃疡的效果

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【摘要】 目的：观察加味黄芪建中汤联合瑞巴派特三联疗法治疗脾胃虚寒型消化性溃疡（peptic ulcer，PU）的临床效果。方法：选取2017年2月-2019年2月笔者所在科室收治的脾胃虛寒型PU患者124例，随机分为研究组（62例）与对照组（62例）。对照组仅给予瑞巴派特三联疗法治疗，在此基础上，研究组加用加味黄芪建中汤治疗，两组干预时间均为1个月。比较两组临床疗效、炎症反应指标及预后质量的差异。结果：研究组治疗总有效率为95.16%，明显高于对照组的82.26%，差异有统计学意义（字2=5.153，P=0.023）;治疗1个月后，研究组炎症反应指标IL-6、IL-17、IL-23水平均明显低于对照组（P<0.05）;研究组止血时间、输血量、住院时间均明显优于对照组（P<0.05）。结论：加味黄芪建中汤联合瑞巴派特三联疗法可明显改善脾胃虚寒型PU患者临床症状及机体高炎症状态，且对预后质量的改善效果显著，值得临床推荐。

【关键词】 加味黄芪建中汤 瑞巴派特三联疗法 脾胃虚寒型 消化性溃疡

doi：10.14033/j.cnki.cfmr.2019.28.007 文献标识码 B 文章编号 1674-6805（2019）28-00-03

Effect of Jiawei Huangqi Jianzhong Decoction Combined with Rebamipide Triple Therapy in the Treatment of Peptic Ulcer of Spleen-stomach Deficiency and Cold Type/GAO Houyou. //Chinese and Foreign Medical Research， 2019， 17（28）： -19

[Abstract] Objective： To explore the clinical effect of Jiawei Huangqi Jianzhong Decoction combined with Rebamipide triple therapy in the treatment of peptic ulcer （PU） of spleen-stomach deficiency and cold type. Method： A total of 124 PU patients with spleen-stomach deficiency and cold type were randomly divided into the study group （62 cases） and the control group （62 cases）. The control group was only treated with Rebamipide triple therapy. On this basis， the study group was treated with Jiawei Huangqi Jianzhong Decoction. The intervening time of both groups was 1 month. The differences of clinical efficacy， inflammatory response indexes and prognosis quality between the two groups were compared.Result： The total effective rate of the study group was 95.16%， which was significantly higher than 82.26% of the control group， and the difference was statistically significant （字2=5.153， P=0.023）. After one month of treatment， the levels of IL-6， IL-17 and IL-23 in the study group were significantly lower than those of the control group （P<0.05）. The hemostasis time， blood transfusion volume and hospitalization time in the study group were significantly better than those of the control group （P<0.05）. Conclusion： Jiawei Huangqi Jianzhong Decoction combined with Rebamipide triple therapy can significantly improve the clinical symptoms and high inflammatory state of PU patients with spleen-stomach deficiency and cold type， and significantly improve the prognosis quality， which is worthy of clinical recommendation.

[Key words] Jiawei Huangqi Jianzhong Decoction Rebamipide triple therapy Spleen-stomach deficiency and cold type Peptic ulcer

First-authors address： Shunchang County Hospital of Traditional Chinese Medicine， Shunchang 353200， China

消化性溃疡（peptic ulcer，PU）主要指胃溃疡和十二指肠溃疡，是消化科常见疾病之一，多因喝酒、饮食无规律等因素导致胃蛋白酶、胃酸自身消化和黏膜防御因子失衡，从而引发疾病。PU主要臨床症状为上腹部的规律性疼痛，可出现穿孔、出血等并发症，甚至导致失血性休克，对患者生命安全造成严重威胁[1]。目前，西医以质子泵抑制剂作为主要用药，多通过阻滞胃酸分泌及维持pH值以达到治疗PU目的，但长期服用具有一定不良反应，效果常难达到预期[2]。基于西医措施的局限性、短暂性等特点，近年来，多数国内学者逐渐倾向于将中医治疗理念加入PU治疗中，运用中西医结合疗法以提升整体治疗效果[3]。目前，临床上尚无加味黄芪建中汤联合瑞巴派特三联疗法对脾胃虚寒型PU的研究报道，为此笔者于临床展开对照性研究，以期为临床实践提供参考。……