荜铃胃痛颗粒提高Hp阳性消化性溃疡患者溃疡愈合质量及对生长因子的影响

Improvement of Biling Weitong Granule on the ulcer healing quality and its effect on growth factors in Hp-positive peptic ulcer patients

关键词:  荜铃胃痛颗粒  幽门螺杆菌阳性消化性溃疡  溃疡愈合质量  生长因子  临床研究

Key words:  Biling Weitong Granule  Hp positive peptic ulcer  ulcer healing quality  growth factor  clinical research

摘要:

[目的] 探讨荜铃胃痛颗粒提高幽门螺杆菌（Hp）阳性消化性溃疡患者溃疡愈合质量及对生长因子的影响。[方法] 将2019年1月—2020年6月多中心收治的86例符合入组标准的Hp阳性消化性溃疡按随机数字表分为观察组43例和对照组43例，对照组患者给予常规三联疗法治疗，观察组在对照组的基础上再给予荜铃胃痛颗粒治疗，两组均治疗4周，干预前后评价中医症状积分，采用¹³C-尿素呼气试验（¹³C-UBT）比较两组患者幽门螺杆菌转阴率，进行无痛胃镜检查评价镜下再生黏膜成熟度，采用五肽胃泌素刺激进行胃酸分泌功能评估，采用酶联免疫技术测定血清血管内皮细胞生长因子（VEGF）、碱性成纤维细胞生长因子（bFGF），治疗8周结束时评判临床疗效，所有患者均随访12个月，比较两组患者随访复发率。[结果] 对照组和观察组治疗后胃脘灼痛、吞酸、暖气、腹胀评分较治疗前明显下降（P<0.05），观察组治疗后胃脘灼痛、吞酸、暖气、腹胀评分明显低于对照组（P<0.05）。观察组Hp转阴率为90.70%，明显高于对照组67.44%，差异有统计学意义（P<0.05）。观察组治疗4周溃疡愈合质量明显优于对照组（P<0.01）。对照组和观察组治疗4周时VEGF、bFGF均较治疗前明显升高（P<0.05），观察组治疗4周时VEGF、bFGF均明显高于对照组（P<0.05）。对照组和观察组治疗4周后基础胃酸排出量（BAO）、最大胃酸排出量（MAO）、高峰胃酸排出量（PAO）较治疗前明显降低（P<0.05），观察组治疗4周后BAO、MAO、PAO明显低于对照组（P<0.05）。观察组治疗4周总有效率为95.35%，明显高于对照组79.07%（P<0.05）。观察组随访12个月复发6.98%，明显低于对照组30.23%（P<0.05）。[结论] 荜铃胃痛颗粒治疗Hp阳性消化性溃疡能够有效提高溃疡愈合质量及临床疗效，与其抗幽门螺杆菌、抑制胃酸分泌、提高生长因子表达有关，且能有助于降低疾病复发。

Abstract:

[Objective] To investigate the effect of Biling Weitong Granules on improving the quality of ulcer healing in patients with Hp positive peptic ulcer and its influence on growth factors.[Methods] A total of 86 Hp positive peptic ulcer patients who met the enrollment criteria in our hospital from January 2019 to June 2020 were divided into observation group (43 cases) and control group (43 cases) according to a random number table. Patients in the control group were treated with conventional triple therapy,and the observation group was treated with Biling Weitong Granules on the basis of the control group. Both groups were treated for 4 weeks.TCM syndrome scores were performed before and after the intervention. The C13-urea breath test (¹³C-UBT) was used to compare the conversion rate of helicobacter pylori between the two groups. Painless gastroscopy was performed to evaluate the maturity of the regenerative mucosa under the microscope,and pentagastrin was used for gastric acid. Secretory function assessment,serum vascular endothelial cell growth factor (VEGF) and basic fibroblast growth factor (bFGF) were measured by enzyme-linked immunosorbent technique,and the clinical efficacy was evaluated at the end of 8 weeks of treatment. All patients were followed up for 12 months. Comparison of follow-up recurrence rates between the two groups of patients.[Results] After treatment in the control group and the observation group,the scores of epigastric burning,soreness,heating,and abdominal distension were significantly lower than those before treatment (P<0.05). After treatment,the scores of epigastric burning pain,acid swallowing,heating and abdominal distension in the observation group were significantly lower than those in the control group (P<0.05). The negative conversion rate of Hp in the observation group was 90.70%,which was significantly higher than 67.44% in the control group,and the difference was statistically significant(P<0.05). The quality of ulcer healing in the observation group after 4 weeks of treatment was significantly better than that of the control group(P<0.01). The VEGF and bFGF of the control group and the observation group were significantly higher than those before the treatment after 4 weeks of treatment (P<0.05),and the VEGF and bFGF of the observation group were significantly higher than those of the control group after 4 weeks of treatment (P<0.05). The BAO,MAO,and PAO of the control group and the observation group were significantly lower than before treatment after 4 weeks of treatment (P<0.05),and the BAO,MAO,and PAO of the observation group were significantly lower than those of the control group after 4 weeks of treatment (P<0.05).The total effective rate of the observation group for 4 weeks was 95.35% which was significantly higher than that of the control group 79.07%(P<0.05). The observation group had a recurrence of 6.98% during a 12-month follow-up,which was significantly lower than 30.23% of the control group.[Conclusion] The treatment of Hp positive peptic ulcer with Biling Weitong Granules can effectively improve the quality of ulcer healing and the clinical efficacy,which is related to its anti-H. pylori,inhibition of gastric acid secretion,increase of growth factor expression,and can help reduce the recurrence of the disease.