益气活血通络方联合雷贝拉唑治疗慢性萎缩性胃炎的疗效及对血清HIF-1α、VEGF水平的影响

Efficacy of Yiqi Huoxue Tongluo Formula combined with rabeprazole in treating atrophic gastritis and its effect on patients' HIF-1α and VEGF levels

摘要:

目的 观察益气活血通络方联合雷贝拉唑治疗慢性萎缩性胃炎的疗效，以及对患者血清缺氧诱导因子-1α（HIF-1α）、血管内皮生长因子（VEGF）水平的影响，为临床治疗提供循证依据。方法 选取2024年1月—2025年6月南京中医药大学附属苏州市中医医院收治的80例脾胃气虚、瘀血阻络证慢性萎缩性胃炎患者，采用随机数字表法分为观察组和对照组，各40例。对照组口服雷贝拉唑钠肠溶片，观察组在对照组基础上联合益气活血通络方，两组均持续治疗12周。比较两组患者的疗效，中医证候积分，胃黏膜病理评分，HIF-1α、VEGF水平，以及不良反应。结果 两组患者总有效率比较，差异有统计学意义（P <0.05）。观察组治疗后胃脘隐痛、痞满、纳呆和神疲乏力评分均低于对照组（P <0.05）；同组内治疗后胃脘隐痛、痞满、纳呆和神疲乏力评分均低于治疗前（P <0.05）。观察组治疗后萎缩评分、肠化评分、异型增生评分均低于对照组（P <0.05）；同组内治疗后萎缩评分、肠化评分、异型增生评分均低于治疗前（P <0.05）。观察组治疗后HIF-1α、VEGF水平均低于对照组（P <0.05）；同组内治疗后HIF-1α、VEGF水平均低于治疗前（P <0.05）。两组不良反应总发生率比较，差异无统计学意义（P >0.05）。结论 益气活血通络方联合雷贝拉唑治疗脾胃气虚、瘀血阻络证慢性萎缩性胃炎患者疗效显著，可改善患者中医证候及胃黏膜病理状态，降低血清HIF-1α、VEGF水平，且不会增加患者不良反应。

Abstract:

Objective To observe the efficacy of Yiqi Huoxue Tongluo Formula combined with rabeprazole in treating chronic atrophic gastritis and its effect on serum levels of hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) in patients, providing evidence for clinical treatment.Methods A total of 80 patients with chronic atrophic gastritis of the pattern of spleen-stomach qi deficiency and blood stasis obstructing collaterals, admitted to Suzhou Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine from January 2024 to June 2025, were randomly divided into an observation group and a control group using a random number table method, with 40 cases in each group. The control group received oral rabeprazole sodium enteric-coated tablets, while the observation group was treated with Yiqi Huoxue Tongluo Formula in addition to the treatment given to the control group. Both groups received continuous treatment for 12 weeks. The therapeutic efficacy, Traditional Chinese Medicine (TCM) syndrome scores, gastric mucosal pathology scores, HIF-1α and VEGF levels, and adverse reactions were compared between the two groups.Results The total effective rate was significantly higher in the observation group than in the control group (P < 0.05). After treatment, the scores for dull epigastric pain, abdominal distension and discomfort, poor appetite, and fatigue and weakness were significantly lower in the observation group than in the control group (all P < 0.05). Within the same group, the post-treatment scores for the above symptoms were significantly lower than the pre-treatment scores (all P < 0.05). After treatment, the scores for atrophy, intestinal metaplasia, and dysplasia were significantly lower in the observation group than in the control group (all P < 0.05). Within the same group, post-treatment pathological scores were significantly lower than the pre-treatment scores (all P < 0.05). After treatment, serum HIF-1α and VEGF levels were significantly lower in the observation group than in the control group (all P < 0.05). Within the same group, post-treatment HIF-1α and VEGF levels were significantly lower than pre-treatment levels (all P < 0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups (P > 0.05).Conclusion Yiqi Huoxue Tongluo Formula combined with rabeprazole demonstrates significant efficacy in treating patients with chronic atrophic gastritis of the pattern of spleen-stomach qi deficiency and blood stasis obstructing collaterals. It improves TCM syndromes and gastric mucosal pathological status, reduces serum HIF-1α and VEGF levels, and does not increase adverse reactions.