健脾清胃汤治疗复发性口腔溃疡（脾虚胃热证）的临床观察

发布时间：2018-02-15 01:05

本文关键词： 复发性口腔溃疡健脾清胃汤脾虚胃热证临床观察　出处：《湖北中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的通过对健脾清胃汤治疗复发性口腔溃疡(脾虚胃热证)患者的临床观察,评价健脾清胃汤的临床疗效及用药安全性;运用中医学及现代医学知识探讨复发性口腔溃疡的病因、病机、治法,讨论健脾清胃汤的组方特点及健脾清胃汤治疗复发性口腔溃疡的现代药学药理特点。方法选择2015年1月至2015年10月于湖北省中医院花园山院区脾胃科甘爱萍教授专家门诊符合西医诊断为复发性口腔溃疡,中医辨证为脾虚胃热证口疮患者60例,随机分组分为2组:治疗组33例,予甘教授经验方健脾清胃汤口服治疗;对照组27例,予维生素B2、维生素C片口服治疗;两组均治疗14天。治疗前后观察患者溃疡面积、数目、充血、疼痛、烧灼感、大便情况、腹胀、口干口渴、舌脉等临床症状、体征变化,对症状作出评分,并记录其它不良反应;记录第3天、5天、7天溃疡局部疼痛情况。比较两组用药后局部病损疗效、中医证候疗效及安全性。追踪观察疗程结束后3个月患者复发情况,比较两组的远期疗效。数据统一采用SPSS19.0进行统计学处理,计数资料采用χ2检验,计量资料及等级资料采用t检验、秩和检验。结果1.比较治疗前后组内主要症状及体征单项积分、总积分,两组治疗后主要症状及体征单项积分、总积分较治疗前均有显著改善(P0.05)。比较治疗后两组间的主要症状、体征单项积分和总积分,结果显示两组经治疗后总积分有显著统计学差异(P0.05);其中在改善溃疡面积、数目、充血、疼痛、口干口渴及大便异常、舌苔方面,治疗组优于对照组(P0.05);在改善溃疡烧灼感、脉象方面,无显著统计学差异(P0.05)。2.起效时间比较:治疗组药物起效时间短于对照组(P0.05),具有显著统计学差异。3.两组局部病损疗效比较:治疗组总有效率93.6%,对照组总有效率81.5%,两组比较无显著性差异(P0.05)。4.两组中医证候疗效总有效率比较:治疗组总有效率93.6%,对照组总有效率74.1%,两组比较有显著统计学差异(P0.05)。5.两组复发率比较:治疗组复发率为40%,对照组复发率为77.8%,两组复发率比较有显著统计学差异(P0.05),可认为治疗组比对照组能更有效预防复发性口腔溃疡复发。6.安全性比较:治疗后两组均未见明显不良反应。结论脾胃内伤是复发性口腔溃疡致病的基础,脾虚胃热是其病机,“热”与“虚”、“瘀”三者胶着是本病反复发作及缠绵难愈的关键。健脾清胃汤具有清热泻火、健脾益胃、敛疮生肌的功能,能明显收敛溃疡创面、减少溃疡数目、缓解溃疡灼痛、促进溃疡愈合、缩短溃疡病程,同时改善全身不适、延长溃疡间歇期、能有效防治溃疡复发,并具有起效快、安全性好的优点。健脾清胃汤治疗复发性口腔溃疡(脾虚胃热证)疗效显著,临床安全有效,值得进一步研究及推广运用。
[Abstract]:Objective to evaluate the clinical efficacy and safety of Jianpi Qingwei decoction in the treatment of recurrent oral ulcer (spleen deficiency and stomach heat syndrome). To explore the etiology, pathogenesis and treatment of recurrent oral ulcer with the knowledge of traditional Chinese medicine and modern medicine. To discuss the prescription characteristics of Jianpi Qingwei decoction and the modern pharmacological characteristics of Jianpi Qingwei decoction in the treatment of recurrent oral ulcers. Methods from January 2015 to October 2015, Professor Kogan Aiping of spleen and stomach of Huayuan Mountain Hospital of Hubei Province was selected. The expert outpatient clinic is in accordance with the western medicine diagnosis for recurrent oral ulcer, Sixty patients with oral ulcers due to spleen deficiency and stomach heat syndrome were randomly divided into two groups: treatment group (n = 33), treatment group (n = 33) treated by oral administration of Professor Gan's experience prescription Jianpi Qingwei decoction, control group (n = 27) treated with vitamin B2 and vitamin C tablets orally, and control group (n = 27). Before and after treatment, the area, number, hyperemia, pain, burning sensation, stool condition, abdominal distension, dry mouth thirst, tongue pulse and other clinical symptoms, signs and signs of the patients were observed, and the symptoms were evaluated. Other adverse reactions were recorded, the local pain of ulcer was recorded on the 3rd day, the 5th day and the 7th day. The curative effect of local lesion, the curative effect of TCM syndrome and the safety of the two groups were compared, and the recurrence of the ulcer was observed 3 months after the end of the course of treatment. The long-term effects of the two groups were compared. SPSS19.0 was used for statistical analysis, 蠂 2 test for counting data, t test for measurement data and grade data. The main symptoms and signs of the two groups were compared before and after treatment, the total scores of the main symptoms and signs after treatment, the total scores of the two groups were significantly improved compared with those before and after treatment, and the main symptoms between the two groups were compared after treatment. 2. The results showed that there was a significant difference between the two groups in the total score after treatment (P 0.05), especially in the improvement of ulcer area, number, congestion, pain, dry mouth, thirst and stool abnormality, tongue coating, etc. The treatment group was superior to the control group (P 0.05) in improving the burning sensation and pulse of ulcers. There was no significant statistical difference (P 0.05) .2.Comparison of effective time: the effective time of drugs in the treatment group was shorter than that in the control group (P 0.05), and there was significant statistical difference between the two groups. 3. Comparison between the two groups: the total effective rate of the treatment group was 93.6%, the total effective rate of the control group was 81.5%, and the total effective rate of the two groups was 81.5%. There was no significant difference between the two groups. The total effective rate of TCM syndromes in the two groups was 93.6 in the treatment group, 74.1 in the control group, and significantly different in the two groups. The recurrence rate of the two groups was compared: the recurrence rate in the treatment group was 40 beats, and the total effective rate in the control group was 74.1. The recurrence rate of the radiation group was 77.8. There was significant difference in the recurrence rate between the two groups. It can be concluded that the treatment group is more effective than the control group in preventing the recurrence of recurrent oral ulcer. 6. Comparison of safety: after treatment, there is no obvious adverse reaction between the two groups. Conclusion Internal injury of spleen and stomach is the basis of recurrent oral ulcer. Spleen deficiency and stomach heat are its pathogenesis, "heat" and "deficiency" and "blood stasis" are the key to the repeated attack of the disease and the difficulty of tangle healing. Jianpi Qingwei decoction has the function of clearing away heat and reducing fire, invigorating spleen and nourishing stomach, and astringent ulcers to produce muscle, which can obviously converge on ulcer wound. Reducing the number of ulcers, relieving the burning pain of ulcers, promoting the healing of ulcers, shortening the course of ulcerative diseases, improving the general discomfort, prolonging the interval period of ulcers, can effectively prevent and cure the recurrence of ulcers and have a quick effect. The efficacy of Jianpi Qingwei decoction in the treatment of recurrent oral ulcers (spleen deficiency and stomach heat syndrome) is significant, and the clinical efficacy is safe and effective, which is worthy of further study and application.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R276.8

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