Article(id=1322923640722957049, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923490592043032, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.05.011, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339174680, onlineDateStr=2026-10-30, pubDate=1746806400000, pubDateStr=2025-05-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339174680, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339174680, creator=13701087609, updateTime=1793339174680, updator=13701087609, issue=Issue{id=1322923490592043032, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='5', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1746806400000', pubDateStr='2025-05-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339138887, creator='13701087609', updateTime=1793340572227, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322929502539612595, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923490592043032, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322929502539612596, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923490592043032, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=48, endPage=51, ext={EN=ArticleExt(id=1322923640957838074, articleId=1322923640722957049, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Clinical Study on Modified Banxia Xiexin Decoction(半夏泻心汤)in the Treatment of Chronic Gastritis, columnId=1256183361521967297, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Target on National Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the clinical effect of Modified Banxia Xiexin Decoction(半夏泻心汤)in the treatment of chronic gastritis.

Methods

A total of 128 patientswith chronic gastritis admitted to our hospital from February 2021 to July 2024 were included as the research objects. They were divided into two groups by the random number tablemethod.64 patients in the control group were treated with the Western medicine quadruple therapy,and 64 patients in the observation group were treated with themodified Banxia Xiexin Decoction on the basis of the above-mentioned treatment. The differences in curative effects,TCM syndrome scores,gastric mucosal function,inflammatory factors,and Helicobacter pylori(Hp)negative conversion rate were compared between the two groups.

Results

The total effective rate of treatment in the observation group was 96.88%(62/64),which wasmuch higher than 82.81%(53/64)in the control group,and the difference between the two groups was significant(P<0.05). After treatment,the scores of four symptoms,including epigastric pain,fullness and discomfort,epigastric burning,belching and acid reflux,bitter taste and drymouth in the observation group were lower than those in the control group(P<0.05). After treatment,the levels of pepsinogen I(PG I),pepsinogenⅡ(PGⅡ),pepsinogen ratio(PGR),gastrin-17(G-17),and the levels of inflammatory factors such as tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),and interleukin-6(IL-6)in the observation group were all lower than those in the control group(P<0.05). One month after treatment,the Hp negative conversion rate in the observation group was 90.63%(58/64),which was significantly higher than 75.00%(48/64)in the control group,and the difference between the two groupswas significant(P<0.05).

Conclusion

The application ofmodified Banxia Xiexin Decoction in the treatment of patientswith chronic.

, authors=Yao FU1, Cheng GUO1, Fang LIANG1, Cheng QIAN2, authorsList=Yao FU, Cheng GUO, Fang LIANG, Cheng QIAN, authorCompany=null, correspAuthors=Cheng QIAN, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322923643965154054, articleId=1322923640722957049, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=半夏泻心汤加减治疗慢性胃炎临床研究, columnId=1256183362172142382, journalTitle=中华中医药学刊, columnName=国家项目点击, runingTitle=null, highlight=null, articleAbstract=
目的

分析半夏泻心汤加减治疗慢性胃炎的临床效果。

方法

纳入2021年2月—2024年7月上海交通大学医学院附属第六人民医院收治的慢性胃炎患者128例为研究对象,随机数字表法分为两组,对照组64例采用西医四联疗法进行治疗,观察组64例在对照组基础上联合半夏泻心汤加减治疗,对比两组疗效差异、中医证候积分、胃黏膜功能、炎症因子、幽门螺杆菌转阴率等。

结果

观察组治疗总有效率为96.88%(62/64),远高于对照组的82.81%(53/64),组间比较差异有统计学意义(P<0.05);治疗后观察组胃脘疼痛、胀满不适、胃脘灼热、嗳气反酸、口苦口干四项症状评分低于对照组(P<0.05);治疗后观察组胃蛋白酶I(Pepsinogen I,PG I)、胃蛋白酶Ⅱ(PepsinogenⅡ,PGⅡ)、胃泌素受体(Gastrin receptor,PGR)、胃泌素-17(Gastrin-17,G-17)水平及炎症因子肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、白细胞介素-1β(Interleukin-1β,IL-1β)、白细胞介素-6(Interleukin-6,IL-6)水平均低于对照组(P<0.05);治疗1个月后观察组幽门螺杆菌(Hp)转阴率为90.63%(58/64),明显高于对照组的75.00%(48/64),组间差异有统计学意义(P<0.05)。

