加味左金丸联合三联疗法对胃溃疡患者的疗效及三叶因子与表皮生长因子的影响

目的:探讨加味左金丸联合三联疗法对胃溃疡(GU)的疗效及对血清三叶因子(TFF2)及表皮生长因子(EGF)的影响.方法:将80例活动期GU(肝胃郁热证)患者随机分为治疗组和对照组各40例.对照组口服奥美拉唑肠溶胶囊(20 mg/次,2次/d),克拉霉素胶囊(0.25 g/次,2次/d),阿莫西林胶囊(0.5g/次,2次/d).治疗组在对照组基础上加用加味左金丸,6g/次,2次/d.两组疗程均为4周.观察肝胃郁热证积分、胃镜疗效及幽门螺旋杆菌(HP)清除率,并检测血清TFF2及EGF水平.结果:治疗组肝胃郁热证总积分及各症状评分均明显低于对照组(P＜0.01)；治疗组溃疡面积(0.17±0.21)cm2,低于对照组的(0.28±0.24)cm2(p ＜0.05)；治疗组胃镜疗效总有效率97.5％,对照组为92.5％,无统计学差异；治疗组HP清除率为84.8％,对照组清除率为67.6％,治疗组优于对照组(P＜0.01)；两组治疗后TFF2、EGF均较治疗前上升,治疗组TFF2、EGF水平均明显高于对照组(P＜0.01).结论:加味左金丸提高血清中金丸可以显著提高三联疗法对胃溃疡的疗效,其作用机制可能与提高TFF2及EGF有关.

Efficacy of Combined Therapy of Jiawei Zuojin Pill and Triple Therapy for Gastric Ulcer and the Influence on Trefoil Factor and Epidermal Growth Factor

Objective: To observe the efficacy of combined therapy of Jiawei Zuojin pill and triple therapy for gastric ulcer (GU) and the influence on trefoil factor (TFF2) and epidermal growth factor (EGF). Method: 80 patients with GU (the stagnated heat syndrome in the liver and stomach) were randomly divided into treated group (n=40) and control group (n=40). Patients in the control group received triple therapy, that is Omeprazole Enteric-coated capsules Azithromycin (20 mg, two times per day), Clarithromycin Capsules (0.5 g, two times per day) and Amoxicillin capsules (0.5 g, two times per day, oral). Jiawei Zuojin pill (6 g, two times per day) combined with triple therapy was administrated to patients in the treated group. The course is last for 4 weeks. The score of stagnated heat syndrome in the liver and stomach, eradication rate of Helicobacter pylori (HP), efficacy of endoscopy and TFF2 and EGF levels in Serum were observed. Result: The score of stagnated heat syndrome in the liver and stomach in the treated group was significantly lower than that of control group(P<0.01). Ulcer area of treatment group (0.17±0.21)cm² was significantly lower than that of control group(P<0.05).There was no significant difference in total efficiency between treated group (97.5%) and control groups (92.5%).Curative effect of TCM syndromes in the treated group were significantly better than the control group(P<0.01). Eradication rate of HP of the treated group(84.8%) was better than that of the control group (67.6%)(P<0.01). After treatment, TFF2 and EGF levels in treatment group were significantly higher than that of the control group, though levels of the two cytokines in both group increased. Conclusion: Jiawei Zuojin pill can significantly improve the curative effect of triple therapy for gastric ulcer, the mechanism may be related to the increasing of TFF2 and EGF.