International Journal of Clinical Research
International Journal of Clinical Research. 2025; 9: (8) ; 10.12208/j.ijcr.20250408 .
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泸州市合江县中医医院 四川泸州
*通讯作者： 王芳琼,单位：泸州市合江县中医医院 四川泸州；
目的 观察左金丸治疗肝胃郁热型胆汁反流性胃炎的临床疗效及对相关指标的影响。方法 研究纳入2023年1月-2024年6月合江县中医医院脾胃病肝胆内科门诊及住院治疗的符合肝胃郁热型原发性胆汁反流性胃炎的患者66例，以随机数字表法分为对照组（33例）与治疗组（33 例），给予对照组患者铝碳酸镁咀嚼片治疗，给予治疗组患者铝碳酸镁咀嚼片结合左金丸治疗；2组患者临床数据观察：临床治疗效果、治疗前后中医证候积分变化、治疗前后患者胃泌素、胃动素、血管活性肠肽水平变化。结果 治疗组患者治疗总有效率比对照组高；治疗组患者中医证候改善情况优于对照组（P＜ 0.0010）；治疗后治疗组患者胃泌素、胃动素水平均优于对照组（P ＜0.001），对照组血管活性肠肽水平优于治疗组（P ＜0.001）。结论 左金丸治疗肝胃郁热型胆汁反流性胃炎可较好改善患者症状，促进患者胃肠功能恢复，提高患者生活质量，安全有效。
Objective To evaluate the clinical efficacy of Zuojin Pill in the treatment of bile reflux gastritis (BRG) of liver-stomach heat stagnation type and its effects on related physiological indicators. Methods A total of 66 patients diagnosed with primary BRG of liver-stomach heat stagnation type who were treated at the Department of Spleen, Stomach, Liver and Gallbladder Diseases, Hejiang County Hospital of Traditional Chinese Medicine from January 2023 to June 2024 were enrolled in this study. Using the random number table method, patients were divided into a control group (n = 33) and a treatment group (n = 33). The control group received magaldrate chewable tablets, while the treatment group was administered a combination of magaldrate chewable tablets and Zuojin Pill. Clinical outcomes were compared between the two groups, including overall therapeutic efficacy, changes in traditional Chinese medicine (TCM) syndrome scores before and after treatment, and levels of serum gastrin (GAS), motilin (MTL), and vasoactive intestinal peptide (VIP). Results The total effective rate in the treatment group was significantly higher than that in the control group. The improvement in TCM syndrome scores was more pronounced in the treatment group (P < 0.001). After treatment, the levels of GAS and MTL were significantly higher in the treatment group compared to the control group (P < 0.001), while the VIP level was significantly higher in the control group than in the treatment group (P < 0.001). Conclusion Zuojin Pill, when combined with conventional treatment, can effectively alleviate symptoms in patients with BRG of liver-stomach heat stagnation type, promote gastrointestinal functional recovery, and improve quality of life. The treatment is both safe and effective.
[1] LIU SA,GＲIGOＲYAN H,EDMANDS WMB,et al.Cys34 adductomes differ between patients with chronic lung or heart disease and healthy controls in central london[J]. Environ Sci Technol,2018,52 ( 4) : 2307－2313.
[2] 杨国红,魏晓梦.胆汁反流性胃炎镜下表现与中医证候及相关因素分析[J]. 中医临床研究,2020,12(18):4-6,21.
[3] 张声生, 唐旭东, 黄穗平等. (2017). 慢性胃炎中医诊疗专家共识意见(2017).中华中医药杂志(7), 5.
[4] 中华医学会消化病学分会. "2020年中国胃食管反流病专家共识."中华消化杂志40.10(2020):649-663.
[5] 李亚鼎,王轶,周秉舵,等.经方治疗肝胃郁热型胃食管反流病的网状 Meta分析[J].临 床消化病杂志,2023, 35(1): 1-7.
[6] 吴宜华,葛惠男 .左金丸合半夏厚朴汤加减治疗胃食道反流病临床研究[J].中医学报,2016,31（11）:1782-1785.
[7] 刘晓伟,张红梅,曲宏达,等 .左金丸对应激性胃溃疡粘膜损伤保护作用机理的研究[J]. 江西中医药,2004,35（8）: 18-20.
[8] 叶旭星,何钦,徐斌,等. 加味百合汤合左金丸治疗原发性胆汁反流性胃炎临床研究[J]. 新中医,2020,52( 2) : 41-43.
[9] DuanS, RicoK, MerchantJL. Gastrin:From Physiologyto Gastrointestinal Malignancies[J].Function (Oxf),2021,3(1): zqab062.
[10] 吴燕华,季雁浩.胆汁反流性胃炎的中医证候规律与血浆胃动素、血管活性肠肽的相关性研究[J].世界中西医结合杂志,2021,16(11):2119-2123.
[11] KALKAN C,SOYKAN I. The relations among serum ghrelin,motilin and gastric emptying and autonomic function in autoimmune gastritis [J].Am J Med Sci,2018, 355( 5) : 428-433.
[12] Role of PACAP1 Receptor in Regulation of ECL Cells and Gastric Acid Secretion by Pituitary Adenylate Cyclase Activating Peptide." Annals of the New York Academy of Sciences 921.VIP(2010):233-241.
[13] VERMA A K,MANOHAR M,VENKATESHAIAH S U,et al. Role of vasoactive intestinal peptide in promoting the pathogenesis of eosinophilic esophagitis( EoE) [J]. Cell Mol Gastroenterol Hepatol, 2017,22( 1) : 99-100.
[14] 王光铭,黄玉珍,刘万里,等.加味左金丸治疗肝胃郁热型功能性消化不良临床疗效及对相关激素水平的影响[J].中华中医药学刊,2024,42(07):48-51.