理中汤加减治疗脾胃虚寒型胃十二指肠溃疡的疗效及对患者胃功能、炎症介质的影响

doi:10.3969/j.issn.1006-5725.2025.23.021

Abstract

Abstract:

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.

Key words: gastric and duodenal ulcers, spleen and stomach cold deficiency type, modified lizhong decoction, therapeutic effect, gastric function, inflammatory mediators, gastric mucosa morphology

CLC Number:

R259

Xiaoguang WEI,Quan WANG,Wenjuan SUN,Ling CHENG,Lei. MA. The therapeutic effect of modified lizhong decoction on gastric and duodenal ulcers of spleen and stomach cold deficiency type and its impact on gastric function and inflammatory mediators[J]. The Journal of Practical Medicine, 2025, 41(23): 3773-3779.

Figures/Tables 7

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References 28

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组别	例数	临床治愈	显效	有效	无效	总有效率
西医组	53	18（33.96）	15（28.30）	10（18.87）	10（18.87）	43（81.13）
联合组	53	26（49.06）	18（33.96）	6（11.32）	3（5.66）	50（94.34）
χ²值						4.296
P值						0.038

组别	例数	治疗前			治疗6周后
组别	例数	黏膜厚度	炎性细胞浸润程度	腺体密度	黏膜厚度	炎性细胞浸润程度	腺体密度
西医组	53	1.63 ± 0.32	1.72 ± 0.35	1.61 ± 0.34	1.37 ± 0.34^#	1.12 ± 0.30^#	1.21 ± 0.31^#
联合组	53	1.59 ± 0.31	1.80 ± 0.32	1.58 ± 0.31	1.06 ± 0.29^#	0.83 ± 0.22^#	0.94 ± 0.28^#
t值		0.654	1.228	0.475	5.050	5.675	4.705
P值		0.515	0.222	0.636	< 0.001	< 0.001	< 0.001

组别	例数	治疗前				治疗6周后
组别	例数	GAS/ （μmol/L）	CCK/ （pg/mL）	MTL/ （pg/mL）	CGRP/ （pg/mL）	GAS/（μmol/L）	CCK/ （pg/mL）	MTL/ （pg/mL）	CGRP/ （pg/mL）
西医组	53	107.12 ± 12.11	17.54 ± 1.48	522.54 ± 54.52	8.89 ± 2.11	70.87 ± 9.34^#	15.02 ± 3.65^#	338.43 ± 42.83^#	12.40 ± 3.01^#
联合组	53	106.89 ± 12.09	17.61 ± 1.51	524.49 ± 57.49	9.09 ± 2.09	60.16 ± 9.29^#	12.43 ± 3.59^#	303.21 ± 32.01^#	14.02 ± 3.45^#
t值		0.098	0.241	0.179	0.490	5.919	3.683	4.795	2.576
P值		0.922	0.810	0.858	0.625	< 0.001	< 0.001	< 0.001	0.011

组别	例数	治疗前
组别	例数	IL-6/（ng/L）	TNF-α/（ng/L）	NF-κB/（ng/L）	SOD/（U/L）	MDA/（μmol/L）
西医组	53	39.54 ± 2.21	66.62 ± 6.65	61.49 ± 7.32	55.37 ± 7.34	7.96 ± 1.65
联合组	53	40.01 ± 2.32	67.14 ± 6.71	60.87 ± 8.39	56.07 ± 6.40	8.06 ± 1.83
t值		1.068	0.401	0.405	0.523	0.295
P值		0.288	0.689	0.686	0.602	0.768
组别	例数	治疗6周后
组别	例数	IL-6/（ng/L）	TNF-α/（ng/L）	NF-κB/（ng/L）	SOD/（U/L）	MDA/（μmol/L）
西医组	53	22.32 ± 5.03^#	30.54 ± 6.58^#	21.72 ± 4.38^#	97.56 ± 9.35^#	6.07 ± 1.54^#
联合组	53	14.43 ± 3.18^#	22.54 ± 5.62	15.97 ± 4.31^#	112.62 ± 15.36^#	4.32 ± 1.15^#
t值		9.652	6.730	6.812	6.097	6.629
P值		< 0.001	< 0.001	< 0.001	< 0.001	< 0.001

组别	例数	治疗前			治疗6周后
组别	例数	TFF1（ng/mL）	EGF（pg/mL）	EGFR（pg/mL）	TFF1（ng/mL）	EGF（pg/mL）	EGFR（pg/mL）
西医组	53	1.93 ± 0.46	159.25 ± 29.56	0.71 ± 0.22	3.31 ± 0.76^#	258.68 ± 55.17^#	1.01 ± 0.33^#
联合组	53	2.02 ± 0.45	158.35 ± 27.66	0.68 ± 0.20	4.52 ± 0.95^#	321.34 ± 56.65^#	1.30 ± 0.31^#
t值		1.018	0.162	0.735	7.241	5.769	4.663
P值		0.311	0.872	0.464	< 0.001	< 0.001	< 0.001

The therapeutic effect of modified lizhong decoction on gastric and duodenal ulcers of spleen and stomach cold deficiency type and its impact on gastric function and inflammatory mediators

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组别	例数	治疗前
组别	例数	精神健康	生理职能	情感职能	躯体功能	躯体疼痛	社会功能	活力	总体健康
西医组	53	63.43 ± 5.64	59.30 ± 5.20	65.57 ± 5.69	58.54 ± 8.39	63.63 ± 6.52	69.28 ± 6.56	59.82 ± 5.43	62.19 ± 5.49
联合组	53	64.53 ± 5.43	60.57 ± 5.19	64.42 ± 5.66	57.35 ± 9.37	64.11 ± 6.55	70.93 ± 6.21	60.81 ± 5.66	63.10 ± 5.15
t值		1.023	1.258	1.043	0.689	0.378	1.330	0.919	0.880
P值		0.309	0.211	0.299	0.492	0.706	0.186	0.360	0.381
组别	例数	治疗6周后
组别	例数	精神健康	生理职能	情感职能	躯体功能	躯体疼痛	社会功能	活力	总体健康
西医组	53	78.43 ± 4.64^#	79.30 ± 3.20^#	76.85 ± 4.25^#	77.45 ± 3.15^#	79.95 ± 5.20^#	76.81 ± 4.45^#	74.68 ± 4.51^#	77.67 ± 5.40^#
联合组	53	84.53 ± 2.43^#	85.57 ± 3.19^#	80.27 ± 5.06^#	82.48 ± 3.17^#	83.07 ± 5.22^#	82.74 ± 4.45^#	83.64 ± 4.52^#	82.73 ± 4.46^#
t值		8.479	10.102	3.768	8.194	3.083	6.860	10.216	5.260
P值		< 0.001	< 0.001	< 0.001	< 0.001	0.003	< 0.001	< 0.001	< 0.001

组别	例数	头晕	皮疹	便秘	恶心	不良反应发生率
西医组	53	1（1.89）	1（1.89）	0（0.00）	1（1.89）	3（5.66）
联合组	53	2（3.77）	2（3.77）	1（1.89）	1（1.89）	6（11.32）
χ²值						0.486^*
P值						0.486

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