结论

对慢性胃炎患者应用半夏泻心汤加减治疗效果明确,能有效改善患者胀满不适等症状,同时调节胃蛋白酶水平,减轻炎症因子刺激作用,促进胃黏膜功能恢复,提高幽门螺杆菌转阴率,有较高应用价值。

, authors=傅瑶1, 郭澄1, 梁芳1, 钱程2, authorsList=傅瑶, 郭澄, 梁芳, 钱程, authorCompany=null, correspAuthors=钱程, authorNote=

傅瑶(1987-),女,黑龙江大庆人,主管中药师,硕士,研究方向:中医临床药学。

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钱程(1983-),男,上海人,副主任中药师,硕士,研究方向:中医临床药学、中药制剂分析。E-mail:。
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傅瑶(1987-),女,黑龙江大庆人,主管中药师,硕士,研究方向:中医临床药学。

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傅瑶(1987-),女,黑龙江大庆人,主管中药师,硕士,研究方向:中医临床药学。

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半夏泻心汤加减治疗脾胃湿热型慢性胃炎对患者胃功能及炎症反应水平的影响[J]. 四川中医,2023,41(11):124-127., articleTitle=半夏泻心汤加减治疗脾胃湿热型慢性胃炎对患者胃功能及炎症反应水平的影响, refAbstract=null), Reference(id=1322923654601909080, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923640722957049, doi=null, pmid=null, pmcid=null, year=2023, volume=31, issue=5, pageStart=47, pageEnd=50, url=null, language=null, rfNumber=[27], rfOrder=26, authorNames=李家兴, 梁欣奕, 李慧臻, journalName=中国民间疗法, refType=null, unstructuredReference=李家兴,梁欣奕,李慧臻. 李永成运用“开心气,泻肝气”法治疗胃痞病肝郁气滞证经验[J]. 中国民间疗法,2023,31(5):47-50., articleTitle=李永成运用“开心气,泻肝气”法治疗胃痞病肝郁气滞证经验, refAbstract=null), Reference(id=1322923654669017945, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923640722957049, doi=null, pmid=null, pmcid=null, year=2023, volume=30, issue=2, pageStart=271, pageEnd=273, url=null, language=null, rfNumber=[28], rfOrder=27, authorNames=钮国英, journalName=中国中医药科技, refType=null, unstructuredReference=钮国英. 半夏泻心汤加减治疗Hp相关性胃炎的疗效观察及其对血清PGI、TNF-α的影响[J]. 中国中医药科技,2023,30(2):271-273., articleTitle=半夏泻心汤加减治疗Hp相关性胃炎的疗效观察及其对血清PGI、TNF-α的影响, refAbstract=null), Reference(id=1322923654748709722, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923640722957049, doi=null, pmid=null, pmcid=null, year=2024, volume=45, issue=2, pageStart=244, pageEnd=247,252, url=null, language=null, rfNumber=[29], rfOrder=28, authorNames=焦林珂, 崔向宁, 王玉玲, journalName=陕西中医, refType=null, unstructuredReference=焦林珂,崔向宁,王玉玲,等. 名中医崔向宁从“和法”治疗慢性胃炎经验[J]. 陕西中医,2024,45(2):244-247,252., articleTitle=名中医崔向宁从“和法”治疗慢性胃炎经验, refAbstract=null), Reference(id=1322923654811624283, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923640722957049, doi=null, pmid=null, pmcid=null, year=2024, volume=51, issue=8, pageStart=202, pageEnd=208, url=null, language=null, rfNumber=[30], rfOrder=29, authorNames=黎秀娟, 马超北, 王玉燕, journalName=辽宁中医杂志, refType=null, unstructuredReference=黎秀娟,马超北,王玉燕,等. 半夏泻心汤治疗胃病研究进展[J]. 辽宁中医杂志,2024,51(8):202-208., articleTitle=半夏泻心汤治疗胃病研究进展, refAbstract=null), Reference(id=1322923654887121757, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923640722957049, doi=null, pmid=null, pmcid=null, year=2024, volume=44, issue=8, pageStart=1839, pageEnd=1843, url=null, language=null, rfNumber=[31], rfOrder=30, authorNames=柳正清, 庞元鑫, 刘珍珍, journalName=中国老年学杂志, refType=null, unstructuredReference=柳正清,庞元鑫,刘珍珍,等. 加味半夏泻心汤联合莫沙必利对老年糖尿病性胃轻瘫患者胃肠功能及Ghrelin、IGF-1水平的影响[J]. 中国老年学杂志,2024,44(8):1839-1843., articleTitle=加味半夏泻心汤联合莫沙必利对老年糖尿病性胃轻瘫患者胃肠功能及Ghrelin、IGF-1水平的影响, refAbstract=null)], funds=[Fund(id=1322923650999001916, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923640722957049, awardId=82074063, language=CN, fundingSource=国家自然科学基金项目(82074063), fundOrder=null, country=null), Fund(id=1322923652609614653, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923640722957049, 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组别例数显效有效无效总有效
观察组6447(73.44)15(23.44)2(3.13)62(96.88)
对照组6434(53.13)19(29.69)11(17.19)53(82.81)
χ2值6.496 7
P值0.024 8
), ArticleFig(id=1322923650143363891, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923640722957049, language=CN, label=表1, caption=

