發(fā)布時間：2019-01-18 11:45

【摘要】：目的:慢性淺表性胃炎(Chronic Superficial Gastritis,CSG)是由多種病因?qū)е碌奈刚衬ぢ�性炎性病變。祖國傳統(tǒng)醫(yī)學(xué)則將其歸屬于"胃痛"、"胃痞"等范疇。本病雖不至于威脅患者的生命,但時刻影響著患者的生活質(zhì)量。故如何提高治療CSG的臨床療效是我們探索的方向,目前西醫(yī)對本病尚無特殊療法,而中醫(yī)通過辨證論治,在治療慢性淺表性胃炎具有價格低廉、癥狀緩解明顯、復(fù)發(fā)率低等優(yōu)勢。健脾六味方是導(dǎo)師治療慢性淺表性胃炎的經(jīng)驗方,臨床上大量服用過該方的慢性淺表性胃炎的門診患者反饋健脾六味方能有效的改善其臨床癥狀,且無明顯的不良反應(yīng)。故本研究的目的在于:通過該研究,探究本方聯(lián)合西藥治療脾胃氣虛型慢性淺表性胃炎的臨床療效,并初步探討健脾六味方的作用機制。方法:針對2016-7至2016-12于廣州中醫(yī)藥大學(xué)第一附屬醫(yī)院脾胃科病門診就診的慢性淺表性胃炎患者,按納入標(biāo)準和排除標(biāo)準選取81例脾胃氣虛型CSG患者,并隨機分為中藥組、西藥組、中西醫(yī)組。三組均給予健康生活方式教育等基礎(chǔ)治療(見附錄4)。中藥組予以健脾六味方加減,西藥組予以替普瑞酮加鋁碳酸鎂片,中西醫(yī)組予健脾六味方加味、替普瑞酮、鋁碳酸鎂片。均以4周為一療程,三組治療前后均要填中醫(yī)癥狀量表,評估各組治療前后癥狀改善情況。結(jié)果:1.中醫(yī)證候比較1.1治療4周后三組自身前后比較中西醫(yī)組、中藥組及西藥組對胃脘痛、胃脘痞悶、反酸噯氣、惡心嘔吐、食少納呆、疲倦乏力、四肢不溫、大便溏八個癥狀均有療效,中西醫(yī)組、中藥組、西藥組三組各組治療前后差異具有統(tǒng)計學(xué)意義(P0.05)。1.2治療4周后三組之間兩兩比較中西醫(yī)在胃痞滿、納食減少、四肢不溫三個癥狀效果較中醫(yī)組、西醫(yī)組顯著。而對于胃脘痛、反酸噯氣、惡心嘔吐三個癥狀三組治療效果相同,無差異。中藥組對于疲倦乏力、便溏方面治療效果優(yōu)于西藥組。2.三組間中醫(yī)證候總有效率的比較治療4周后,中醫(yī)組總有效率為74.1%,無效率為25.9%;西醫(yī)組總有效率為66.7%,無效率為33.3%;中西醫(yī)組總有效率為92.6%,無效率為7.4%。三組總有效率經(jīng)非參數(shù)秩和檢驗分析,P0.05,差異具有統(tǒng)計學(xué)意義。結(jié)論:中西醫(yī)組、中藥組、西藥組三組治療脾胃氣虛型慢性淺表性胃炎均有療效,中西醫(yī)在胃痞滿、納食減少、四肢不溫三個方面較中藥組及西藥組的治療效果好。而中醫(yī)組對于疲倦乏力、便溏兩方面的癥狀改善較西藥組明顯。
[Abstract]:Objective: chronic superficial gastritis (Chronic Superficial Gastritis,CSG) is a chronic inflammation of gastric mucosa caused by many causes. Traditional Chinese medicine is classified as "stomach pain", "stomach ruffian" and other categories. Although the disease does not threaten the life of patients, but always affects the quality of life of patients. Therefore, how to improve the clinical efficacy of CSG is the direction we explore. At present, there is no special treatment for this disease in western medicine, while TCM has low price and obvious relief in treating chronic superficial gastritis by differentiation of symptoms and signs. The recurrence rate is low and so on. Jianpi Liuwei prescription is an experiential prescription for the treatment of chronic superficial gastritis by mentors. The inpatients with chronic superficial gastritis who have taken it in large quantities can effectively improve their clinical symptoms and have no obvious adverse reactions. The purpose of this study is to explore the clinical efficacy of this prescription combined with western medicine in the treatment of chronic superficial gastritis with deficiency of spleen and stomach qi, and to explore the mechanism of Jianpi Liuwei prescription. Methods: from June 7 to December 2016-12, 81 CSG patients with spleen and stomach qi deficiency were selected according to the inclusion criteria and exclusion criteria, and were randomly divided into traditional Chinese medicine group. Western medicine group, traditional Chinese and western medicine group. All three groups were given basic treatment such as healthy lifestyle education (see appendix 4). The traditional Chinese medicine group was treated with Jianpi Liuwei recipe, the western medicine group with tipritone plus magnesium aluminum carbonate, and the traditional Chinese and western medicine group with Jianpi Liuwei prescription, tipritone, and magnesium bicarbonate tablets. Four weeks were used as a course of treatment. The symptom scale of TCM was filled out before and after treatment in the three groups to evaluate the improvement of symptoms before and after treatment. Results: 1. Comparison of TCM syndromes 1.1 after 4 weeks of treatment, the three groups were compared before and after treatment. After 4 weeks of treatment, the three groups were compared before and after treatment. The Chinese medicine group and the western medicine group treated with epigastric pain, epigastric distension, acid regurgitation, nausea and vomiting, low food intake, fatigue and weakness, and non-warm limbs. The eight symptoms of loose stool were all effective. The difference between the three groups before and after treatment was statistically significant (P0.05). 1.2 after 4 weeks of treatment, two groups of traditional Chinese and western medicine were compared in gastric distension, and the intake of food decreased. The effect of three symptoms of limbs unwarming was more significant than that of traditional Chinese medicine group and western medicine group. But for epigastric pain, acid regurgitation and nausea and vomiting, the effect of three groups was the same, no difference. Traditional Chinese medicine group for fatigue, loose stools better than Western medicine group. 2. After 4 weeks of treatment, the total effective rate of TCM group was 74.1 and the ineffective rate was 25.9.The total effective rate of Western medicine group was 66.7 and the ineffective rate was 33.3. The total effective rate of traditional Chinese and western medicine group was 92.6 and the non-effective rate was 7.4. The total effective rate of the three groups was analyzed by non-parametric rank sum test (P 0. 05), and the difference was statistically significant. Conclusion: the treatment of chronic superficial gastritis with deficiency of spleen and stomach qi in TCM group, Chinese medicine group and western medicine group are all effective. The three aspects of TCM and Western medicine are better than that of Chinese medicine group and western medicine group in the three aspects of stomach fullness, reduction of food intake and temperature of limbs. The symptoms of fatigue and loose stool in TCM group were better than that in western medicine group.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R573.31

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