疏肝健脾和胃方治疗肝郁脾虚型慢性胃炎的临床疗效

余维微 曾耀明 蔡宗宗

[摘要] 目的 探究疏肝健脾和胃方治疗肝郁脾虚型慢性胃炎的临床疗效。 方法 选取2018年9月～2019年9月我院收治的肝郁脾虚型慢性胃炎患者142例作为研究对象，按随机数字表法分为对照组和研究组，每组71例，对照组给予常规西药治療，研究组在对照组基础上给予疏肝健脾和胃方治疗。评价两组临床疗效，测定C反应蛋白（CRP）、白细胞介素-8（IL-8）、分泌型免疫球蛋白A（sIgA）水平，对比胃动力情况。 结果 ①研究组总有效率高于对照组（P<0.05）。②治疗后两组CRP、IL-8、sIgA水平均下降（P<0.05），且治疗后研究组CRP、IL-8、sIgA水平均低于对照组（P<0.05）。③治疗后两组胃泌素、胃窦收缩幅度、胃收缩频率均上升（P<0.05），且治疗后研究组胃泌素高于对照组（P<0.05），治疗后两组胃窦收缩幅度、胃收缩频率对比，差异无统计学意义（P>0.05）。 结论 用疏肝健脾和胃方治疗肝郁脾虚型慢性胃炎可提高总有效率，其作用机制可能与CRP、IL-8、sIgA水平的合理调节、胃动力情况的改善相关。

[关键词] 疏肝健脾和胃方;肝郁脾虚型;慢性胃炎;临床疗效

[中图分类号] R24;R65          [文献标识码] B          [文章编号] 1673-9701（2020）15-0162-04

Clinical effect of Shugan Jianpi Hewei recipe in the treatment of chronic gastritis of liver stagnation and spleen deficiency

YU Weiwei   ZENG Yaoming   CAI Zongzong

Department of Gastroenterology， Wenzhou Hospital of Traditional Chinese Medicine in Zhejiang Province， Wenzhou   325000， China

[Abstract] Objective To explore the clinical efficacy of Shugan Jianpi Hewei recipe in the treatment of chronic gastritis with liver stagnation and spleen deficiency. Methods From September 2018 to September 2019， 142 patients with chronic gastritis of liver stagnation and spleen deficiency were selected as research objects. According to the random number table method， they were divided into control group and study group， with 71 cases in each group. The control group was given conventional western medicine. The study group was given Shugan Jianpi Hewei recipe on the basis of the control group. The clinical efficacy was evaluated. The levels of C-reactive protein（CRP）， interleukin-8（IL-8）， and secreted immunoglobulin A（sIgA） were measured， and gastric motility was compared. Results ①The total effective rate in the study group was higher than that in the control group（P<0.05）. ② After treatment， the levels of CRP， IL-8 and sIgA were decreased in both groups（P<0.05）. The levels of CRP， IL-8 and sIgA in the study group were lower than those in the control group after treatment（P<0.05）. ③ After treatment， the gastrin， gastric antral contraction amplitude and gastric contraction frequency were increased in both groups（P<0.05）， and the gastrin in the study group was higher than that in the control group after treatment（P<0.05）. There was no significant difference in gastric antral contraction amplitude and gastric contraction frequency between the two groups after treatment（P>0.05）. Conclusion Shugan Jianpi Hewei recipe in the treatment of chronic gastritis of liver stagnation and spleen deficiency can improve the total effective rate. Its mechanism of action may be related to the reasonable regulation of CRP， IL-8， and sIgA levels and improvement of gastric motility.

[Key words] Shugan Jianpi Hewei recipe; Liver stagnation and spleen deficiency; Chronic gastritis; Clinical efficacy

慢性胃炎屬于慢性胃黏膜炎性病变，发病率高，病因多样，常见包括幽门螺杆菌感染、自身免疫等[1-2]。患病后罹患胃癌几率增大，故应准确治疗[3-4]。传统医学将其归为“痞满证”范畴，治疗强调“辨证论治”，依据症状、病机等不同辨证分型，故其治疗方案不尽然一致[5-6]。肝郁脾虚型多见，疏肝健脾和胃方为效验方剂，可疏肝理气、健运脾胃，药中病机适用于治疗肝郁脾虚型慢性胃炎[7-8]。基于此，本研究将疏肝健脾和胃方用于治疗肝郁脾虚型慢性胃炎，现报道如下。

1 资料与方法

1.1 入选标准

1.1.1 纳入标准  ①确诊慢性胃炎，经胃镜、病理诊断，且辨证分型为肝郁脾虚型;②近30 d未接受其他治疗;③患者知情本次研究，且同意参与。

1.1.2 排除标准  ①合并胃癌、上消化道出血等;②患有脏器严重原发性疾患者;③精神异常，智力异常者;④过敏体质者。……