制肝安胃法治疗肝胃郁热型慢性萎缩性胃炎伴糜烂的临床研究

发布时间：2018-02-26 21:18

本文关键词： 慢性萎缩性胃炎糜烂制肝安胃法肝胃郁热证临床研究　出处：《南京中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：观察制肝安胃法对肝胃郁热型慢性萎缩性胃炎伴糜烂患者的临床症状、内镜表现及病理改善情况,并从理论上积极探讨其作用机制,为制肝安胃法的临床应用提供依据。方法：收集昆山市中医院脾胃科门诊中经内镜及病理组织学检查诊断为慢性萎缩性胃炎伴糜烂的患者,且经中医辨证属肝胃郁热证型者60例,随机分为治疗组和对照组,两组患者治疗前性别、年龄、病程构成比及病情资料无统计学差异。治疗组30例给予徐进康教授自拟方口服,对照组予叶酸片联合奥美拉唑肠溶胶囊、瑞巴派特片口服,两组分别治疗3个月。结束后观察两组患者临床症状、胃镜及病理改善情况。结果：(1)临床疗效比较：治疗组与对照组在中医证候疗效方面差异有统计学意义(P0.05)；在各个症状评分方面治疗组与对照组比较差异均有统计学意义(P0.05),其中胃脘疼痛、痞满、烧心、嗳气四项两组比较差异有显著统计学意义(P0.01),其他症状如嘈杂泛酸、口干口苦、烦躁易怒,两组比较差异有统计学意义(P0.05)。(2)内镜及病理组织学比较：在黏膜糜烂改善方面,治疗组的愈显率与对照组比较差异有显著统计学意义(P0.01)；黏膜萎缩改善方面,治疗组与对照组比较差异有统计学意义(P0.05)；肠化生改善方面,治疗组与对照组比较差异无统计学意义(P0.05),且两组治疗前后比较差异无统计学意义(P0.05)。结论：制肝安胃法治疗肝胃郁热型慢性萎缩性胃炎伴糜烂在改善临床症状、内镜下表现及黏膜萎缩方面具有明显效果,临床中值得推广；另需进一步研究中药药理作用并合理配伍,以期对肠上皮化生的改善及逆转起到显著效果。
[Abstract]:Objective: to observe the clinical symptoms, endoscopic manifestations and pathological improvement of patients with chronic atrophic gastritis associated with chronic atrophic gastritis with stagnation of heat of liver and stomach, and to explore its mechanism in theory. Methods: the patients with chronic atrophic gastritis with erosion were collected from the clinic of Department of spleen and stomach of Kunshan traditional Chinese Medicine Hospital by endoscopy and histopathology. 60 cases of syndrome differentiation of liver and stomach stagnation heat were randomly divided into treatment group and control group. There was no significant difference in sex, age, disease course composition ratio and disease condition data between the two groups before treatment, and 30 cases in treatment group were given oral administration of Professor Xu Jinkang's own prescription. The control group was treated with folic acid tablets combined with omeprazole enteric-coated capsule, and repapet tablet orally. The two groups were treated for 3 months respectively. The clinical symptoms of the two groups were observed after the end of the treatment. Results: comparison of clinical efficacy between treatment group and control group: there was significant difference in TCM syndromes between treatment group and control group, and there was statistical difference between treatment group and control group in every symptom score. P0.05, in which epigastric pain, There was a significant difference between the four groups in terms of fullness, heartburn and belching. Other symptoms such as pantothenic acid, dry mouth and bitter mouth, irritability, irritability, irritability and irritability were found in other symptoms such as pantothenic acid, irritability, irritability and irritability. Comparison of endoscopy and histopathology: in the improvement of mucosal erosion, there was a significant difference between the treatment group and the control group (P 0.01), the improvement of mucosal atrophy, the improvement of mucosal atrophy, the improvement of mucosal atrophy, the improvement of mucosal atrophy, the improvement of mucosal atrophy, the improvement of mucosal atrophy and the improvement of mucosal atrophy. The difference between the treatment group and the control group was statistically significant (P 0.05), and the improvement of intestinal metaplasia, There was no significant difference between the treatment group and the control group (P 0.05), and there was no significant difference between the two groups before and after treatment (P 0.05). Conclusion: the treatment of chronic atrophic gastritis with chronic atrophic gastritis with dampness of liver and stomach by the method of making the liver and the stomach can improve the clinical symptoms. The endoscopic manifestations and mucosal atrophy have obvious effect, which is worth popularizing in clinic. Further study on the pharmacological effect of traditional Chinese medicine and its rational compatibility are needed in order to improve and reverse intestinal metaplasia.
【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】：R259

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