张强 郭玲珑 陈建宏 李京伟 姜小艳 张春虹 黄明河

【摘 要】 目的：观察消萎化肠方治疗脾虚血瘀型慢性萎缩性胃炎（CAG）的临床疗效。方法：将60例慢性萎缩性胃炎脾虚血瘀证患者随机分为对照组和观察组各30例。对照组予口服胃复春，观察组予口服消萎化肠方。3个月后比较两组的临床疗效、中医症状积分、病理学积分、生存质量评分、PGI、PGII、PGR、G-17等指标的变化。结果：观察组的总有效率为73.33%，显著高于对照组的60%（P<0.05），观察组治疗后中医症状积分均较前降低（P<0.05），且胃脘疼痛、胃脘胀满、纳呆、舌暗、脉涩积分较对照组降低更明显（P<0.05）。治疗后两组的萎缩、肠上皮化生评分均较前降低，PGI、PGR、G-17、生存质量评分均较治疗前升高（P<0.05），且观察组优于对照组（P<0.05）。结论：消萎化肠方治疗脾虚血瘀型慢性萎缩性胃炎可有效缓解临床症状，改善病理组织学表现与生存质量，可能与其调节血清PGI、PGR、G-17水平的机制有关。

【关键词】 慢性萎缩性胃炎;脾虚血瘀型;消萎化肠方

【中图分类号】R573.3+2 【文献标志码】 A 【文章编号】1007-8517（2021）13-0103-05

Abstract：Objective To observe the clinical efficacy of Xiaowei Huachang Decoction in treating chronic atrophic gastritis （CAG） of spleen deficiency and blood stasis type.Methods Sixty patients with chronic atrophic gastritis with spleen deficiency and blood stasis syndrome were randomly divided into control group and observation group with 30 cases each.The control group was given Weifuchun，the observation group was given Xiaowei Huachang Decoction orally. Three months later， the clinical efficacy， TCM symptom score， pathology score， quality of life score， PGI， PGII， PGR， G-17 and other indicators were compared between the two groups.Result The total effective rate of the observation group was 73.33%， which was significantly higher than the 60% of the control group （P<0.05）. After treatment， the scores of TCM symptoms in the observation group were lower than before （P<0.05）， and the scores of gastric pain， gastric fullness， loss of appetite， dark tongue， and astringent pulse were significantly lower than those of the control group （P<0.05）. After treatment， the scores of atrophy and intestinal metaplasia of the two groups of patients were lower than before， and PGI， PGR， G-17， and quality of life scores were all higher than before treatment （P<0.05）， and the observation group was better than control group （P<0.05）. Conclusion Xiaowei Huachang Decoction in the treatment of chronic atrophic gastritis of spleen deficiency and blood stasis type can effectively relieve clinical symptoms， improve histopathological performance and quality of life， which may be related to the mechanism of regulating serum PGI， PGR and G-17 levels.

Keywords：Chronic Atrophic Gastritis;Spleen Deficiency and Blood Stasis Type;Xiaowei Huachang Decoction

慢性萎縮性胃炎（Chronic atrophic gastritis，CAG）是各种因素导致胃黏膜固有腺体减少，伴或不伴肠上皮化生、不典型增生的一种消化系统疾病[1]，属于胃癌前病变，与胃癌的发生密切相关。临床表现无明显特异性，以胃脘痛、上腹部胀满、反酸、嗳气等为主要症状[2]。目前西医主要采取保护胃黏膜、抗HP、促胃肠动力等治疗方法，虽能部分缓解临床症状，但对延缓疾病进展、阻止疾病恶性发展及逆转萎缩、肠化等方面尚无特异性治疗手段[3]。因此如何缓解临床症状及降低癌变风险成为目前治疗CAG的研究热点。本研究旨在观察消萎化肠方治疗CAG的临床疗效及对实验室指标的影响，并探讨其对CAG的作用机制，以期为临床工作提供一定的借鉴作用。现将结果报告如下。

1 资料与方法

1.1 一般资料 选取2018年1月至2020年1月深圳市中医院收治的60例CAG患者，按照随机数字表法分为对照组和观察组各30例。对照组中男14例，女16例，年龄36～61岁，平……