Clinical Study on Shihu Xiaowei Decoction(石斛消萎汤)Combined with Standard Quadruple Therapy in Treatment of Chronic Atrophic Gastritis Complicated with Gastric Intestinal Metaplasia

LIU Shanmin; LIU Ping; DENG Fen; LI Qin; YANG Meidong; LUO Qin

doi:10.16295/j.cnki.0257-358x.2026.02.009

Abstract：Objective:To explore the effects of Shihu Xiaowei Decoction(石斛消萎汤)combined with standard quadruple therapy on intestinal flora,oxidative stress and inflammatory factors in patients with chronic atrophic gastritis(CAG)complicated with gastric intestinal metaplasia(GIM).Methods:A total of 110 CAG patients complicated with GIM were selected and randomly divided into the western medicine group(treated with standard quadruple therapy)and the integrated traditional Chinese and western medicine group(treated with Shihu Xiaowei Decoction combined with standard quadruple therapy)according to the random number table method,with 55 cases in each group.The intestinal flora indexes,oxidative stress indexes,inflammatory factors,gastric function indexes,and gastric mucosal pathological scores before and after treatment were compared between the two groups.In addition,the clinical efficacy and incidence of adverse reactions were compared between the two groups.Results:After treatment,the levels of Lactobacillus,Bifidobacterium and superoxide dismutase(SOD)in both groups increased significantly compared with those before treatment,and the levels in the integrated traditional Chinese and western medicine group were higher than those in the western medicine group(P＜0.05).The levels of Enterococcus,Enterobacter,nitric oxide(NO),and malondialdehyde(MDA)were all lower than those before treatment,and the levels in the integrated traditional Chinese and western medicine group were lower than those in the western medicine group(P＜0.05).After treatment,the levels of interleukin-6(IL-6),Creactive protein(CRP),and tumor necrosis factor-α(TNF-α)in both groups were lower than those before treatment,and the levels in the integrated traditional Chinese and western medicine group were lower than those in the western medicine group(P＜0.05).After treatment,the levels of pepsinogen Ⅰ(PG Ⅰ)and pepsinogen ratio(PGR)in both groups increased compared with those before treatment,and the levels in the integrated traditional Chinese and western medicine group were higher than those in the western medicine group(P＜0.05).The level of pepsinogen Ⅱ(PG Ⅱ)was lower than that before treatment,and the level of the integrated traditional Chinese and western medicine group was lower than in the western medicine group(P＜0.05).After treatment,the GIM,gastric mucosal atrophy and mucosal inflammation scores of both groups were lower than those before treatment,and the scores of the integrated traditional Chinese and western medicine group were lower than those of the western medicine group(P＜0.05).The total effective rate of treatment of the integrated traditional Chinese and western medicine group(94.55％)was higher than that of the western medicine group(80.00％)(P＜0.05).The total incidence of adverse reactions in the integrated traditional Chinese and western medicine group was 7.27％,which was lower than 23.64％in the western medicine group(P＜0.05).Conclusion:Shihu Xiaowei Decoction combined with standard quadruple therapy has a better therapeutic effect in the treatment of CAG complicated with GIM.It can inhibit oxidative stress response and inflammatory factors,maintain the balance of intestinal flora,protect gastric mucosa,improve gastric function indexes and reduce the incidence rate of adverse reactions.