Bai Wen-Jun, Liang Jun-Wei, Miao Xiu-Ming, Yan Hua, Chi Li-Li
Department of Acu-moxibustion, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250000, China.
Department of Spleen and Stomach Diseases, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250000, China.
Zhen Ci Yan Jiu. 2022 Jun 25;47(6):537-43. doi: 10.13702/j.1000-0607.20210502.
To evaluate the clinical effects of acupoint catgut embedding combined with quadruple therapy on Helicobacter pylori (Hp)-positive (+) chronic atrophic gastritis (CAG) of spleen and stomach deficiency syndrome and explore the underlying mechanism.
Hp (+) CAG patients with spleen and stomach deficiency syndrome were randomly divi-ded into a control group (=68) and a treatment group (=71). In addition to the routine quadruple therapy for two weeks, the patients in the control group received oral Weifuchun Tablets (4 tablets once, tid.), and those in the treatment group underwent acupoint catgut embedding at Pishu (BL20), Weishu (BL21), Zhongwan (CV12), and Zusanli (ST36), once a week. The two groups were treated for three months in total. The scores of traditional Chinese medicine (TCM) symptoms and signs, clinical efficacies, quality of life scale scores (PRO scores and HAMA scores), endoscopic and histopathologic scores, Hp eradication rates detected by 13C breath test, and the recurrence rates after six months of the two group were compared. The changes in serum gastrin 17 (G-17), pepsinogen Ⅰ (PGⅠ) and pepsinogen Ⅱ (PGⅡ) were detected by ELISA, and PGⅠ/PGⅡ was calculated.
There was no significant difference in the eradication rate of Hp between the two groups after treatment (>0.05), but the recurrence rate after six months in the treatment group was lower than that of the control group (<0.05). After treatment, the scores of TCM symptoms and signs, endoscopic and histopathologic scores, PRO scores, and HAMA scores were decreased in both groups (<0.01), while serum levels of G-17, PG Ⅰ, PG Ⅱ, and PG Ⅰ/PG Ⅱ were increased (<0.05, <0.01). The treatment group was superior to the control group in alleviating stomach discomfort by pressing or warmth, decreasing the total score of TCM symptoms and signs, relieving anorexia, mottled gastric mucosa, mucosal ulcer, chronic inflammation, and activity, improving anxiety, and regulating G-17 (<0.05, <0.01). The effective rates of the treatment group and the control group were 40.85% (29/71) and 23.53% (16/68)，the treatment group was higher than the control group (<0.05).
Acupoint catgut embedding combined with quadruple therapy in the treatment of Hp (+) CAG of spleen and stomach deficiency syndrome is significant in clinical efficacy and low in recurrence rate, which is presumedly achieved by repairing gastric mucosa and sensitizing the secretion of G-17 and pepsinogen.
评价穴位埋线联合四联疗法对幽门螺杆菌（Hp）阳性的脾胃虚弱型慢性萎缩性胃炎（CAG）的临床疗效，并探讨其作用机制。
将Hp阳性的脾胃虚弱型CAG患者随机分为对照组（68例）和治疗组（71例）。对照组在常规四联疗法治疗两周的基础上，口服胃复春片（一次4片，每日3次）；治疗组在常规四联疗法治疗两周的基础上，加用穴位埋线治疗，取穴脾俞（BL20）、胃俞（BL21）、中脘（CV12）、足三里（ST36），每周1次。两组均治疗3个月。比较两组患者的中医症状体征积分、临床疗效、生活质量量表评分（PRO评分和HAMA评分）、内镜及病理组织学评分、13C呼气试验检测的Hp根除率及停药6个月后的复发率。采用ELISA法检测血清胃泌素17（G-17）、胃蛋白酶原Ⅰ（PGⅠ）、胃蛋白酶原Ⅱ（PGⅡ）水平，并计算PGⅠ/PGⅡ比值。
两组治疗后Hp根除率比较，差异无统计学意义（>0.05），但治疗组停药6个月后的复发率低于对照组（<0.05）。两组治疗后中医症状体征积分、内镜及病理组织学评分、PRO评分、HAMA评分均降低（<0.01），血清G-17、PGⅠ、PGⅡ水平及PGⅠ/PGⅡ比值均升高（<0.05, <0.01）。治疗组在缓解胃脘压痛或喜温症状、降低中医症状体征总积分、改善食欲不振、胃黏膜花斑、黏膜溃疡、慢性炎症及活动度、改善焦虑情绪及调节G-17水平方面均优于对照组（<0.05, <0.01）。治疗组和对照组的有效率分别为40.85%（29/71）和23.53%（16/68），治疗组高于对照组（<0.05）。
穴位埋线联合四联疗法治疗Hp阳性的脾胃虚弱型CAG临床疗效显著，复发率低，其机制可能与修复胃黏膜及调节G-17、胃蛋白酶原分泌有关。
