温针灸联合小建中汤治疗脾胃虚寒型消化性溃疡疗效观察

目的观察温针灸联合小建中汤治疗脾胃虚寒型消化性溃疡的临床疗效。方法 100例脾胃虚寒型消化性溃疡患者,随机分为对照组和观察组,每组50例。对照组采用小建中汤加减治疗,观察组在对照组基础上加用温针灸治疗。观察两组治疗后溃疡复发率、溃疡面积、胃幽门螺旋杆菌(Hp)清除率和生活质量评分,并检测外周血清和胃液表皮生长因子(EGF)、胃黏膜表皮生长因子受体(EGFR)的水平变化,并比较临床疗效。结果观察组总有效率为88.0%,对照组为66.0%,两组总有效率比较,差异有统计学意义(P<0.05)。观察组治疗后溃疡复发率、溃疡面积、Hp清除率优于对照组(P<0.05);观察组治疗后生活质量评分各维度优于对照组(P<0.05)。观察组治疗后血清、胃液EGF以及胃黏膜EGFR水平高于对照组(P<0.05)。结论运用温针灸联合小建中汤的方式治疗脾胃虚寒型消化性溃疡可以显著提高临床疗效,通过上调EGF、EGFR水平来促进胃黏膜修复和溃疡的愈合。

Therapeutic Efficacy of Warm Needling plus Xiao Jian Zhong Decoction for Peptic Ulcers Due to Deficiency Cold in Spleen-stomach

Objective To observe the clinical efficacy of warm needling plus Xiao Jian Zhong decoction in treating peptic ulcers due to deficiency cold in spleen-stomach.Method One hundred patients with peptic ulcers due to deficiency cold in spleen-stomach were randomized into a control group and an observation group,with 50 cases in each group.The control group was intervened by modified Xiao Jian Zhong decoction,while the observation group was additionally given warm needling treatment.The ulcer relapse rate,ulcer size,Helicobacter pylori(Hp)elimination rate and quality of life score in the two groups were observed after the treatment.The changes in the level of epidermal growth factor(EGF)in peripheral blood serum and gastric fluid,and the level of EGF receptor(EGFR)in gastric mucosa were detected.The clinical efficacies were also compared.Result The total effective rate was 88.0%in the observation group versus 66.0%in the control group,and the between-group difference in the total effective rate was statistically significant(P<0.05).After the treatment,the ulcer relapse rate,ulcer size and Hp elimination rate in the observation group were better than those in the control group(P<0.05);the observation group was superior to the control group in the score of each dimension in measuring the quality of life(P<0.05).The EGF levels in serum and gastric fluid and EGFR level in gastric mucosa in the observation group were higher than those in the control group after the intervention(P<0.05).Conclusion Warm needling plus Xiao Jian Zhong decoction can significantly enhance the clinical efficacy,boost the repair of gastric mucosa and the ulcer healing by up-regulating the level of EGF and EGFR in the treatment of peptic ulcers due to deficiency cold in spleen-stomach.