汪湃 冯世兵 刘宏伟 晋颖 雷霏

摘要  目的：探究溫针灸联合黄连温胆汤治疗慢性浅表性胃炎（CSG）的疗效。方法：选取2016年5月至2018年4月北京市和平里医院收治的CSG患者89例作为研究对象，按照随机数字表法分为对照组（ n =44）和观察组（ n =45）。对照组给予常规治疗，观察组在对照组基础上给予温针灸联合黄连温胆汤治疗，2组均连续治疗4周。统计2组的临床疗效;比较2组治疗前后中医证候积分与血清炎性反应递质水平;比较2组患者胃黏膜改善情况及幽门螺杆菌（Hp）根除率。结果：治疗后观察组临床有效率（95.56%）显著高于对照组（70.45%），差异有统计学意义（ P <0.05）;与治疗前比较，治疗后2组反酸、纳差、胃脘疼痛、腹胀、大便稀溏、嗳气、畏寒怕冷积分、总分与血清白细胞介素-1β（IL-1β）、白细胞介素-8（IL-8）、肿瘤坏死因子-α（TNF-α）、超敏C反应蛋白（hs-CRP）水平及胃黏膜充血、水肿、胆汁反流、糜烂发生率均显著降低，且观察组低于对照组，差异有统计学意义（ P <0.05）;治疗后观察组患者Hp根除率（88.89%）显著高于对照组（63.64%），差异有统计学意义（ P <0.05）。结论：温针灸联合黄连温阳汤可有效缓解CSG患者症状，抑制炎性反应，提高Hp根除率，保护胃黏膜，且疗效优于常规治疗。

关键词  慢性浅表性胃炎;温针灸;黄连温胆汤;炎性反应;胃黏膜;疗效;中医证候;幽门螺杆菌

Curative Effect of Warm Acupuncture Combined with Huanglian Wendan Decoction on Chronic Superficial Gastritis

WANG Pai， FENG Shibing， LIU Hongwei， JIN Ying， LEI Fei

（Department of Gastroenterology， Beijing Hepingli Hospital， Beijing 100013， China）

Abstract Objective： To explore the effects of warm acupuncture combined with Huanglian Wendan decoction on chronic superficial gastritis（CSG）.  Methods： A total of 89 cases CSG patients admitted to Beijing Hepingli Hospital were selected as the research objects and were divided into a control group（ n =44）and an observation group（ n =45）according to random number table method. The control group was treated with routine treatment， while the observation group was given warm acupuncture combined with Huanglian Wendan Decoction on the basis of the control group. The 2 groups treated continuously for 4 weeks. The clinical efficacy in the 2 groups of patients were evaluated after treatment; traditional Chinese medicine（TCM）syndromes and serum inflammatory factors levels in the 2 groups of patients were compared before and after treatment; gastric mucosa improved conditions and eradication rate of helicobacter pylori（HP）in the 2 groups of patients were compared.  Results： The total clinical effective rate of the observation group after treatment（95.56%）was significantly higher than that of the control group（70.45%）（ P <0.05）; compared with those before treatment， the sour regurgitation， poor appetite， stomach duct pain， abdominal distension， thin sloppy stool， belching， chills to the cold scores and total scores and serum TNF-α， IL-8， IL-1β， hs-CRP levels and the incidence of gastric mucosa hyperaemia， edema， bile reflux， erosion in 2 groups decreased significantly after treatment， and the observation group was significantly lower than the control group（ P <0.05）; the HP eradication rate（88.89%）of the observation group was significantly higher than that of the control group（63.64%）after treatment（ P <0.05）.  Conclusion： Warm acupuncture combine with Huanglian Wendan Decoction can effectively alleviate the symptoms of CSG patients， inhibit the inflammatory reaction， improve the eradication rate of HP， and protect the gastric mucosa， and the efficacy is superior to routine treatment.

Keywords  Chronic superficial gastritis; Warm acupuncture; Huanglian Wendan Decoction; Inflammation; Gastric mucosa; Efficacy; TCM syndromes; Helicobacter pylori

中图分类号：R289.5;R245;R573 文献标识码：A  doi： 10.3969/j.issn.1673-7202.2020.14.028

慢性浅表性胃炎（Chronic Superficial Gastritis，CSG）是一种慢性胃黏膜炎症，与幽门螺杆菌（Hp）感染、饮食不当等有关，患者会出现不同程度的消化不良，临床有腹部隐痛、恶心、反酸、嗳气等症状，该病易反复发作，病史较长，难以根治[1]。西医以抑制胃酸分泌、抗Hp感染等对症治疗为主，但长期服药易产生不良反应及耐药性，病情容易反复，患者依从性差。中医认为，CSG发病是由脾胃损伤、升降失司等所致，因此以和胃健脾、清热燥湿为治疗原则[2-3]，黄连温阳汤具有疏肝理气、降逆和胃、祛湿散寒等功效[4-5];针灸以其独特的经络腧穴及辨证论治理论，对CSG的治疗也具有良好的疗效，且不良反应较小。因此本研究温针灸联合黄连温胆汤治疗CSG对炎性反应及胃黏膜的影响。……