两组慢性胃炎患者治疗效果比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数显效有效无效总有效
观察组6447(73.44)15(23.44)2(3.13)62(96.88)
对照组6434(53.13)19(29.69)11(17.19)53(82.81)
χ2值6.496 7
P值0.024 8
), ArticleFig(id=1322923650218861364, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923640722957049, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数胃脘疼痛胀满不适胃脘灼热嗳气反酸口苦口干
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
观察组644.35±1.211.03±0.23*3.65±1.491.09±0.25*2.69±1.241.03±0.25*2.68±1.251.01±0.13*2.78±1.351.03±0.16*
对照组644.36±1.242.36±0.11*3.67±1.512.14±0.27*2.67±1.271.98±0.58*2.69±1.352.32±1.42*2.79±1.341.23±0.25*
t值0.482 37.189 50.189 59.582 20.156 29.485 40.264 811.264 40.136 511.264 7
P值0.156 30.000 00.294 50.000 00.325 70.000 00.315 70.000 00.248 80.000 0
), ArticleFig(id=1322923650315330357, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923640722957049, language=CN, label=表2, caption=

两组慢性胃炎患者中医证候积分情况比较(±s)

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数胃脘疼痛胀满不适胃脘灼热嗳气反酸口苦口干
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
观察组644.35±1.211.03±0.23*3.65±1.491.09±0.25*2.69±1.241.03±0.25*2.68±1.251.01±0.13*2.78±1.351.03±0.16*
对照组644.36±1.242.36±0.11*3.67±1.512.14±0.27*2.67±1.271.98±0.58*2.69±1.352.32±1.42*2.79±1.341.23±0.25*
t值0.482 37.189 50.189 59.582 20.156 29.485 40.264 811.264 40.136 511.264 7
P值0.156 30.000 00.294 50.000 00.325 70.000 00.315 70.000 00.248 80.000 0
), ArticleFig(id=1322923650403410742, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923640722957049, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数PG I/(μg/L)PG Ⅱ/(μg/L)PGRG-17/(pmol/L)
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
观察组64139.52±26.5898.58±16.25*12.98±2.157.02±2.14*7.98±0.353.21±0.25*7.56±0.235.03±0.24*
对照组64140.25±25.82115.52±19.25*12.91±3.159.85±1.25*7.99±0.966.57±0.24*7.56±0.246.15±0.24*
t值1.130 542.110 70.817 73.604 50.774 49.356 50.247 38.484 2
P值0.262 10.028 30.416 50.011 20.441 30.021 00.248 70.000 0
), ArticleFig(id=1322923650525045559, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923640722957049, language=CN, label=表3, caption=

两组慢性胃炎患者胃黏膜功能相关指标情况比较(±s)

