【目的】 探究纳达合剂（由赭石、煅海螵蛸、芙蓉叶、制大黄、黄芩、枳实、北沙参、麦冬、香附、郁金、法半夏、 川厚朴等组成）对慢性萎缩性胃炎（CAG）伴胆汁反流患者胃肠道激素及免疫炎症因子的影响。【方法】 选取2023年1月至2024年 10月上海市中医医院脾胃病科收治的胃阴不足型CAG伴胆汁反流患者108例，采用随机数字表法将患者随机分为观察组和 对照组，每组各59例。对照组给予常规西药治疗，观察组在对照组的基础上加用纳达合剂治疗，疗程为8周。观察2组患者 治疗前后胃肠道激素[胃泌素17（G-17）、胃蛋白酶原Ⅰ（PGⅠ）、胃蛋白酶原Ⅱ（PGⅡ）]及免疫炎症因子[白细胞介素1β（IL-1β）、 白细胞介素8（IL-8）、白细胞介素10（IL-10）]的变化情况，根据内镜检查结果评估患者的病灶活动性、慢性炎症及腺体萎缩 情况，并于治疗8周后对2组患者的临床疗效和用药安全性进行评价。【结果】（1）疗效方面，治疗8周后，观察组的总有效率 为 89.83%（53/59），对照组为 74.58%（44/59），组间比较（χ2检验），观察组的疗效明显优于对照组（P＜0.05）。（2）胃肠道激素 方面，治疗后，2组患者血清 G-17、PGⅠ、PGⅡ水平均较治疗前升高（P＜0.05），且观察组的升高幅度均明显优于对照组 （P＜0.01）。（3）免疫炎症因子方面，治疗后，2组患者的血清IL-1β、IL-8水平均较治疗前降低（P＜0.05），血清IL-10水平均 较治疗前升高（P＜0.05），且观察组对血清 IL-1β、IL-8水平的降低幅度及对血清 IL-10水平的升高幅度均明显优于对照组 （P＜0.01）。（4）胃镜病理方面，治疗后随访 6个月，2组患者的病灶活动度、慢性炎症及腺体萎缩评分均较治疗前降低（P＜ 0.05），且观察组对慢性炎症评分的降低幅度明显优于对照组（P＜0.01），而对病灶活动度及腺体萎缩评分的降低幅度有优于 对照组趋势，但差异无统计学意义（P＞0.05）。（5）用药安全性方面，观察组的不良反应发生率为 8.47%（5/59），对照组为 16.95%（10/59），组间比较，差异无统计学意义（P＞0.05）。【结论】 纳达合剂能够提高胃阴不足型CAG伴胆汁反流患者的治疗 效果，改善胃肠道激素及免疫炎症因子水平，降低病灶活动性、慢性炎症及萎缩情况，安全有效。

Objective To investigate the effects of Nada Mixture （composed of Haematitum，calcined Endoconcha Sepiae， Hibisci Mutabilis Folium， prepared Rhei Radix et Rhizoma， Scutellariae Radix， Aurantii Fructus Immaturus， Glehniae Radix， Ophiopogonis Radix， Cyperi Rhizoma， Curcumae Radix， Pinelliae Rhizoma Praeparatum，Sichuan Magnoliae Officinalis Cortex，etc.） on gastrointestinal hormones and immunoinflammatory factors in patients with chronic atrophic gastritis （CAG） accompanied by bile reflux. Methods A total of 108 patients with CAG accompanied by bile reflux of insufficiency of stomach yin type， admitted to the Department of Spleen and Stomach Diseases of Shanghai Municipal Hospital of Traditional Chinese Medicine between January 2023 and October 2024，were selected and randomly divided into an observation group and a control group using a random number table method，with 59 patients in each group. The control group received conventional western medicine treatment，while the observation group received Nada Mixture in addition to the conventional treatment for 8 weeks. Changes in gastrointestinal hormones [gastrin-17（G-17），pepsinogen Ⅰ（PG Ⅰ），pepsinogen Ⅱ（PG Ⅱ）] and immunoinflammatory factors [interleukin-1β（IL-1β），interleukin-8（IL-8）， interleukin-10（IL-10）] were observed before and after treatment. Lesion activity， chronic inflammation， and glandular atrophy were evaluated based on endoscopic findings. Clinical efficacy and medication safety were assessed after 8 weeks of treatment. Results（1） Therapeutic effect：After 8 weeks of treatment，the total effective rate was 89.83% （53/59） in the observation group and 74.58% （44/59） in the control group. Intergroup comparison （by chi-square test） showed that the clinical efficacy of the observation group was significantly superior to that of the control group，and the difference was statistically significant （P＜0.05）.（2） Gastrointestinal hormones：After treatment，serum levels of G-17，PG Ⅰ，and PG Ⅱ were increased in both groups compared to those before treatment （P＜0.05）. Furthermore， the increase was significantly greater in the observation group than in the control group （P＜0.01）.（3） Immunoinflammatory factors： After treatment， serum levels of IL-1β and IL-8 were decreased （P＜0.05），while the serum level of IL-10 was increased （P＜0.05） in both groups compared to pre-treatment levels. Moreover，the reductions in IL-1β and IL-8 and the increase in IL-10 were all significantly greater in the observation group than in the control group （P＜0.01）.（4） Gastroscopic pathology：At the 6-month follow-up after treatment，the scores for lesion activity，chronic inflammation，and glandular atrophy were all decreased in both groups compared to pre-treatment scores （P＜0.05）. The reduction in the chronic inflammation score was significantly greater in the observation group than in the control group （P＜0.01）. Although the observation group showed a trend towards greater reductions in lesion activity and glandular atrophy scores compared to the control group，these differences were not statistically significant （P＞0.05）.（5）Medication safety： The incidence of adverse reactions was 8.47% （5/59） in the observation group and 16.95% （10/59） in the control group. The intergroup comparison showed no statistically significant difference （P＞0.05）. Conclusion Nada Mixture can enhance therapeutic efficacy， improve levels of gastrointestinal hormones and immunoinflammatory factors， and reduce lesion activity， chronic inflammation， and glandular atrophy in patients with CAG accompanied by bile reflux of insufficiency of stomach yin deficiency type，demonstrating safety and effectiveness.

R259.733

国家自然科学基金资助项目（编号：82174128）