目的 探讨理中汤加减治疗脾胃虚寒型胃十二指肠溃疡（GDU）的疗效及对患者胃功能、炎症介质的影响。 方法 将2023年4月至2025年5月南阳市第一人民医院收治的脾胃虚寒型GDU患者随机纳入西医组（53例）、联合组（53例）。西医组采用雷贝拉唑钠肠溶片及硫糖铝混凝胶口服治疗，联合组采用西医组+理中汤加减治疗，两组均治疗6周。比较两组治疗6周后疗效，治疗前、治疗6周后胃黏膜形态评分、胃功能、炎症介质、黏膜修复相关因子、氧化应激指标、生活质量，治疗期间安全性。 结果 治疗6周后，联合组的总有效率为94.34%（50/53），高于西医组的81.13%（43/53）（P < 0.05）。治疗6周后两组黏膜厚度、炎性细胞浸润程度、腺体密度评分，血清胆囊收缩素（CCK）、胃动素（MTL）、胃泌素（GAS）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、核因子-κB（NF-κB）、丙二醛（MDA）水平较治疗前降低，且联合组更低（P < 0.05）。治疗6周后两组血清降钙素基因相关肽（CGRP）、三叶肽因子1（TFF1）、表皮生长因子（EGF）、表皮生长因子受体（EGFR）、超氧化物歧化酶（SOD）水平，生活质量各项评分较治疗前升高，且联合组更高（P < 0.05）。治疗期间，联合组治疗期间不良反应发生率11.32%与西医组5.66%接近（P > 0.05）。 结论 理中汤加减治疗脾胃虚寒型GDU的疗效确切，可改善胃黏膜形态，提高胃功能，抑制炎症反应及氧化应激，促进黏膜修复相关因子分泌，优化患者生活质量，安全性良好。

Objective To investigate the therapeutic effects of modified Lizhong Decoction on gastric and duodenal ulcers （GDU） of the spleen-stomach cold deficiency type， as well as its influence on gastric function and inflammatory mediators. Methods From April 2023 to May 2025， patients diagnosed with gastric dyspepsia of the spleen and stomach cold deficiency type at Nanyang First People's Hospital were randomly assigned to either the Western medicine group （n = 53） or the combined therapy group （n = 53）. The Western medicine group received oral rabeprazole sodium enteric-coated tablets and sucralfate suspension， while the combined therapy group received the same Western medication regimen plus modified Lizhong Decoction. Both groups underwent a 6-week treatment course. Outcomes including clinical efficacy after 6 weeks， gastric mucosal morphology scores， gastric function， levels of inflammatory mediators， mucosal repair-related factors， oxidative stress markers， quality of life before and after treatment， and treatment safety were compared between the two groups. Results The total effective rate in the combined group after 6 weeks of treatment was significantly higher than that in the Western medicine group （P < 0.05）. After 6 weeks of treatment， both groups showed reduced mucosal thickness， inflammatory cell infiltration， glandular density scores， and decreased serum levels of cholecystokinin （CCK）， motilin （MTL）， gastrin （GAS）， interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α）， nuclear factor-κB （NF-κB）， and malondialdehyde （MDA） compared to baseline， with greater reductions observed in the combined group （P < 0.05）. Additionally， serum levels of calcitonin gene-related peptide （CGRP）， trefoil factor 1 （TFF1）， epidermal growth factor （EGF）， epidermal growth factor receptor （EGFR）， and superoxide dismutase （SOD）， as well as quality-of-life scores across multiple domains， were significantly increased from baseline in both groups， with the combined group showing superior improvements （P < 0.05）. During the treatment period， the incidence of adverse reactions was 11.32% in the combined group and 5.66% in the Western medicine group， with no statistically significant difference between the two groups （P > 0.05）. Conclusion Modified Lizhong Decoction demonstrated a definite therapeutic effect on GDU of the spleen and stomach cold deficiency type， effectively improving gastric mucosal morphology， enhancing gastric function， suppressing inflammatory responses and oxidative stress， promoting the secretion of mucosal repair-related factors， improving patients' quality of life， and exhibiting favorable safety.