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数PG I/(μg/L)PG Ⅱ/(μg/L)PGRG-17/(pmol/L)
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
观察组64139.52±26.5898.58±16.25*12.98±2.157.02±2.14*7.98±0.353.21±0.25*7.56±0.235.03±0.24*
对照组64140.25±25.82115.52±19.25*12.91±3.159.85±1.25*7.99±0.966.57±0.24*7.56±0.246.15±0.24*
t值1.130 542.110 70.817 73.604 50.774 49.356 50.247 38.484 2
P值0.262 10.028 30.416 50.011 20.441 30.021 00.248 70.000 0
), ArticleFig(id=1322923650600543032, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923640722957049, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数TNF-α/(μg/mL)IL-1β/(ng/L)IL-6/(ng/L)
治疗前治疗后治疗前治疗后治疗前治疗后
观察组4624.25±3.2511.58±1.21*76.82±2.5123.52±3.25*25.85±6.9510.25±7.92*
对照组4623.58±4.2115.62±24.79*77.58±4.9747.85±4.95*25.95±7.5915.95±6.72*
t值0.295 46.784 30.139 513.874 30.634 812.494 8
P值0.142 30.000 00.298 70.000 00.239 70.000 0
), ArticleFig(id=1322923650692817721, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923640722957049, language=CN, label=表4, caption=

两组慢性胃炎患者血清炎症因子水平比较(±s)

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数TNF-α/(μg/mL)IL-1β/(ng/L)IL-6/(ng/L)
治疗前治疗后治疗前治疗后治疗前治疗后
观察组4624.25±3.2511.58±1.21*76.82±2.5123.52±3.25*25.85±6.9510.25±7.92*
对照组4623.58±4.2115.62±24.79*77.58±4.9747.85±4.95*25.95±7.5915.95±6.72*
t值0.295 46.784 30.139 513.874 30.634 812.494 8
P值0.142 30.000 00.298 70.000 00.239 70.000 0
), ArticleFig(id=1322923650776703802, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923640722957049, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数Hp转阴例数转阴率
观察组6458(90.63)
对照组6448(75.00)
χ2值6.782 3
P值0.024 8
), ArticleFig(id=1322923650848006971, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923640722957049, language=CN, label=表5, caption=

两组慢性胃炎患者Hp转阴情况比较

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组别例数Hp转阴例数转阴率
观察组6458(90.63)
对照组6448(75.00)
χ2值6.782 3
P值0.024 8
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半夏泻心汤加减治疗慢性胃炎临床研究
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傅瑶 1 , 郭澄 1 , 梁芳 1 , 钱程 2
中华中医药学刊 | 国家项目点击 2025,43(5): 48-51
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中华中医药学刊 |国家项目点击 2025 , 43 (5) : 48 -51
半夏泻心汤加减治疗慢性胃炎临床研究
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傅瑶1, 郭澄1, 梁芳1, 钱程2
作者信息
  • 1.上海交通大学医学院附属第六人民医院,上海 200233
  • 2.复旦大学附属华东医院,上海 200040
通讯作者:
钱程(1983-),男,上海人,副主任中药师,硕士,研究方向:中医临床药学、中药制剂分析。E-mail:。
作者简介:

傅瑶(1987-),女,黑龙江大庆人,主管中药师,硕士,研究方向:中医临床药学。

Clinical Study on Modified Banxia Xiexin Decoction(半夏泻心汤)in the Treatment of Chronic Gastritis
Yao FU1, Cheng GUO1, Fang LIANG1, Cheng QIAN2
Affiliations
  • 1.Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200233,China
  • 2.East China Hospital Affiliated to Fudan University,Shanghai 200040,China
出版时间: 2025-05-10 doi: 10.13193/j.issn.1673-7717.2025.05.011
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目的

分析半夏泻心汤加减治疗慢性胃炎的临床效果。

方法

纳入2021年2月—2024年7月上海交通大学医学院附属第六人民医院收治的慢性胃炎患者128例为研究对象,随机数字表法分为两组,对照组64例采用西医四联疗法进行治疗,观察组64例在对照组基础上联合半夏泻心汤加减治疗,对比两组疗效差异、中医证候积分、胃黏膜功能、炎症因子、幽门螺杆菌转阴率等。

结果

观察组治疗总有效率为96.88%(62/64),远高于对照组的82.81%(53/64),组间比较差异有统计学意义(P<0.05);治疗后观察组胃脘疼痛、胀满不适、胃脘灼热、嗳气反酸、口苦口干四项症状评分低于对照组(P<0.05);治疗后观察组胃蛋白酶I(Pepsinogen I,PG I)、胃蛋白酶Ⅱ(PepsinogenⅡ,PGⅡ)、胃泌素受体(Gastrin receptor,PGR)、胃泌素-17(Gastrin-17,G-17)水平及炎症因子肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、白细胞介素-1β(Interleukin-1β,IL-1β)、白细胞介素-6(Interleukin-6,IL-6)水平均低于对照组(P<0.05);治疗1个月后观察组幽门螺杆菌(Hp)转阴率为90.63%(58/64),明显高于对照组的75.00%(48/64),组间差异有统计学意义(P<0.05)。

