中华中医药学刊

香砂六君子汤加减对慢性萎缩性胃炎癌前病变的干预及对胃黏膜相关因子水平的影响

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陈马兰 , 郭莲 , 黄雄涛 , 章雄英

中华中医药学刊 | 国家项目点击 2026,44(3): 159-163

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中华中医药学刊 |国家项目点击 2026 , 44 (3) : 159 -163

香砂六君子汤加减对慢性萎缩性胃炎癌前病变的干预及对胃黏膜相关因子水平的影响

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陈马兰, 郭莲, 黄雄涛, 章雄英

作者信息

浙江中医药大学附属金华中医院，浙江金华 321000

作者简介:

陈马兰（1985 -），女，浙江诸暨人，副主任中药师，学士，研究方向：中医药学。

Intervention of Modified Xiangsha Liujunzi Decoction（香砂六君子汤加减）on Precancerous Lesions of Chronic Atrophic Gastritis and Its Influence on Levels of Gastric Mucosa Related Factors

Malan CHEN, Lian GUO, Xiongtao HUANG, Xiongying ZHANG

Affiliations

Jinhua Hospital of Traditional Chinese Medicine, Zhejiang Chinese Medical University, Jinhua 321000, Zhejiang, China

出版时间: 2026-03-10 doi: 10.13193/j.issn.1673-7717.2026.03.029

文章导航

摘要

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目的

探讨香砂六君子汤加减对慢性萎缩性胃炎癌前病变的干预研究及对胃黏膜相关因子水平的影响。

方法

选取2021年5月—2024年4月浙江中医药大学附属金华中医院就诊中的100例脾胃虚弱型慢性萎缩性胃炎患者，用随机数字表法分为对照组和联合组，各50例。两组患者入院后嘱清淡饮食，忌辛辣刺激食物，并注意休息。对照组患者予叶酸联合胃复春片治疗，联合组在上述基础上予香砂六君子汤加减治疗，以4周为1个疗程，连用3个疗程。治疗结束后，比较两组患者中医证候积分、临床总有效率、胃镜病理积分及治疗过程中的不良反应，及对胃黏膜相关因子一氧化氮（NitricOxide，NO）、P选择素（Recombinant P-Selectin，SELP）、白细胞内皮细胞黏附分子-1（leukocyte endothelial cell adhesion molecule-1，LECAM-1）、内皮素-1（Endothelin-1，ET-1）变化情况。

结果

（1）中医症状积分：治疗后两组各个症状积分均低于治疗前（P < 0.05），且联合组对于改善胃痛、嗳气、纳呆、大便稀溏、气短懒言、疲倦乏力6项中医症状积分优于对照组（P < 0.05）。两组对于胃脘胀满改善差异无统计学意义（P > 0.05）。（2）临床疗效：联合组临床总有效率为94.00%，与对照组（72.00%）比较显著升高，差异有统计学意义（P < 0.05）。（3）胃镜病理积分：治疗后两组患者的胃镜病理积分较治疗前均有降低（P < 0.05），且联合组各项胃镜病理积分与对照组比较均降低（P < 0.05）。（4）治疗后，两组患者NO、SELP、LECAM-1、ET-1较治疗前降低（P < 0.05）；且联合组较对照组降低更为显著，差异有统计学意义（P < 0.05）。（5）不良反应：联合组治疗期间不良反应发生率为8.00%，低于对照组（14.00%），但差异无统计学意义（P > 0.05）。

结论

香砂六君子汤加减对于脾胃虚弱型慢性萎缩性胃炎患者有一定治疗效果，可提高总有效率，改善患者病理状况，抑制NO、SELP、LECAM-1、ET-1的分泌，调节患者胃黏膜炎性微环境，起到保护胃黏膜的作用。

关键词

香砂六君子汤 / 慢性萎缩性胃炎 / 癌前病变 / 胃黏膜相关因子

Abstract

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Objective

To investigate the effect of Modified Xiangsha Liujunzi Decoction（香砂六君子汤加减）on the precancerous lesions of chronic atrophic gastritis and the levels of gastric mucosal related factors.

