大柴胡汤加减治疗胆胃郁热型胆汁反流性胃炎临床疗效观察及对CCK、MLT表达的影响

发布时间：2018-05-14 20:27

本文选题：大柴胡汤 + 胆汁反流性胃炎　；参考：《南京中医药大学》2017年硕士论文

【摘要】：目的通过对大柴胡汤加减治疗胆胃郁热型胆汁反流性胃炎患者的临床疗效观察及其血浆CCK、MLT的变化,来探讨大柴胡汤加减对CCK、MLT表达的影响及其治疗胆汁反流性胃炎可能的作用机制,从而提高中医药治疗胆汁反流性胃炎的水平。方法本次研究将纳入60例确诊为胆胃郁热型胆汁反流性胃炎的患者,将其随机分为治疗组与对照组,每组各30例,治疗组给予大柴胡汤加减口服,对照组给予多潘立酮片联合铝碳酸镁片治疗,均8周为一疗程。两组患者观察中医症候疗效、中医症状总积分、中医症状单项积分、胃镜下胆汁反流分级情况、胃镜下胆汁反流缓解疗效、血浆CCK、MLT水平等指标,最后将所得资料录入计算机,建立数据库,然后用SPSS20.0统计软件进行分析,得出结论。结果治疗组症候疗效总有效率为93.33%,高于对照组为73.33%(P0.05)。治疗组在实验结束后中医症状总积分为7.92±7.75,对照组为13.57±9.61,均低于治疗前(P0.01),然而治疗组优于对照组(P0.05)。两组在"胃脘疼痛灼热""腹胀腹满""口干口苦""烧心嘈杂" "泛酸""嗳气""便秘"等主要症状积分方面,治疗组优于对照组(P0.05)。对比治疗前后胃镜下疗效情况,治疗组总有效率为93.33%,高于对照组为73.33%(P0.05)。两组治疗后胃镜下胆汁反流分级情况比较,P0.05,说明两者在改善胆汁反流方面差异不明显。对比治疗前后血浆MLT值,两组均有所提高,治疗后治疗组278.70± 11.24高于对照组234.17±8.19(P0.01)。对比治疗前后血浆CCK值,两组均有所下降,治疗后治疗组150.90±15.95低于对照组165.90± 12.32,差异具有明显统计学意义(P0.01)。两组患者治疗前后血尿粪常规等安全性指标均无明显异常。结论研究结果表明:大柴胡汤加减为治疗胆胃郁热型胆汁反流性胃炎的有效方药,其作用机理可能与调整血浆MLT、CCK水平有关。
[Abstract]:Objective to observe the clinical efficacy of Dachaihu decoction in the treatment of bile reflux gastritis of choledochic stagnation heat type and the change of CCKN MLT in plasma. To explore the effect of Dachaihu decoction on the expression of MLT and the possible mechanism of treating bile reflux gastritis, so as to improve the level of traditional Chinese medicine in the treatment of bile reflux gastritis. Methods Sixty patients with bile reflux gastritis were randomly divided into treatment group and control group with 30 cases in each group. The treatment group was treated with Dachaihu decoction. The control group was treated with domperidone tablets combined with magnesium aluminum carbonate tablets for 8 weeks. The therapeutic effect of TCM symptom, the total score of TCM symptom, the single score of TCM symptom, the grade of bile reflux under gastroscope, the curative effect of bile reflux under gastroscope and the level of plasma CCK MLT were observed in the two groups. Finally, the data were recorded in the computer. Establish the database, then use SPSS20.0 statistical software to analyze, draw a conclusion. Results the total effective rate was 93.33 in the treatment group and 73.33 in the control group. The total score of TCM symptoms was 7.92 卤7.75 in the treatment group and 13.57 卤9.61 in the control group, which was lower than that before treatment, but the treatment group was superior to the control group. The treatment group was superior to the control group (P 0.05) in the main symptom scores of "stomachache burning", "abdominal distension and abdomen fullness", "dry mouth bitter", "burning heart noise", "pantothenic acid", "belching", "constipation" and so on. The total effective rate of the treatment group was 93.33, which was higher than that of the control group (73.33%, P 0.05). There was no significant difference between the two groups in improving bile regurgitation by comparing the grade of bile regurgitation under gastroscope between the two groups (P 0.05). After treatment, the plasma MLT level in the treatment group was higher than that in the control group (278.70 卤11.24 vs 234.17 卤8.19 P 0.01). After treatment, the plasma CCK level in the treatment group (150.90 卤15.95) was lower than that in the control group (165.90 卤12.32), and the difference was statistically significant (P 0.01). Before and after treatment, there was no significant abnormality in the safety indexes such as hematuria and fecal routine in both groups. Conclusion: Dachaihu decoction is an effective prescription for the treatment of bile reflux gastritis of choledochic stagnation heat type, and its mechanism may be related to the regulation of plasma MLTCCK level.
【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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