结论

对慢性胃炎患者应用半夏泻心汤加减治疗效果明确,能有效改善患者胀满不适等症状,同时调节胃蛋白酶水平,减轻炎症因子刺激作用,促进胃黏膜功能恢复,提高幽门螺杆菌转阴率,有较高应用价值。

慢性胃炎  /  半夏泻心汤  /  西医四联疗法  /  胃黏膜功能  /  幽门螺杆菌  /  炎症因子  /  中西医结合治疗
Objective

To analyze the clinical effect of Modified Banxia Xiexin Decoction(半夏泻心汤)in the treatment of chronic gastritis.

Methods

A total of 128 patientswith chronic gastritis admitted to our hospital from February 2021 to July 2024 were included as the research objects. They were divided into two groups by the random number tablemethod.64 patients in the control group were treated with the Western medicine quadruple therapy,and 64 patients in the observation group were treated with themodified Banxia Xiexin Decoction on the basis of the above-mentioned treatment. The differences in curative effects,TCM syndrome scores,gastric mucosal function,inflammatory factors,and Helicobacter pylori(Hp)negative conversion rate were compared between the two groups.

Results

The total effective rate of treatment in the observation group was 96.88%(62/64),which wasmuch higher than 82.81%(53/64)in the control group,and the difference between the two groups was significant(P<0.05). After treatment,the scores of four symptoms,including epigastric pain,fullness and discomfort,epigastric burning,belching and acid reflux,bitter taste and drymouth in the observation group were lower than those in the control group(P<0.05). After treatment,the levels of pepsinogen I(PG I),pepsinogenⅡ(PGⅡ),pepsinogen ratio(PGR),gastrin-17(G-17),and the levels of inflammatory factors such as tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),and interleukin-6(IL-6)in the observation group were all lower than those in the control group(P<0.05). One month after treatment,the Hp negative conversion rate in the observation group was 90.63%(58/64),which was significantly higher than 75.00%(48/64)in the control group,and the difference between the two groupswas significant(P<0.05).

Conclusion

The application ofmodified Banxia Xiexin Decoction in the treatment of patientswith chronic.