Methods

A hundred patients with chronic atrophic gastritis with deficiency of spleen and stomach treated in Jinhua Hospital of Traditional Chinese Medicine from May 2021 to April 2024 were randomly divided into control group and combination group, with 50 cases in each group. After admission, the patients of two groups were instructed to have a light diet, avoid spicy and stimulating foods, and pay attention to rest. The control group was treated with folic acid combined with Weifuchun Tablets（胃复春片）, and on the basis of the above, Xiangsha Liujunzi Decoction was treated with a course of 4 weeks for 3 consecutive courses. After treatment, TCM syndrome scores, clinical total effective rates, gastroscopy pathological scores and adverse reactions during treatment as well as the changes of gastric mucosal related factors nitric oxide（NO）, recombinant P-selectin（SELP）, leukocyte endothelial cell adhesion molecule-1（LECAM-1）and endothelin-1（ET-1）were compared between the two groups.

Results

（1）TCM symptom score：After treatment, all symptom scores of the two groups were lower than those before treatment（P < 0.05）, and the combination group was better than the control group in improving TCM symptom scores of stomachache, belching, lethargy, loose stool, shortness of breath, fatigue and fatigue（P < 0.05）. There was no significant difference in improvement of epigastric fullness between the two groups（P > 0.05）.（2）Clinical efficacy：The total clinical effective rate of the combination group was 94.00%, which was significantly higher than that of the control group（72.00%）, and the difference was statistically significant（P < 0.05）.（3）Gastroscopy pathological score：After treatment, the gastroscopy pathological scores of the two groups were decreased compared with those before treatment（P < 0.05）, and all the gastroscopy pathological scores of the combination group were decreased compared with those of the control group（P < 0.05）.（4）After treatment, the levels of NO, SELP, LECAM-1 and ET-1 in two groups were lower than those before treatment（P < 0.05）. The reduction in the combination group was more significant than that in the control group, and the difference was statistically significant（P < 0.05）.（5）Adverse reactions：The incidence of adverse reactions during treatment in the combination group was 8.00%, which was lower than that in the control group（14.00%）, but the difference was not statistically significant（P > 0.05）.

Conclusion

Xiangshan Liujunzi Decoction has a certain therapeutic effect on patients with chronic atrophic gastritis with deficiency of spleen and stomach, which can improve the total effective rate and the pathological status of patients, inhibit the secretion of NO, SELP, LECAM-1 and ET-1, regulate the inflammatory microenvironment of gastric mucosa, and plays a role in protecting gastric mucosa.

Key words

Xiangshan Liujunzi Decoction（香砂六君子汤） / chronic atrophic gastritis / precancerous lesions / gastric mucosa-related factors

引用本文

陈马兰, 郭莲, 黄雄涛, 章雄英. 香砂六君子汤加减对慢性萎缩性胃炎癌前病变的干预及对胃黏膜相关因子水平的影响. 中华中医药学刊, 2026 , 44 (3) : 159 -163 . DOI: 10.13193/j.issn.1673-7717.2026.03.029

Malan CHEN, Lian GUO, Xiongtao HUANG, Xiongying ZHANG. Intervention of Modified Xiangsha Liujunzi Decoction（香砂六君子汤加减）on Precancerous Lesions of Chronic Atrophic Gastritis and Its Influence on Levels of Gastric Mucosa Related Factors[J]. Chinese Archives of Traditional Chinese Medicine, 2026 , 44 (3) : 159 -163 . DOI: 10.13193/j.issn.1673-7717.2026.03.029

基金

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国家中医药管理局全国中药特色技术传承项目(2023-96号)
浙江省自然科学基金项目(LR20H260001)

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2026年第44卷第3期

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doi: 10.13193/j.issn.1673-7717.2026.03.029

首发时间：2026-10-14
出版时间：2026-03-10

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国家中医药管理局全国中药特色技术传承项目(2023-96号)

浙江省自然科学基金项目(LR20H260001)

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浙江中医药大学附属金华中医院，浙江金华 321000

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2种不同金属材料的力学参数

科 Family	属数 Number of genus	种数 Number of species	占总种数比例 Percentage of total species (%)	属 Genus	种数 Number of species	占总种数比例 Percentage of total species (%)
鹅膏菌科Amanitaceae	2	11	5.26	鹅膏菌属 Amanita	10	4.78
小菇科 Mycenaceae	2	12	5.74	丝盖伞属 Inocybe	5	2.39
多孔菌科 Polyporaceae	8	14	6.70	蜡蘑属 Laccaria	5	2.39
红菇科 Russulaceae	3	23	11.00	小皮伞属 Marasmius	6	2.87
				小菇属 Mycena	11	5.26
				光柄菇属 Pluteus	5	2.39
				红菇属 Russula	17	8.13
				栓菌属 Trametes	5	2.39

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