温中清化法联合雷贝拉唑治疗消化性溃疡寒热错杂证临床疗效观察

发布时间：2018-08-12 12:45

【摘要】：目的：观察温中清化法联合雷贝拉唑治疗消化性溃疡寒热错杂证的临床疗效和不良反应。方法：选取经胃镜确诊为消化性溃疡并且属寒热错杂证的患者60例,患者均为南京中医药大学附属医院2014年9月至2015年10月脾胃病科门诊及住院就诊消化性溃疡活动期,无明显严重并发症病例。将患者随机分为两组,治疗组30例,对照组30例,两组患者的性别、年龄、溃疡类型及治疗前临床症状总积分等方面无显著性差异(P0.05)具有可比性。治疗组予中药温中清化法联合雷贝拉唑治疗,对照组仅予雷贝拉唑治疗。两组疗程均为8周。并分别于第2周末(±2天)、第8周末(±2天)、第32周末(±2天)观察记录患者临床症状、体征,以及不良反应情况。通过临床症状改善、内镜下愈合等指标评价两组患者的治疗有效率。8周疗程结束后随访至发病后半年,记录消化性溃疡有无复发情况。结果：1.两组患者证候疗效比较：治疗组痊愈22例,显效6例,有效1例,无效1例,总有效率96.67%,对照组痊愈15例,显效7例,有效2例,无效6例,总有效率80.00%,经统计分析,两组病例疗效具有差异性(P0.05),且治疗组的证候疗效要优于对照组。2.两组患者症状积分比较：两组患者的临床症状总积分较治疗前均有明显降低(P0.05)；且治疗组患者临床症状总积分变化明显优于对照组(P0.01)；并在改善各症状方面,两组患者均有较好的疗效(P0.05),且治疗组在改善胃脘痛、口干苦、嗳气、嘈杂烧心、四肢不温、大便溏结等优于对照组(P0.05)。3.两组患者内镜下愈合率比较：治疗后两组病例愈合率与治疗前比较具有显著性差异(P0.05)；治疗组内镜下愈合率明显高于对照组(P0.05)。4.两组患者复发率比较：疗程结束6个月后,经统计分析,治疗组复发率为3.45%,对照组复发率为12.5%,治疗组复发率低于对照组(P0.05),具有统计学差异。结论：中药温中清化法联合雷贝拉唑治疗消化性溃疡中寒热错杂证的临床疗效确切,比单独应用雷贝拉唑治疗,症状改善更加明显,内镜下愈合更高,复发率更低。证明中药温中清化法联合雷贝拉唑治疗消化性溃疡可作为中西医治疗消化性溃疡有效方案之一,对改善患者预后,降低不良反应能起到明显作用。
[Abstract]:Objective: to observe the clinical efficacy and side effects of warming and clearing method combined with rabeprazole in the treatment of peptic ulcer with cold and heat disorder syndrome. Methods: sixty patients with peptic ulcer diagnosed by gastroscopy were selected as peptic ulcer patients, all of whom were from September 2014 to October 2015 in the affiliated Hospital of Nanjing University of traditional Chinese Medicine. There were no significant serious complications. The patients were randomly divided into two groups: treatment group (30 cases) and control group (30 cases). There was no significant difference in sex, age, ulcer type and total score of clinical symptoms before treatment between the two groups (P0.05). The treatment group was treated with traditional Chinese medicine Wenzhong Qing method combined with rabeprazole, while the control group was treated with rabeprazole only. The course of treatment was 8 weeks in both groups. The clinical symptoms, signs and adverse reactions were observed at weekend 2 (卤2 days), weekend 8 (卤2 days) and weekend 32 (卤2 days) respectively. The effective rate of treatment was evaluated by clinical symptom improvement and endoscope healing. The patients were followed up to half a year after the end of the course of treatment for 8 weeks and the recurrence of peptic ulcer was recorded. The result is 1: 1. Comparison of syndromes efficacy between the two groups: 22 cases were cured, 6 cases were markedly effective, 1 case was ineffective, and the total effective rate was 96.67g in the treatment group. In the control group, 15 cases were cured, 7 cases were markedly effective, 2 cases were effective, 6 cases were ineffective, and the total effective rate was 80.00g. The curative effect of the two groups has difference (P0.05), and the therapeutic effect of the treatment group is better than that of the control group. 2. 2. Two groups of patients symptom score comparison: the two groups of patients with clinical symptoms were significantly lower than before treatment (P0.05); and the treatment group patients with clinical symptoms of the total score significantly better than the control group (P0.01); and in improving the symptoms, Two groups of patients have a better effect (P0.05), and the treatment group in improving stomachache, dry mouth bitter, belching, noisy heartburn, limbs not warm, loose stool knot than the control group (P0.05) .3. Comparison of endoscopic healing rate between the two groups: after treatment there was a significant difference between the two groups (P0.05); the treatment group was significantly higher than the control group (P0.05). 4. After 6 months of treatment, the recurrence rate of treatment group was 3.45 and that of control group was 12.5. The recurrence rate of treatment group was lower than that of control group (P0.05). Conclusion: the clinical curative effect of traditional Chinese medicine Wenzhong Qinghua combined with rabeprazole in treatment of cold and heat disorder syndrome in peptic ulcer is definite. Compared with the treatment of rabeprazole alone, the symptoms are improved more obviously, the endoscopy healing is higher, and the recurrence rate is lower. It is proved that the combination of traditional Chinese medicine warming and clearing method combined with rabeprazole in the treatment of peptic ulcer can be regarded as one of the effective regimens for the treatment of peptic ulcer, which can improve the prognosis of the patients and reduce the adverse reactions.
【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】：2016
【分类号】：R573.1

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