健脾六味方联合铝碳酸镁、替普瑞酮治疗脾胃气虚型慢性浅表性胃炎临床疗效

发布时间：2019-01-18 11:45

【摘要】：目的:慢性浅表性胃炎(Chronic Superficial Gastritis,CSG)是由多种病因导致的胃粘膜慢性炎性病变。祖国传统医学则将其归属于"胃痛"、"胃痞"等范畴。本病虽不至于威胁患者的生命,但时刻影响着患者的生活质量。故如何提高治疗CSG的临床疗效是我们探索的方向,目前西医对本病尚无特殊疗法,而中医通过辨证论治,在治疗慢性浅表性胃炎具有价格低廉、症状缓解明显、复发率低等优势。健脾六味方是导师治疗慢性浅表性胃炎的经验方,临床上大量服用过该方的慢性浅表性胃炎的门诊患者反馈健脾六味方能有效的改善其临床症状,且无明显的不良反应。故本研究的目的在于:通过该研究,探究本方联合西药治疗脾胃气虚型慢性浅表性胃炎的临床疗效,并初步探讨健脾六味方的作用机制。方法:针对2016-7至2016-12于广州中医药大学第一附属医院脾胃科病门诊就诊的慢性浅表性胃炎患者,按纳入标准和排除标准选取81例脾胃气虚型CSG患者,并随机分为中药组、西药组、中西医组。三组均给予健康生活方式教育等基础治疗(见附录4)。中药组予以健脾六味方加减,西药组予以替普瑞酮加铝碳酸镁片,中西医组予健脾六味方加味、替普瑞酮、铝碳酸镁片。均以4周为一疗程,三组治疗前后均要填中医症状量表,评估各组治疗前后症状改善情况。结果:1.中医证候比较1.1治疗4周后三组自身前后比较中西医组、中药组及西药组对胃脘痛、胃脘痞闷、反酸嗳气、恶心呕吐、食少纳呆、疲倦乏力、四肢不温、大便溏八个症状均有疗效,中西医组、中药组、西药组三组各组治疗前后差异具有统计学意义(P0.05)。1.2治疗4周后三组之间两两比较中西医在胃痞满、纳食减少、四肢不温三个症状效果较中医组、西医组显著。而对于胃脘痛、反酸嗳气、恶心呕吐三个症状三组治疗效果相同,无差异。中药组对于疲倦乏力、便溏方面治疗效果优于西药组。2.三组间中医证候总有效率的比较治疗4周后,中医组总有效率为74.1%,无效率为25.9%;西医组总有效率为66.7%,无效率为33.3%;中西医组总有效率为92.6%,无效率为7.4%。三组总有效率经非参数秩和检验分析,P0.05,差异具有统计学意义。结论:中西医组、中药组、西药组三组治疗脾胃气虚型慢性浅表性胃炎均有疗效,中西医在胃痞满、纳食减少、四肢不温三个方面较中药组及西药组的治疗效果好。而中医组对于疲倦乏力、便溏两方面的症状改善较西药组明显。
[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.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R573.31

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