目的 探讨养胃颗粒联合吉法酯治疗慢性萎缩性胃炎的临床疗效。方法 选取2019年1月—2021年1月首都医科大学附属北京友谊医院内科门诊收治的80例慢性萎缩性胃炎患者。按照随机数字表法分为对照组和治疗组，每组各40例。对照组患者口服吉法酯片，2片/次，3次/d。治疗组在对照组治疗基础上口服养胃颗粒，1袋/次，3次/d。两组均治疗12周观察效果。观察两组的临床疗效和症状好转时间，比较两组治疗前后胃功能指标、血清因子水平的变化情况。结果 治疗后，治疗组总有效率是97.50%，显著高于对照组的77.50%（P＜0.05）。经治疗，治疗组出现胃痛、胃脘胀满、嗳气反酸、乏力等症状好转时间均短于对照组（P＜0.05）。治疗后，两组胃泌素（GAS）、胃蛋白酶原Ⅰ（PGⅠ）水平均较治疗前显著升高，而内皮素（ET）、胃动素（MTL）水平显著降低（P＜0.05）；治疗后，治疗组胃功能指标改善优于对照组（P＜0.05）。治疗后，两组白细胞介素6（IL-6）、白细胞介素2（IL-2）、肿瘤坏死因子α（TNF-α）、C反应蛋白（CRP）水平均较治疗前显著降低（P＜0.05），且治疗后，治疗组血清因子水平低于对照组（P＜0.05）。治疗组不良反应发生率是7.5%，显著低于对照组的15.0%（P＜0.05）。结论 养胃颗粒联合吉法酯治疗慢性萎缩性胃炎效果确切，可有效改善患者症状，并能改善胃功能状态和胃黏膜炎症，值得临床推广。

Objective To investigate the clinical effect of Yangwei Granules combined with Gefatate Tablets in the treatment of chronic atrophic gastritis. Methods A total of 80 patients with chronic atrophic gastritis admitted to the Internal medicine outpatient department of Beijing Friendship Hospital, Capital Medical University from January 2019 to January 2021 were selected. According to the random number table method, they were divided into control group and treatment group, 40 cases in each group. Patients in the control group were po administered with Gefarnate Tablets, 2 tablets/time, three times daily. Patients in the treatment group were po administered with Yangwei Granules on the basis of the control group, 1 bag/time, three times daily. Both groups were treated for 12 weeks to observe the effect. The clinical efficacy and symptom improvement time of the two groups were observed, and the changes of gastric function indexes and serum factor levels before and after treatment were compared between the two groups. Results After treatment, the total effective rate of the treatment group was 97.50%, significantly higher than that of the control group (77.50%) (P < 0.05). After treatment, the improvement time of symptoms such as stomachache, epigastric distention, acid reflux and fatigue in the treatment group was shorter than that in the control group (P < 0.05). After treatment, the levels of gastrin (GAS) and pepsinogen Ⅰ (PG Ⅰ) in both groups were significantly increased compared with before treatment, while the levels of endothelin (ET) and motilin (MTL) were significantly decreased (P < 0.05). After treatment, the improvement of gastric function indexes in treatment group were better than those in control group (P < 0.05). After treatment, the levels of interleukin 6 (IL-6), interleukin 2 (IL-2), tumor necrosis factor α (TNF-α) and C-reactive protein (CRP) in two groups were significantly decreased compared with those before treatment (P < 0.05), and the level of serum factors in treatment group was lower than that in control group (P < 0.05). The incidence of adverse reactions in the treatment group was 7.5%, significantly lower than that in the control group (15.0%, P < 0.05). Conclusion Yangwei Granules combined with Gefatate Tablets has exact effect in the treatment of chronic atrophic gastritis, and can effectively improve the symptoms of patients, and improve the gastric function and gastric mucosa inflammation, which is worthy of clinical promotion.

R975

国家自然科学基金青年项目(81902472)