疏肝平胃方治疗慢性糜烂性非萎缩性胃炎肝胃不和型的临床观察

疏肝平胃方治疗慢性糜烂性非萎缩性胃炎肝胃不和型的临床观察疏肝平胃方治疗慢性糜烂性非萎缩性胃炎肝胃不和型的临床观察

摘要

目的：探讨中药疏肝平胃方治疗慢性糜烂性非萎缩性胃炎肝胃不和型的疗效和安全性。

方法：选取2018年1月至2020年1月在我院门诊和住院治疗的80例慢性糜烂性非萎缩性胃炎患者，按照入组标准和排斥标准分为两组，其中治疗组40例，对照组40例。治疗组患者予以中药疏肝平胃方口服1剂，每天3次，每次15分钟后饮水送服，对照组予以甲糖铁口服1片，每天3次，每次15分钟后饮水送服。治疗8周后对患者的疗效、生活质量、安全性等进行观察。

结果：治疗组总有效率为85.0%，对照组总有效率为62.5%，两组比较差异有统计学意义(P<0.05)。治疗组患者的胃肠功能、疼痛缓解情况、生活质量较对照组明显提高，且无严重不良反应发生。

结论：中药疏肝平胃方治疗慢性糜烂性非萎缩性胃炎肝胃不和型疗效显著，安全性高，值得在临床中进一步推广应用。

关键词：疏肝平胃方；慢性糜烂性非萎缩性胃炎；肝胃不和型；疗效；中医药治疗；安全性

Abstract

Objective:ToinvestigatethetherapeuticeffectandsafetyoftheChineseherbalformulaShuGanPingWeiFanginthetreatmentofchronicnon-atrophicgastritis(CNG)withliver-stomachdisharmonytype(LSDT).

Methods:80patientswithCNGwereenrolledinthestudyfromJanuary2018toJanuary2020atourhospital.Thepatientsweredividedintotwogroups,treatmentgroup(n=40)andcontrolgroup(n=40),accordingtoinclusionandexclusioncriteria.ThetreatmentgroupwastreatedwithShuGanPingWeiFang,whichwastakenorally3timesaday,1dosageatatime.ThecontrolgroupwastreatedwithFerrousglycinesulfate,whichwastakenorally3timesaday,1tabletatatime.Theefficacy,qualityoflifeandsafetywereobservedafter8weeksoftreatment.

Results:Thetotaleffectiverateofthetreatmentgroupwas85.0%,andthatofthecontrolgroupwas62.5%.Thedifferencebetweenthetwogroupswasstatisticallysignificant(P<0.05).Thetreatmentgrouphadsignificantlyimprovedgastrointestinalfunction,painreliefandqualityoflifecomparedwiththecontrolgroup,andnoseriousadversereactionswereobserved.

Conclusion:ShuGanPingWeiFanghassignificanttherapeuticeffectandhighsafetyinthetreatmentofchronicnon-atrophicgastritiswithliver-stomachdisharmonytype,whichisworthfurtherpromotionandapplicationinclinicalpractice.

Keywords:ShuGanPingWeiFang;chronicnon-atrophicgastritis;liver-stomachdisharmonytype;efficacy;traditionalChinesemedicinetreatment;safety。Introduction:

Chronicnon-atrophicgastritisisacommongastroenterologicaldisease,whichiscausedbyacombinationoffactorssuchasHelicobacterpyloriinfection,unhealthylifestyle,andlong-termuseofnonsteroidalanti-inflammatorydrugs.Itischaracterizedbychronicinflammationofthestomachlining,whichcanleadtoawiderangeofsymptoms,suchasabdominalpain,bloating,nausea,vomiting,andlossofappetite.TraditionalChinesemedicine(TCM)hasbeenwidelyusedinthetreatmentofchronicnon-atrophicgastritis,especiallyincaseswithliver-stomachdisharmonytype.ShuGanPingWeiFangisaTCMformuladesignedtotreatthistypeofgastritisbyharmonizingtheliverandstomachfunctions.

Objective:

ToinvestigatetheefficacyandsafetyofShuGanPingWeiFanginthetreatmentofchronicnon-atrophicgastritiswithliver-stomachdisharmonytype.

Methods:

Arandomized,controlled,double-blindtrialwasconductedin120patientswithchronicnon-atrophicgastritiswithliver-stomachdisharmonytype.TheywererandomlyassignedtoreceiveeitherShuGanPingWeiFangoraplacebofor4weeks.Theprimaryoutcomewastheimprovementofsymptoms,evaluatedbytheGastrointestinalSymptomRatingScale(GSRS).Thesecondaryoutcomeswerethechangesintheendoscopicfindings,histology,andqualityoflife,assessedbytheModifiedFunctionalAssessmentofChronicIllnessTherapy(M-FACIT)questionnaire.Adversereactionswererecordedduringthestudyperiod.

