加味安胃汤联合黛力新治疗老年萎缩性胃炎(脾虚血瘀证)伴焦虑抑郁状态疗效及其对血清PGⅠ、PGⅡ、PGR、G-17影响

The therapeutic effect of modified Anwei decoction combined with deanxit on elderly patients with atrophic gastritis(spleen deficiency and blood stasis syndrome)complicated with anxiety and depression,and its effect on serum PGⅠ,PGⅡ,G-17 and PGR

中文关键词: 老年  加味安胃汤  黛力新  萎缩性胃炎  脾虚血瘀型  焦虑抑郁  胃蛋白酶原Ⅰ  胃蛋白酶原Ⅰ/胃蛋白酶原Ⅱ  胃泌素17

英文关键词: elderly  modified Anwei decoction  deanxit  atrophic gastritis  spleendeficiency and blood stasis  anxiety and depression  pepsinogen Ⅰ  ratio of PGⅠ to PGⅡ  gastrin 17

中文摘要:

      目的 观察加味安胃汤联合黛力新治疗老年脾虚血瘀型慢性萎缩性胃炎伴焦虑抑郁状态的临床疗效及其对血清PGⅠ、PGⅡ、PGR、G-17 影响.方法 选取了2017 年12 月—2019 年6 月间在上海市中医医院脾胃病科门诊被诊断为慢性萎缩性胃炎伴焦虑抑郁状态的患者中证属脾虚血瘀型的病例81 例,按数字随机法分为2 组.治疗随访过程中,对照组2 例失访、3 例退出.最终纳入治疗组41 例给予加味安胃汤+黛力新治疗,对照组35 例则予胃复春+黛力新治疗.治疗12 周后,统计2 组治疗前后中医临床症状积分,胃镜表现改善率,病理积分,焦虑抑郁积分,以及血清PGⅠ、PGⅡ、PGR、G-17 变化情况.结果 (1)治疗组及对照组的中医临床症状总积分以及主症在治疗后均得到改善(P＜0.05),且治疗组对于口苦、便溏、乏力症状的改善优于对照组,积分差异具有统计学意义(P＜0.05);(2)对比2 组临床疗效中的有效率,治疗组及对照组分别为92.69%、82.86%,治疗组优于对照组(P＜0.05);(3)通过对比 2 组治疗前后的萎缩、肠化、异型增生,治疗组的疗效优于对照组(P＜0.05);(4)治疗后,2 组的焦虑、抑郁状态较前均有一定好转,治疗组与对照组比较差异具有统计学意义(P＜0.05);(5)2 组治疗后血PGⅠ、PGR、G-17 含量均高于治疗前(P＜0.05),且治疗组治疗后三者含量均高于对照组,差异有统计学意义(P＜0.05),但对PGⅡ的影响,2 组均未见明显改变.结论 加味安胃汤联合黛力新治疗脾虚血瘀型慢性萎缩性胃炎伴有抑郁焦虑状态疗效确切,值得临床应用.

英文摘要:

      Objective To investigate the clinical effect of modified Anwei decoction combined with deanxit on elderly patients with atrophic gastritis(spleen deficiency and blood stasis syndrome)complicated with anxiety and depression,and its effects on serum pepsinogenⅠ(PGⅠ),pepsinogenⅡ(PGⅡ),gastrin 17(G-17)and ratio of PGⅠto PGⅡ(PGR).Methods 81 patients diagnosed with chronic atrophic gastritis complicated with anxiety and depression who belonged to spleen deficiency and blood stasis syndrome treated in Department of Spleen and Stomach Disease of Shanghai Municipal Hospital of Traditional Chi-nese Medicine from December 2017 to June 2019 were selected.They were divided into 2 groups by numerical random method.During the treatment follow-up,2 patients in the control group were lost to follow-up and 3 ones dropped out.Finally,41 cases were included in the treatment group and treated with modified Anwei decoction+deanxit,and 35 ones were included in the control group and treated with Weifuchun+deanxit.After 12 weeks of treatment,the clinical symptom score of traditional Chinese medicine(TCM),improvement rate of gastroscopy,pathological score,anxiety and depression score,as well as chan-ges in the levels of serum PGI,PGII,G-17 and PGR were statistically analyzed and compared between the two groups before and after treatment.Results(1)The total score of TCM clinical symptoms and main symptoms of both groups were improved after treatment(P＜0.05),and the improvement of symptoms of bitter mouth,loose stool and fatigue in the treatment group was better than that in the control group,and the score differences were statistically significant(P＜0.05).(2)The clinical effective rates of the treatment group and the control group were 92.69%and 82.86%,respectively,and the treatment group was better than the control group(P＜0.05).(3)The changesof atrophy,intestinal metaplasia and dysplasia before and after treatment were compared between the two groups.The therapeutic effect of the treatment group was better than that of the con-trol group(P＜0.05).(4)Compared with before treatment,anxiety and depression of both groups were improved to a certain extent after treatment,and the difference between the two groupswasstatistically significant(P＜0.05).(5)After treatment,the levels of serum PGI,G-17 and PGR of both groups were higher than those of the same group before treatment(P＜0.05),and the levels of the three of the treatment group were higher than those of the control group after treatment,with statistical sig-nificance(P＜0.05).However,there was no significant change in serum PGII level before and after treatment in both groups.Conclusion The combination of modified Anwei decoction combined with deanxit is effective in the treatment of chronic atrophic gastritis(spleen deficiency and blood stasis syndrome)complicated with anxiety and depression,and is worthy of clin-ical application.