chronic gastritis  /  Banxia Xiexin Decoction(半夏泻心汤)  /  western medicine quadruple therapy  /  gastric mucosal function  /  helicobacter pylori  /  inflammatory factors  /  integrated traditional Chinese and western medicine treatment
傅瑶, 郭澄, 梁芳, 钱程. 半夏泻心汤加减治疗慢性胃炎临床研究. 中华中医药学刊, 2025 , 43 (5) : 48 -51 . DOI: 10.13193/j.issn.1673-7717.2025.05.011
Yao FU, Cheng GUO, Fang LIANG, Cheng QIAN. Clinical Study on Modified Banxia Xiexin Decoction(半夏泻心汤)in the Treatment of Chronic Gastritis[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (5) : 48 -51 . DOI: 10.13193/j.issn.1673-7717.2025.05.011
慢性胃炎为临床常见、高发疾病之一,属于一种胃黏膜慢性炎症,以腹胀、腹痛、嗳气为主要症状表现。引起该病发生的原因较多,多是由于饮食不节、细菌感染等众多因素致使胃黏膜发生炎症,腺体出现萎缩,泌酸腺功能减弱而导致的[1]。临床研究认为,幽门螺杆菌(Hp)感染是导致慢性胃炎发生的主要致病菌,其所释放的毒素可对胃黏膜腺体构成破坏,从而产生溃疡病、炎症等[2]。目前临床针对该病主要予以质子泵抑制剂、铋剂、抗生素进行四联疗法,以促进Hp转阴,改善胃黏膜状态;但由于Hp耐药性增加使得该疗效降低,应用存在一定局限性[3];中医在治疗胃炎方面具有丰富经验,中医认为饮食不节、情志不舒、外感六淫邪与本病的发生存在密切相关,常表现为寒热错杂,虚实兼备[4]。半夏泻心汤最早出自《伤寒论》,为经典名方,具有调和肝脾、寒热平调、消痞散结的功效[5]。鉴于此,本次研究对慢性胃炎患者应用半夏泻心汤加减治疗,获得较好效果。现报道如下。
纳入2021年2月—2024年7月上海交通大学医学院附属第六人民医院收治的慢性胃炎患者128例为研究对象,随机数字表法分为两组。对照组64例,男38例,女26例,年龄27~76岁,平均(59.78±6.52)岁;病程4~31个月,平均(16.35±2.19)个月,其中萎缩性胃炎占25例,非萎缩性胃炎占39例;观察组64例,男35例,女29例,其中萎缩性胃炎占28例,非萎缩性胃炎占36例。两组患者上述资料比较差异无统计学意义(P>0.05),可比性较好。本研究经医院伦理委员会审批通过。
①均符合《中国慢性胃炎诊治指南(2022年,上海)》[6]中制定的关于慢性胃炎的相关诊断标准,以腹痛、腹胀、嗳气反酸为主要表现;慢性萎缩性胃炎内镜下可见部分黏膜血管,黏膜红白相间,以白为主,皱襞变平甚至消失,有黏膜结节状或颗粒等表现;慢性非萎缩性胃炎内镜下可见黏膜粗糙、红斑,伴或不伴水肿,伴肠上皮化生或不典型增生;且经病理组织检查明确诊断;②经14 C-尿素呼吸试验明确诊断为Hp阳性。
①参照《中国慢性胃炎共识意见(2017年)》[7]、《中药新药临床研究指导原则》[8]关于慢性胃炎的相关诊断标准,辨证为寒热错杂证,主症表现为胃脘疼痛、胀满不适、口干口苦;次症表现为胃脘灼热、嗳气反酸、大便稀溏、舌质淡红,苔黄,脉沉细数。符合上述主症及2项以上次症并结合舌脉即可明确诊断。
①患者均符合上述中西医相关诊断标准;②签署知情同意书;③临床资料完善。④年龄大于18岁;⑤近1个月内未应用相关药物进行治疗。
①病理组织检查疑是恶性病变者;②合并消化性溃疡、胃息肉等其他消化道器质性病变者;③胃镜病理检查提示胃重度异型增生者;④近期应用相关药物治疗者;⑤妊娠期或哺乳期妇女;⑥对本次应用药物过敏者;⑦肝肾功能存在严重器质性疾病者;⑧合并精神疾病、认知障碍等不能合作者。
采用西医四联疗法进行治疗,予以湖南华纳大药厂股份有限公司所生产的胶体果胶铋(国药准字H20043253,规格50 mg)餐前30 min口服,200 mg/次,3次/d;给予阿斯利康制药有限公司所生产的艾司奥美拉唑镁肠溶片(国药准字H20046380,规格20 mg)口服,20 mg/次,2次/d;给予上海现代制药股份有限公司所生产的克拉霉素片(国药准字H20073783,规格250 mg)口服,500 mg/次,2次/d;同时予以鲁南贝特制药有限公司所生产的阿莫西林克拉维酸钾片(国药准字H20053424,规格:0.375 g/片)口服,1片/次,3次/d。持续治疗2周。
