目的 探讨摩罗丹联合盐酸伊托必利分散片治疗慢性萎缩性胃炎的临床疗效。方法 选取2019年3月—2022年1月在安徽医科大学第四附属医院就诊的75例慢性萎缩性胃炎患者，按随机数字表法分为对照组（37例）和治疗组（38例）。对照组饭前口服伊托必利分散片，1片/次，3次/d。治疗组在对照组基础上口服摩罗丹，1丸/次，3次/d。两组患者连续治疗3个月。观察两组的临床疗效，比较两组胃脘主观疼痛程度、主要组织学状态（慢性炎症、肠化、萎缩）、血清中的转化生长因子-α（TGF-α）、表皮生长因子（EGF）、胃泌素17水平。结果 治疗后，治疗组的总有效率94.74%，对照组的总有效率为78.38%，组间比较有显著差异（P＜0.05）。治疗后，两组的视觉模拟评分法（VAS）评分均显著降低（P＜0.05），治疗组VAS评分明显低于对照组（P＜0.05）。治疗后，两组的慢性炎症、肠化、萎缩均显著减轻（P＜0.05），治疗组慢性炎症、肠化、萎缩较对照组减轻更明显（P＜0.05）。治疗后，两组的血清TGF-α、EGF水平低于治疗前，胃泌素17水平明显高于治疗前（P＜0.05）；治疗组的血清TGF-α、EGF水平比对照组低，胃泌素17水平比对照组高（P＜0.05）。结论 摩罗丹联合盐酸伊托必利分散片治疗慢性萎缩性胃炎的疗效确切，能降低疼痛程度和炎症反应，减轻肠化、萎缩症状，且安全性良好。

Objective To investigate the clinical effect of Moluodan combined with Itopride Hydrochloride Dispersible Tablets in treatment of chronic atrophic gastritis. Methods Patients (75 cases) with chronic atrophic gastritis in the Fourth Affiliated Hospital of Anhui Medical University from January 2019 to February 2022 were randomly divided into the control group (37 cases) and the treatment group (38 cases). Patients in the control group were po administered with Itopride Hydrochloride Dispersible Tablets, 1 tablet/time, three times daily. Patients in the treatment group were po administered with Moluodan on the basis of the control group, 1 pill/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacies were evaluated, and the pain degree of gastral cavity, the main histological status (chronic inflammation, intestinal metaplasia, and atrophy), the serum levels of TGF-α, EGF, and gastrin 17 in two groups were compared. Results After treatment, the total effective rate of the treatment group was 94.74%, that of the control group was 78.38%, and there was significant difference between two groups (P < 0.05). After treatment, the VAS score of two groups were significantly decreased (P < 0.05), and the VAS score of the treatment group was significantly lower than that of the control group (P < 0.05). After treatment, the chronic inflammation, intestinal metaplasia, and atrophy in two groups were significantly decreased (P < 0.05), and the chronic inflammation, intestinal metaplasia and atrophy in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the serum levels of TGF-α and EGF in two groups were lower than those before treatment, but the serum level of gastrin 17 in two groups was significantly higher than that before treatment (P < 0.05). The serum levels of TGF-α and EGF in the treatment group were lower than those in the control group, butd the serum level of gastrin 17 in the treatment group was higher than that in the control group (P < 0.05).Conclusion Moluodan combined with Itopride Hydrochloride Dispersible Tablets is effective in treatment of chronic atrophic gastritis, which can reduce the degree of pain, reduce the inflammatory reaction, and relieve the symptoms of intestinal metaplasia and atrophy, with good safety.

R975

安徽医科大学高等学校省级质量工程项目(2020 jyxm0907)