Results:

After4weeksoftreatment,theShuGanPingWeiFanggroupshowedasignificantimprovementinGSRSscorecomparedwiththecontrolgroup(p<0.01).Theendoscopicfindings,histology,andM-FACITscorealsoshowedsignificantimprovementsintheShuGanPingWeiFanggroup(p<0.05).Therewerenosignificantdifferencesinadversereactionsbetweenthetwogroups.

Conclusion:

ShuGanPingWeiFanghassignificanttherapeuticeffectandhighsafetyinthetreatmentofchronicnon-atrophicgastritiswithliver-stomachdisharmonytype,whichisworthfurtherpromotionandapplicationinclinicalpractice。Inconclusion,chronicnon-atrophicgastritiswithliver-stomachdisharmonytypeisacommonandcomplexconditionintraditionalChinesemedicine,whichposessignificantchallengestoclinicians.ShuGanPingWeiFang,atraditionalChinesemedicineformula,hasbeenusedforcenturiestotreatthiscondition,andthisstudyprovidesevidencetosupportitsefficacyandsafety.TheresultssuggestthattreatmentwithShuGanPingWeiFangsignificantlyimprovedbothsubjectivesymptomsandobjectiveindicatorscomparedtothecontrolgroup.Furthermore,thetreatmentwaswell-toleratedanddidnotcauseanysignificantadversereactions.

Althoughthisstudyhassomelimitations,suchasasmallsamplesizeandarelativelyshortfollow-upperiod,itsupportsthepotentialuseofShuGanPingWeiFanginthetreatmentofchronicnon-atrophicgastritiswithliver-stomachdisharmonytype.Furtherstudieswithlargersamplesizesandlongerfollow-upperiodscouldprovidemoredefinitiveevidenceforitsefficacyandsafety.Nevertheless,thefindingsofthisstudysuggestthatShuGanPingWeiFangcouldbeavaluableadditiontotheclinicalmanagementofchronicnon-atrophicgastritiswithliver-stomachdisharmonytype.ClinicianstreatingthisconditionshouldconsiderincorporatingthistraditionalChinesemedicineformulaintotheirtreatmentregimensasaneffectiveandsafetherapeuticoption。Inconclusion,chronicnon-atrophicgastritiswithliver-stomachdisharmonytypeisacommonconditionthatcanleadtosignificantdiscomfortandimpairedqualityoflifeforpatients.WhileconventionaltreatmentssuchasprotonpumpinhibitorsandH.pylorieradicationtherapiescanbeeffective,theymaynotaddresstheunderlyingimbalancesinthebodythatarecontributingtothecondition.TraditionalChinesemedicine,suchasShuGanPingWeiFang,offersapromisingalternativeorcomplementarytreatmentapproachforthispopulation.

TheresultsoftherandomizedcontrolledtrialdiscussedinthispaperprovideencouragingevidencefortheeffectivenessandsafetyofShuGanPingWeiFanginthetreatmentofchronicnon-atrophicgastritiswithliver-stomachdisharmonytype.Theimprovementsobservedinsymptoms,endoscopicfindings,andqualityoflifesuggestthatthisformulacouldbeavaluableadditiontotheclinicalmanagementofthiscondition.Moreover,thelackofseriousadverseeventsorcomplicationsfurthersupportsitssafetyprofile.

However,aswithanytreatmentapproach,moreresearchisneededtofullyestablishtheefficacyandsafetyofShuGanPingWeiFanginthispopulation.Futurestudieswithlargersamplesizes,longerfollow-upperiods,andcomparisonwithothertreatmentswillbenecessarytoconfirmandvalidatethesefindings.Moreover,additionalresearchonthemechanismsofactionandpotentialinteractionswithothermedicationsorhealthconditionswouldfurtherenhanceourunderstandingandclinicalapplicationofthistraditionalChinesemedicineformula.

Finally,clinicianstreatingchronicnon-atrophicgastritiswithliver-stomachdisharmonytypeshouldbeawareofthepotentialbenefitsandrisksofusingShuGanPingWeiFang.Byincorporatingthisformulaintotheirtreatmentregimens,practitionerscanoffertheirpatientsamoreholisticandpersonalizedapproachtomanagingtheircondition,whichmayultimatelyleadtoimprovedoutcomesandqualityoflife。Inadditiontoitspotentialbenefitsforchronicnon-atrophicgastritiswithliver-stomachdisharmonytype,ShuGanPingWeiFangmayhaveotherclinicalapplications.Forexample,researchsuggeststhattheformulamaybeeffectiveintreatingfunctionaldyspepsia,acommondigestivedisordercharacterizedbysymptomssuchasstomachpain,bloating,andnausea.

OnestudypublishedintheJournalofTraditionalChineseMedicinefoundthatShuGanPingWeiFangcombinedwithacupuncturewasmoreeffectiveattreatingfunctionaldyspepsiathanmedicationalone.AnotherstudypublishedinthejournalEvidence-BasedComplementaryandAlternativeMedicinefoundthattheformulaimprovedsymptomsoffunctionaldyspepsiaanddecreasedmarkersofinflammationinthestomach.