在对照组基础上予以半夏泻心汤加减治疗,方药组成:法半夏10 g,川黄连3 g,炒黄芩6 g,干姜5 g,党参10 g,陈皮10 g,大枣4枚,炙甘草6 g。若舌苔厚腻则加白花蛇舌草15 g,薏苡仁15 g,苍术6 g;若嗳腐纳差则加焦山楂15 g,神曲15 g。将上述中药以水煎煮至400 mL,200 mL/次,分早晚服用,1剂/d。持续治疗2周。
经过治疗后患者胃脘痛、反酸嗳气等症状体征基本消失,胃镜检查提示胃黏膜充血、水肿等情况消失,未发现炎症,Hp呈阴性,证候积分减少超过80%,则为治疗显效;治疗后患者胃脘痛、反酸嗳气等症状体征改善,胃镜检查提示胃黏膜有轻微水肿、充血,Hp检测提示阴性,证候积分减少30%~80%,则为治疗有效;治疗后患者症状改善不明显,甚至有严重趋势,则无治疗无效。总有效率=显效率+有效率。
参照《中药新药临床研究指导原则》对患者胃脘疼痛、胀满不适、胃脘灼热、嗳气反酸、口苦口干4项症状进行评分,依据无、轻、中、重分别赋予0、2、4、6分,总分30分,分值越高表示其症状越严重。
于治疗前后采集患者空腹肘静脉血5 mL,1500 r/min进行离心处理,离心时间5 min,获得血清后采用酶联免疫法检测胃蛋白酶原I(Pepsinogen I,PG I)、胃蛋白酶原Ⅱ(PepsinogenⅡ,PGⅡ)、PGⅠ与PGⅡ的比值(PGR)、胃泌素17(Gastrin-17,G-17),观察其水平变化情况。
于治疗前后采集两组肘静脉血3 mL,室温下静置30 min,然后离心处理,3500 r/min离心15 min,离心半径设置为10.5 cm,获得血清后。采用酶联免疫吸附实验检测肿瘤坏死因子-α(Tumor Necrosis Factor-α,TNF-α)、白细胞介素-1β(Interleukin-1β,IL-1β)、白细胞介素-6(Interleukin-6,IL-6),观察其水平变化情况。
于治疗后1个月清晨空腹状态下使用呼气试验测试仪对两组患者进行14 C呼气试验,观察两组Hp转阴率。
将采集的数据采用SPSS 25.0处理分析,数据资料均符合正态分布,治疗效果、Hp转阴率用例(%)表示,采用χ2检验;中医证候积分、胃黏膜功能、炎症反应等指标用表示,用t检验。P<0.05为差异有统计学意义。
观察组治疗总有效率为96.88%,远高于对照组的82.81%,组间比较差异有统计学意义(P<0.05)。见表1。
治疗前两组胃脘疼痛、胀满不适、胃脘灼热、嗳气反酸、口苦口干4项症状评分比较差异无统计学意义(P>0.05);治疗两组上述4项症状评分均有所降低(P<0.05),且相较于对照组,观察组分值降低更为显著(P<0.05)。见表2。
治疗前两组PG I、PGⅡ、PGR、G-17水平比较差异无统计学意义(P>0.05);治疗后两组上述指标均较治疗前降低,且相比于对照组,观察组降低更为显著,组间差异有统计学意义(P<0.05)。见表3。
治疗前两组TNF-α、IL-1β、IL-6比较差异无统计学意义(P>0.05);治疗后两组上述指标水平均有所降低,且相较于对照组,观察组水平降低更为明显,组间比较差异有统计学意义(P<0.05)。见表4。
治疗1个月后观察组Hp转阴率为90.63%,明显高于对照组的75.0%,组间差异有统计学意义(P<0.05)。见表5。
慢性胃炎为临床常见的一种胃黏膜慢性炎症性疾病,以淋巴细胞浸润为主要病理特点,部分患者在后期可出现胃黏膜固有层腺体萎缩、化生,继而出现上皮内瘤变等[9]。该病的发生与Hp感染存在密切的关系,相关研究表明,Hp感染率大致相当于慢性胃炎的患病率,90%以上的慢性胃炎患者多伴有Hp感染的情况[10-11]。若不及时治疗,随着慢性胃炎的持续发展,可演变为胃癌,与胃癌的发生、发展存在密切的关系[12]。目前临床针对该病多予以三联或四联治疗,但单纯西药治疗效果不甚理想,停药后易复发。因此寻求其他方式联合进行治疗对提升治疗效果,促进胃黏膜修复具有重要意义。
