健胃舒颗粒治疗脾虚阳郁型慢性萎缩性胃炎的临床疗效观察OA

Objective To observe the therapeutic efficacy of Jianweishu Granules in treating chronic atrophic gastritis(CAG)with spleen deficiency and yang depression syndrome.Methods A total of 104 CAG patients with spleen deficiency and yang depression syndrome,treated in the Department of Gastroenterology at Guangdong Second Traditional Chinese Medicine Hospital from July 2023 to March 2025,were selected.Patients were randomly divided into a western medicine group and a Chinese medicine group using a random number table,with 52 patients in each group.The western medicine group received oral folic acid tablets,while the Chinese medicine group received oral Jianweishu Granules.The treatment course for both groups was 16 weeks.Changes in traditional Chinese medicine(TCM)syndrome scores,gastric mucosal histopathological scores,scores of Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS)and Gastrointestinal Symptom Rating Scale(GSRS),serum levels of gastric function markers[gastrin-17(G-17),pepsinogen I(PG I),pepsinogen Ⅱ(PG Ⅱ)],inflammatory factors[interleukin-6(IL-6),interleukin-1β(IL-1β)],and the neutrophil-to-lymphocyte ratio(NLR)were observed before and after treatment.The clinical efficacy and medication safety of the two groups were evaluated.Results(1)Study attrition and exclusion:3 cases from each of the Chinese medicine group and the western medicine group were lost or excluded during the study.Ultimately,49 patients from each group were included in the efficacy analysis.(2)Efficacy:after 16 weeks of treatment,the total effective rate was 87.75%(43/49)in the Chinese medicine group,significantly higher than 73.47%(36/49)in the western medicine group.Intergroup comparison(by rank-sum test)showed that the overall efficacy of the Chinese medicine group was significantly superior to that of the western medicine group(P＜0.01).(3)TCM syndrome scores:after treatment,scores for individual symptoms including epigastric pain,abdominal distension,gastric upset,belching,loose stools,acid reflux,and poor appetite,as well as the total scores,were significantly decreased in both groups compared to before treatment(P＜0.05).The reductions in scores for symptoms like epigastric pain and abdominal distension,and the total score,were significantly greater in the Chinese medicine group than in the western medicine group(P＜0.05).(4)Scale scores,after treatment,SAS,SDS,and GSRS scores were significantly decreased in both groups(P＜0.05),and the reductions were significantly greater in the Chinese medicine group(P＜0.05).(5)Gastric mucosal histopathological scores:after treatment,scores for chronic inflammation,activity and atrophy and the total pathological score in both groups,as well as scores for intestinal metaplasia and dysplasia in the Chinese medicine group,were significantly decreased compared to before treatment(P＜0.05).The reductions in the scores for chronic inflammation,activity,atrophy,intestinal metaplasia,and dysplasia,as well as the total pathological score were significantly greater in the Chinese medicine group(P＜0.05).(6)Gastric function markers:after treatment,serum PG I and PGⅡ levels increased(P＜0.05),while serum G-17 levels decreased(P＜0.05)in both groups compared to before treatment.The increases in PGⅠ and PG Ⅱ and the decrease in G-17 were significantly greater in the Chinese medicine group(P＜0.05).(7)Inflammatory indicators:after treatment,serum levels of IL-6 and IL-1β and the NLR were significantly decreased in both groups compared to before treatment(P＜0.05),and the reductions in IL-6 and IL-1β were significantly greater in the Chinese medicine group(P＜0.05).(8)Safety:no adverse events such as nausea,vomiting,diarrhea,or rash occurred in either group during treatment.Furthermore,no significant abnormalities were observed in liver function,kidney function,or coagulation function in either group after 16 weeks of treatment.Conclusion Jianweishu Granules can effectively improve patients'clinical symptoms,pathological grading,and physical-mental status,enhance quality of life,promote gastric mucosal repair and secretion,reduce levels of inflammatory factors,and ameliorate the gastric mucosal inflammatory microenvironment in CAG patients with spleen deficiency and yang depression syndrome.The therapy demonstrates definite clinical efficacy and reliable safety in treating CAG.