益气活血方对消化性溃疡愈合质量及复发的影响

作者	单位
张卫平	江苏省苏州市中医医院消化科
葛惠男	安徽中医学院第一附属医院实验中心
郭金伟	安徽中医学院第一附属医院实验中心

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中文摘要:

目的观察益气活血方对消化性溃疡愈合质量及复发的影响。方法采用随机对照研究,将46例活动期消化性溃疡患者分为2组。中西药组服用益气活血方加奥美拉唑;西药组服用奥美拉唑。两组幽门螺杆菌(Hp)阳性者先予奥美拉唑加克拉霉素加阿莫西林三联1周根除疗法,1周后服用上述药物开始观察。两组均以4周为1个疗程。疗程结束后复查胃镜,观察Hp根除情况并评价内镜下再生黏膜成熟度及再生黏膜组织学成熟度。ELISA法检测患者治疗前后血管内皮细胞生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)水平的变化。对溃疡愈合者纳入随访,观察溃疡6个月复发情况。结果与对照组比较,中西药组黏膜Sc期成熟度及组织学成熟度的百分率较高(P<0.05)。VEGF、bFGF的水平亦较高(P<0.05);但6个月溃疡复发两组差异无统计学意义,再生黏膜组织学成熟度优者溃疡复发率比良者低(P<0.05),内镜下再生黏膜成熟度Sc期溃疡复发率比Sb期低,而Sb期溃疡复发率比Sa期低(P<0.01)。结论益气活血方能提高溃疡愈合质量,其机制可能与提高VEGF、bFGF表达水平有关,溃疡愈合质量高者溃疡复发率降低。

英文摘要:

Objective To study the effect of Yiqi Huoxue Formula(YHF) on healing and recurrence of peptic ulcer.Methods Adopting randomized and controlled principle,the 46 patients with active peptic ulcer were randomly allocated into the treated group and the control group,they received respectively the treatment of YHF+Omeprazole and Omeprazole alone for 5 weeks.If exhibiting positive Hp,the Trigeminy one-week eradicating treatment,using Omeprazole,Clarithromycin and Amoxicillin,was applied firstly,after then,followed with the prescriptive treatment.Gastroscopy was performed before and after treatment to assess the status of Hp eradicating and the endoscopic and histological maturity of regenerated mucosa.Meanwhile,the changes of vascular endothelial growth factor(VEGF) and basic fibroblast growth factor(bFGF) levels were detected with ELISA.Patients with ulcer healed were followed up for 6 months to observe the condition of recurrence.Results The percentage of Sc phase maturity and excellent histological maturity of regenerated mucosa obtained in the treated group were more than those in the control group respectively(P<0.05),and levels of VEGF and bFGF increased significantly in the treated group after treatment(P<0.05).But the difference of ulcer recurrence rate between the two groups in the 6-month follow-up study showed no statistically significance.However,the recurrence rate in patients with excellent histological maturity of regenerated mucosa was lower than that with good histological maturity(P<0.05);and it was decreasing along with the progressing of regenerated mucosa endoscopic maturity,i.e.Sc<Sb<Sa(P<0.01).Conclusion YHF can improve the quality of ulcer healing,and its mechanism is possibly related to the increase of VEGF and bFGF expressions.The higher the quality of ulcer healing,the lower the recurrence rate.

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