慢性胃炎相关记载最早出自《黄帝内经》:“胃病者……胃脘当心而痛”。《景岳全书》则对嘈杂的病因及病机进行了论述,指出此证“有火嘈,有痰嘈,有酸水浸心而嘈”,认为酸水浸心而诱发嘈杂[13-14]。《伤寒论》指出本病病位在胃,多为本虚标实之证,肝脾同病,并因饮食不节、外感六淫等存在密切联系[15-16]。现代中医认为脾与胃一脏一腑,胃主受纳,脾主运化,五谷入于胃,有赖脾之运化,若饮食不节、素体虚弱,七情过极、外邪入侵则容易致脾胃受损,而运化失健,引湿聚热生,蕴结于中焦,使脾胃气机升降失调,不得宣通,日积月累则引发食滞、寒热错杂等病症[17-18]。故对其的治疗应以辛开苦降、平调寒热、散结消痞、益气健脾为治疗原则。本次研究对慢性胃炎患者应用半夏泻心汤加减治疗,结果发现治疗后观察组胃脘疼痛、胀满不适、胃脘灼热、嗳气反酸、口苦口干四项症状评分低于对照组(P<0.05)。可见该种治疗方式能促进患者症状体征尽快改善。张仲景继承《黄帝内经》理论,创新性地将辛开苦降法应用于临床实践,以半夏、干姜等辛温药物和黄连等苦寒药物为主,创制了半夏泻心汤及其变方,成为辛开苦降法的代表[19-20]。半夏泻心汤方中法半夏具有燥湿化痰、降逆止呕、消痞散结等功效[21];川黄连性寒微苦,归为胃经、脾经,具有清热燥湿、解毒泻火的作用[22];干姜性热,归于脾、胃经,具有温中散寒、助脾胃阳气、回阳通脉的功效[23];党参具有益气固表、补气养血、健脾开胃的功效;大枣甘温和中,以补脾虚;陈皮具有健脾开胃、燥湿化痰的功效[24];炙甘草调和诸药,使全方补而不滞。诸药相伍,可补脾虚之不足,使寒去热清,寒热平衡得复,脾阳得温,胃热得清,脾胃升降复常,肠通调,则诸证皆消[25-26]。此外本次研究发现治疗后观察组PG I、PGⅡ、PGR、G-17水平及炎症因子TNF-α、IL-1β、IL-6水平均低于对照组(P<0.05)。可见该种治疗方式能减少炎症因子水平,调节胃蛋白酶水平,促进胃黏膜功能的恢复。胃蛋白酶主要来源于胃黏膜细胞,其中PG I可反映胃泌酸功能,其高表达表示胃酸分泌过多;PGⅡ则能反映胃底黏膜状态,当Hp感染导致胃黏膜腺体萎缩时,其水平则呈上述趋势[27]。PGR的升高则表示胃部有炎症或恶性病变[];G-17则由胃窦G细胞所分泌,为反映胃黏膜健康情况的敏感指标[28]。TNF-α、IL-1β、IL-6均为常见的炎症因子,主要的促炎细胞因子,在慢性胃炎的进展中扮演了重要角色,可促进炎症细胞的浸润和炎症介质的释放,诱导胃黏膜细胞凋亡,导致胃黏膜屏障功能的破坏,从而加剧炎症反应[29]。半夏泻心汤中半夏经现代药理研究表明,半夏的水煎醇沉液能对胃液分泌、胃蛋白酶活性进行抑制,而促进黏膜进行修复,对胃黏膜起到保护作用[30];黄连中的小檗碱则能对胃炎分泌起到抑制作用,同时还利胆,保护黏膜;干姜的脂溶性成分可发挥抗炎及解热镇痛作用[31];而党参、大枣则可调节机体免疫,增强机体功能,促进蛋白质合成,故半夏泻心汤加减能促进胃黏膜恢复,减轻炎症因子。此外本组治疗后观察组Hp转阴率高于对照组(P<0.05)。分析原因可能是由于半夏提取物对幽门螺杆菌具有较强的抑制和消灭作用;黄连中的小檗碱也有抗炎、抑制Hp的作用。故将半夏泻心汤联合四联疗法治疗,中西合用,能大大提升治疗效果,改善患者症状。
综上所述,对慢性胃炎患者应用半夏泻心汤加减治疗效果明确,能有效改善患者胀满不适等症状,同时调节胃蛋白酶水平,减轻炎症因子刺激作用,促进胃黏膜功能恢复,提高幽门螺杆菌转阴率,有较高应用价值。
  • 国家自然科学基金项目(82074063)
  • 上海交通大学医学院药事管理与合理用药研究专项(JDYX2020KYZX002)
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2025年第43卷第5期
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doi: 10.13193/j.issn.1673-7717.2025.05.011
  • 首发时间:2026-10-30
  • 出版时间:2025-05-10
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国家自然科学基金项目(82074063)
上海交通大学医学院药事管理与合理用药研究专项(JDYX2020KYZX002)
作者信息
    1.上海交通大学医学院附属第六人民医院,上海 200233
    2.复旦大学附属华东医院,上海 200040

通讯作者:

钱程(1983-),男,上海人,副主任中药师,硕士,研究方向:中医临床药学、中药制剂分析。E-mail:。
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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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