四逆散加味治疗慢性萎缩性胃炎疗效观察及机制探析.doc

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1、四逆散加味治疗慢性萎缩性胃炎疗效观察及机制探析［摘要］目的评价四逆散治疗慢性萎缩性胃炎肝郁脾虚型患者的有效性和作用机制。方法选择我院确诊为慢性萎缩性胃炎、中医辨证属肝郁脾虚型患者76例，并设健康对照组36例；将慢性萎缩性胃炎患者又随机分为两组，四逆散治疗组（40例）给予四逆散治疗，胃复春对照组（36例）给予胃复春治疗，两组均治疗3个月。观察三组临床疗效、胃镜下变化、病理改变、血清转化生长因子-a（TGF-a）水平及安全性指标。结果①四逆散治疗组的临床、胃镜、病理疗效显著优于胃复春对照组（P<0.05）；②治疗前四逆散治疗组及胃复春对照组血清TGF-a水平均高于健康对照组，治疗后两组

2、血清TGF-a水平较治疗前明显降低（P<0.05）o结论四逆散对慢性萎缩性胃炎肝郁脾虚型患者有良好的疗效，其作用机制可能与调节TGF-a的合成有关。［关键词］慢性萎缩性胃炎；四逆散；转化生长因子-a；临床观察［中图分类号］R573.3［文献标识码］A［文章编号］1673-7210(2012)08(a)-0116-03TherapeuticefficacyandmechanismofSiniSanDecoctioninthetreatmentofchronicatrophicgastritissZHAOCuiliCAIZhigangTraditionalChineseMedicine

3、HospitalofFutianDistrictinShenzhenCityAffiliatedtoHu，nanUniversityofChineseMedicine,GuangdongProvince,Shenzhen518034,China[Abstract]ObjectiveToevaluatetheeffectivenessandmechanismofSiniSanDecoctioninthetreatmentofpatientswithchronicatrophicgastritisinthesyndromeofliverstagnationandspleendefici

4、ency.Methods76casesofchronicatrophicgastritiswithTCMdiagnosisofliverstagnationandspleendeficiencyand36casesofhealthypeoplewereenrolledinthestudy.Chronicatrophicgastritispatientswererandomlydividedintotwogroups・40casesintreatmentgroupweregivenSiniSanDecoctiontreatmentand36casesintheWeifuchuncon

5、trolgroupweregivenWeifuchuntreatment・76patientsallweretreatedfor3monthsandtheclinicalefficacy,endoscopicchanges,pathologicalchangesofserum,transforminggrowthfactor-alpha(TGF-alpha)levelsandsafetyindicatorsofthepatientswereobserved・ResuIts①Clinical,endoscopicandpathologicaloutcomesoftheSiniSamD

6、ecoctiontreatmentgroupweresignificantlybetterthanthoseofWeifuchuncontrolgroup(P<0.05)；②SerumTGF-alevelsofbothWeifuchuncontrolgroupandSiniSanDecoctiontreatmentgroupwerehigherthanthatofhealthycontrolgroupbeforetreatmentandweresignificantlydecreasedaftertreatment(P<0.05).ConclusionSiniSanDecoctio

7、nshowsagoodefficacyinthetreatmentofpatientswithchronicatrophicgastritisinthesyndromeofliverstagnationandspleendeficiency,anditsmechanismofeffectmayberelatedtothesynthesisofTGF-a.[Keywords]Chronicatrophicgastritis；SiniSanDecoction；Transf