参芪健胃颗粒联合舒肝解郁胶囊治疗慢性萎缩性胃炎伴焦虑抑郁临床研究

摘要

Objective To observe the clinical effect of Shenqijianwei Granules combined with Shuganjieyu Capsules in the treatment of chronic atrophic gastritis (CAG) with anxiety-depression. Methods Totally 57 patients with CAG and anxiety-depression were randomly divided into the control group (n=28)and the combined group (n=29). The control group was treated with Vitacoenzyme Tablets and Paroxetine Hydrochloride Tablets orally,while the combined group was treated with Shenqijianwei Granules combined with Shuganjieyu Capsules. Four weeks was a course of treatment,and the two groups were treated with 3 courses. Results The scores of main clinical symptoms (epigastric pain,acid regurgitation,postprandial fullness,belching,early satiation) and gastric mucosa biopsy in the combined group were significantly lower than those in the control group (P < 0. 05). After treatment,the levels of serum biomarkers (sHLA-G,MG7-Ag,PGⅠ,IL-23 and TK1)in the two groups had significantly difference (P < 0. 05). The scores of anxiety and depression scale (HAD-A,HAD-D,HAMA and HAMD) in the combined group were significantly lower than those in the control group (P < 0. 05). The total effective rate of the combined group was significantly higher than that of the control group (96. 55％vs. 78. 57％,χ2=4. 275,P=0. 039 < 0. 05). The incidence rate of adverse reactions in the combined group was significantly lower than that in the control group during treatment(0 vs. 14. 29％,χ2=4. 456,P=0. 035 < 0. 05). Conclusion Shenqijianwei Granules combined with Shuganjieyu Capsules in the treatment of CAG with anxiety-depression can significantly improve the clinical efficacy,clinical symptoms and gastric mucosal lesion,regulate serum biomarker levels and improve anxiety and depression. It is safe and worthy of clinical promotion.%目的 观察参芪健胃颗粒联合舒肝解郁胶囊治疗慢性萎缩性胃炎(CAG)伴焦虑抑郁的临床疗效.方法 将CAG伴焦虑抑郁患者57例随机分为对照组(n=28)和联合组(n=29),对照组患者给予维酶素片和盐酸帕罗西汀片口服,联合组患者给予参芪健胃颗粒联合舒肝解郁胶囊口服,均以4周为1个疗程,共治疗3个疗程.结果 联合组治疗后主要临床症状(如胃脘痛、反酸、餐后饱胀、嗳气及早饱)评分,以及胃黏膜病理活检评分均显著低于对照组(P<0.05),联合组治疗后的血清生物标志物可溶性人白细胞抗原G(sHLA-G)、胃癌相关抗原(MG7-Ag)、胃蛋白酶原Ⅰ(PGⅠ)、炎症因子IL-23及胸苷激酶1(TK1)水平均与对照组有显著差异(P<0.05);联合组治疗后的综合医院焦虑量表(HAD-A)、综合医院抑郁量表(HAD-D)、汉密尔顿焦虑量表(HAMA)及汉密尔顿抑郁量表(HAMD)评分均显著低于对照组(P<0.05),总有效率显著高于对照组(96.55％ 比78.57％,χ2=4.275,P=0.039<0.05),治疗期间的不良反应发生率显著低于对照组(0比14.29％,χ2=4.456,P=0.035<0.05).结论 参芪健胃颗粒联合舒肝解郁胶囊治疗CAG伴焦虑抑郁,能显著提高临床疗效,改善临床症状和胃黏膜病变,调节各血清生物标志物水平,改善焦虑抑郁情绪,且安全性良好,值得临床推广.