目的 探讨摩罗丹联合铝碳酸镁治疗慢性萎缩性胃炎的临床疗效。方法 选取2019年1月—2020年12月北京京煤集团总医院消化科门诊就诊的128例慢性萎缩性胃炎患者，按随机数字表法将所有患者分为对照组和治疗组，每组各64例。对照组口服铝碳酸镁片，1片/次，3次/d，餐后1～2 h服用。治疗组在对照组基础上口服摩罗丹，16丸/次，3次/d，饭前用温开水送服。两组疗程均为3个月。观察两组的临床疗效，比较治疗前后两组症状积分、慢性病患者生命质量测定量表体系之慢性胃炎量表（QLICD-CG）评分及血清胃泌素-17（G-17）、胃蛋白酶原Ⅰ（PGⅠ）水平和PGⅠ与PGⅡ比值（PGR）。并比较治疗前和1年胃镜随访时两组胃固有腺体萎缩程度。结果 治疗后，治疗组总有效率是93.75%，较对照组81.25%显著提高（P＜0.05）。治疗后，两组主、次症积分及其总积分均显著降低（P＜0.05），而QLICD-CG评分均显著升高（P＜0.05）；且治疗后，治疗组症状积分和QLICD-CG评分改善优于对照组（P＜0.05）。治疗后，两组血清G-17、PGⅠ水平和PGR均显著升高（P＜0.05）；且治疗后，治疗组G-17、PGⅠ水平和PGR均显著高于对照组（P＜0.05）。1年随访时，两组胃固有腺体萎缩程度均显著减轻（P＜0.05）；且1年随访时，治疗组胃固有腺体萎缩程度显著优于对照组（P＜0.05）。结论 摩罗丹联合铝碳酸镁对慢性萎缩性胃炎患者有确切疗效，能有效促进患者临床症状消减，改善胃黏膜萎缩程度及功能状态，使患者生命质量得到提高，安全性良好。

Objective To explore the clinical efficacy of Moluodan combined with hydrotalcite in treatment of chronic atrophic gastritis. Methods A total of 128 patients with chronic atrophic gastritis admitted to the Gastroenterology Department of Beijing Jingmei Group General Hospital from January 2019 to December 2020 were selected and divided into control group and treatment group according to random number table method, with 64 cases in each group. Patients in the control group were po administered with Hydrotalcite Tablets1 to 2 hours after meal, 1 tablet/time, 3 times daily. Patients in the treatment group were po administered with Moluodan on the basis of the control group with warm water before meals, 16 pills/time, 3 times daily. The treatment course of both groups was 3 months. The clinical efficacy of the two groups was observed. The symptom scores, chronic gastritis scale (QLICD-CG) score of chronic disease patients' quality of life measurement scale system, serum gastrin-17 (G-17), pepsinogen I (PG I) and the ratio of PG I to PG II (PGR) were compared between the two groups before and after treatment. The atrophy of gastric intrinsic glands was compared between the two groups before treatment and at 1 year gastroscopic follow-up. Results After treatment, the total effective rate of the treatment group was 93.75%, which was significantly higher than that of the control group 81.25% (P < 0.05). After treatment, the scores of primary and secondary symptoms and their total scores were significantly decreased (P < 0.05), but the QLICD-CG scores were significantly increased (P < 0.05). After treatment, symptom score and QLICD-CG score in the treatment group were better than those in the control group (P < 0.05). After treatment, serum G-17, PG Ⅰ levels and PGR in two groups were significantly increased (P < 0.05). After treatment, the levels of G-17, PG Ⅰ and PGR in treatment group were significantly higher than those in control group (P < 0.05). At 1-year follow-up, the atrophy degree of gastric inherent glands was significantly reduced in both groups (P < 0.05). At 1-year follow-up, the atrophy degree of gastric inherent glands in the treatment group was significantly better than that in the control group (P < 0.05). Conclusion Moluodan combined with hydrotalcite has definite curative effect in treatment of chronic atrophic gastritis, and can effectively promote the reduction of clinical symptoms, improve the degree of gastric mucosa atrophy and functional status, which can improve the life quality of patients with good safety.

R975

北京京煤集团总医院院级科研基金项目（ZZ2023-24）