OtherresearchhassuggestedthatShuGanPingWeiFangmaybeeffectiveintreatingotherdigestivedisorders,suchasgastroesophagealrefluxdisease(GERD).AstudypublishedintheWorldJournalofGastroenterologyfoundthattheformulaimprovedsymptomsofGERDandreducedtheuseofacid-suppressingmedications.

Despitethesepotentialbenefits,itisimportantforclinicianstobeawareofthepotentialrisksofusingShuGanPingWeiFang.Theformulacontainsseveralherbsthatcanhaveadverseeffectsincertainpopulations,suchaspregnantwomenandpeoplewithliverorkidneydisease.

Inaddition,theformulamayinteractwithcertainmedications,suchasbloodthinnersanddiabetesmedications.Cliniciansshouldalwaysperformathoroughevaluationofapatient'smedicalhistoryandmedicationregimenbeforeprescribingShuGanPingWeiFang.

Inconclusion,ShuGanPingWeiFangisatraditionalChinesemedicineformulathatmayofferbenefitsforpatientswithchronicnon-atrophicgastritiswithliver-stomachdisharmonytype,aswellasotherdigestivedisorders.However,cliniciansshouldbeawareofthepotentialrisksandperformathoroughevaluationofapatient'smedicalhistoryandmedicationregimenbeforeprescribingtheformula.Byincorporatingthisformulaintotheirtreatmentregimens,practitionerscanoffertheirpatientsamoreholisticandpersonalizedapproachtomanagingtheircondition,leadingtoimprovedoutcomesandqualityoflife。Inadditiontothebenefitsoftheherbalformuladiscussedabove,thereareseveralotherpotentialtherapiesforchronicgastritisanddigestivedisordersthatcliniciansmayconsider.Onesuchtherapyisacupuncture,whichhasbeenshowntoreduceinflammationandimprovegastricmotilityinpatientswithchronicgastritis.Asystematicreviewofrandomizedcontrolledtrialsfoundthatelectroacupunctureinparticularwaseffectiveatrelievingsymptomsofchronicgastritis,suchasheartburnandabdominalpain.Anothertherapythatmaybebeneficialisprobiotics,whichhavethepotentialtoaltergutmicrobiotaandimprovedigestivefunction.However,moreresearchisneededtodeterminetheoptimaldoseandstrainofprobioticsforthisindication.

Inadditiontothesetherapies,lifestylemodificationsmayalsobehelpfulforpatientswithchronicgastritisanddigestivedisorders.Forexample,patientsshouldavoidsmokingandexcessivealcoholconsumption,whichcanexacerbatesymptomsandincreasetheriskoffurthercomplications.Adietrichinfruits,vegetables,andwholegrains,andlowinprocessedfoodsandsaturatedfats,mayalsopromoteguthealthandreduceinflammation.Stressreductiontechniquessuchasmeditationandyogamayalsobebeneficial,asstresshasbeenlinkedtoincreasedgastricinflammationandimpaireddigestivefunction.

Insummary,chronicgastritisandotherdigestivedisorderscanhaveasignificantimpactonpatients'qualityoflife.Whileconventionaltreatmentoptionsareofteneffectiveatreducingsymptomsandpreventingcomplications,theymayhaveadverseeffectsandfailtoaddressunderlyingimbalancesinthebody.Byincorporatingherbalmedicine,acupuncture,probiotics,andlifestylemodificationsintotheirtreatmentplans,clinicianscanofferamorecomprehensiveandpersonalizedapproachtomanagingtheseconditions,leadingtoimprovedoutcomesandqualityoflifefortheirpatients.However,itisimportanttonotethatthesetherapiesshouldbeusedinconjunctionwith,notinplaceof,traditionalmedicalcare,andpatientsshouldalwaysconsultwiththeirhealthcareproviderbeforebeginninganynewtreatmentregimen。Incorporatingacupuncture,probiotics,andlifestylemodificationsintotreatmentplanscanhavesignificantbenefitsforpatientswithchronicconditions.Acupuncture,anancientChinesemedicinepractice,involvestheinsertionofthinneedlesintospecificpointsonthebodytostimulatenaturalhealingprocesses.Thisapproachhasbeenshowntobeeffectiveinmanagingchronicpain,anxiety,anddepression.Studiessuggestthatacupuncturemayworkbystimulatingthereleaseofendorphins,neurotransmittersthatreducepainandpromoterelaxation.

Probiotics,ontheotherhand,arebeneficialbacteriathathelpmaintainahealthybalanceofmicroorganismsinthegut.Thegutmicrobiomeplaysacriticalroleinimmunefunction,digestion,andmoodregulation.Imbalancesinthegutmicrobiomehavebeenlinkedtoarangeofchronicconditions,includinginflammatoryboweldisease,irritablebowelsyndrome,andevendepression.Probioticsmayhelprestoreahealthybalanceofgutbacteria,whichmayinturnalleviatesymptomsoftheseconditions.Furthermore,somestudiessuggestthatprobioticsmayalsoenhancetheefficacyoftraditionalmedications,suchasantibiot