益气化瘀解毒法治疗慢性萎缩性胃炎癌前病变的临床疗效观察

发布时间：2018-04-10 08:10

本文选题：益气化瘀解毒法　切入点：慢性萎缩性胃炎　出处：《南京中医药大学》2017年硕士论文

【摘要】：目的:观察益气化瘀解毒法治疗慢性萎缩性胃炎癌前病变脾胃气虚,瘀毒内阻证的临床疗效及安全性。方法:选取慢性萎缩性胃炎癌前病变脾胃气虚,瘀毒内阻证患者,共60例,随机分为中药治疗组和对照组,每组各30例,治疗组给予益气化瘀解毒方口服治疗;对照组给予口服胃复春片治疗。两组均以12周为一个疗程,疗程结束后复查胃镜,观察两组治疗前后症状、病理组织学积分变化,以评估两组临床疗效。研究结果用SPSS 21.0统计软件进行分析。结果:临床症状比较:治疗组能明显改善胃脘胀满、胃痛、乏力、食欲不振、大便稀溏症状,治疗前后比较有显著统计学差异(P0.01);对照组能改善胃脘胀满、胃痛、大便稀溏症状,差异有统计学意义(P0.05),在改善乏力、食欲不振方面无统计学差异(P0.05)。治疗组在改善胃脘胀满、胃痛、乏力、食欲不振、大便稀溏方面优于对照组,差异有统计学意义(P0.05)。中医证候疗效比较,治疗组优于对照组,且差异有统计学意义(P0.05)(80.0%vs53.3%)。病理疗效比较:治疗前后,两组均能改善萎缩、肠化、低级别上皮内瘤变,且有统计学差异(P0.05)。治疗后,治疗组在改善萎缩积分方面优于对照组(P0.05),且萎缩疗效比较有统计学差异(P0.05)(83.3%vs60.0%),在改善肠化、低级别上皮内瘤变积分方面无统计学差异(P0.05),且肠化、低级别上皮内瘤变疗效比较无统计学差异(P0.05)(70.0%vs56.7%、84.6%vs63.6%)。在治疗过程中,患者均未发生不良反应。结论:益气化瘀解毒法能有效缓解慢性萎缩性胃炎癌前病变脾胃气虚,瘀毒内阻证患者的临床症状,并有较好的临床疗效,且益气化瘀解毒方有较好的临床安全性。。
[Abstract]:Objective: to observe the clinical efficacy and safety of Yiqi Huayu jiedu method in treating precancerous lesions of chronic atrophic gastritis with deficiency of spleen and stomach qi and internal obstruction of blood stasis.Methods: 60 cases of chronic atrophic gastritis with deficiency of spleen and stomach qi and internal obstruction of blood stasis were randomly divided into Chinese medicine treatment group and control group with 30 cases in each group. The treatment group was treated orally with Yiqi Huayu jiedu recipe.The control group was treated with oral Weifuchun tablets.The patients in both groups were treated with 12 weeks as a course of treatment. After the treatment, the symptoms and histopathological scores of the two groups were observed before and after the treatment, and the clinical efficacy of the two groups was evaluated.The results were analyzed by SPSS 21. 0. 0 statistical software.Results: comparison of clinical symptoms: the treatment group could obviously improve the symptoms of stomachache, stomachache, fatigue, anorexia and loose stools, there was significant difference between before and after treatment (P 0.01), while the control group could improve the symptoms of stomachache, stomachache and loose stools.The difference was statistically significant (P 0.05), but there was no significant difference in improving fatigue and loss of appetite (P 0.05).The treatment group was superior to the control group in improving stomachache, stomachache, fatigue, anorexia and loose stools. The difference was statistically significant (P 0.05).The curative effect of TCM syndrome in the treatment group was better than that in the control group, and the difference was statistically significant (P 0.05) and 80.0% vs 53.3%.Comparison of pathological effects: before and after treatment, both groups could improve atrophy, intestinal metaplasia, low grade intraepithelial neoplasia, and the difference was statistically significant (P 0.05).After treatment, the improvement of atrophy score in the treatment group was better than that in the control group (P 0.05), and there was significant difference in the effect of atrophy. There was no significant difference in improving intestinal metaplasia and low grade intraepithelial neoplasia score in the treatment group (P 0.05) and intestinal metaplasia.There was no statistical difference in the curative effect of low grade intraepithelial neoplasia.No adverse reactions occurred in the course of treatment.Conclusion: Yiqi Huayu detoxification method can effectively relieve the clinical symptoms of patients with precancerous lesions of chronic atrophic gastritis, such as deficiency of spleen and stomach qi and stagnation of blood stasis, and has better clinical efficacy, and Yiqi Huayu jiedu prescription has better clinical safety.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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