欣胃安神汤治疗慢性糜烂性胃炎并失眠症的临床观察

发布时间：2018-05-15 11:30

本文选题：慢性糜烂性胃炎 + 失眠症　；参考：《湖北中医药大学》2016年硕士论文

【摘要】：目的:l.观察欣胃安神汤治疗慢性糜烂性胃炎并失眠症(肝郁脾虚型)患者在治疗前后胃镜分级,体重变化,失眠、主观症状相关测评量表积分的变化,探讨欣胃安神汤的临床意义。2.总结甘爱萍教授临床经验,为慢性糜烂性胃炎并失眠症的中医中药治疗提供新思维,提高临床疗效。方法:1.选取湖北省中医院脾胃科甘爱萍教授专家门诊,西医确诊为慢性糜烂性胃炎并失眠症,中医辨证分型为肝郁脾虚证的64例患者,选取就诊的先后顺序随机分为治疗组和对照组各32例。2.治疗组服用“欣胃安神汤”加减治疗,对照组服用雷贝拉唑钠肠溶胶囊联合艾司唑仑片,两组均连续治疗6周。3.分别于治疗前(0天)和治疗后(第6周±3天和6个月±3)进行评估(进行胃镜检查、称重、填写PSQI及肝郁脾虚证症状分级量化标准表),同时记录试验过程中安全性指标及不良反应发生率。4.所有数据采用SPSS19.0统计软件包进行分析处理,其中计量资料用t检验,计数资料采用卡方检验,等级资料采用Ridit分析,所有统计结果均以P0.05表示有统计学意义。结果:1.治疗组未按规定服药无法评价疗效者2例,对照组服药期间1例合并严重疾病,将其剔除,自行退出1例,最终完成临床观察病例60例。2.治疗组和对照组都能促进胃黏膜糜烂愈合且两者疗效相似。3.治疗组和对照组都能改善睡眠障碍,提高睡眠质量,且改善程度没有明显差异。4.两组药物均可改善患者肝郁脾虚证症状,但治疗组改善程度优于对照组。5.治疗组在防治患者体重减轻方面优于对照组。6.治疗组与对照组均未发生明显不良反应。7.治疗6个月后所选患者复发情况对比,治疗组在PSQI评分、中医证候的复发率均低于对照组(P0.05),说明在远期疗效方面,治疗组优于对照组。结论:欣胃安神汤不但能促进慢性糜烂性胃炎的胃黏膜愈合,也能缓解患者的失眠症状,减少睡眠障碍及催眠药物的应用,提高患者睡眠质量;增加患者体重,并对患者症状改善上比西药有明显的优势。在安全性观测方面未发现明显不良反应,远期疗效满意,复发率低。此研究为慢性糜烂性胃炎并失眠症的中医中药治疗提供新思维,欣胃安神汤较单纯西医疗法有明显的优势,值得在临床上推广应用。
[Abstract]:Objective: To observe the changes of gastroscopy, weight change, insomnia, and subjective symptom related assessment scales before and after treatment for patients with chronic erosive gastritis and insomnia (liver depression and spleen deficiency) in the treatment of chronic erosive gastritis and insomnia (liver depression and spleen deficiency) in the treatment of chronic erosive gastritis and insomnia. The clinical significance of Professor Gan Aiping's clinical experience for chronic erosive gastritis and insomnia was evaluated by L.. The treatment of Chinese medicine and Chinese medicine provides new thinking and improves clinical efficacy. Methods: 1. select the expert outpatient of Professor Ai Ping of the spleen and stomach of Hubei Provincial Traditional Chinese Medical Hospital, the western medicine is diagnosed as chronic erosive gastritis and insomnia, and the TCM syndrome differentiation is divided into 64 patients with liver depression and spleen deficiency syndrome, which are randomly divided into the treatment group and the control group with 32 cases of.2. treatment. The treatment group took "Xin Wei Anshen Decoction" plus or minus treatment, the control group took Rabeprazole Sodium Enteric-coated Capsules combined with Estazolam Tablets, the two groups were treated continuously for 6 weeks.3. before treatment (0 days) and after treatment (sixth weeks + 3 days and 6 months + 3). (gastroscopy, weight, fill in PSQI and liver depression and spleen deficiency syndrome classification standard table), At the same time, the safety index and the incidence of adverse reactions were recorded in the test process.4. all data were analyzed with SPSS19.0 software package, in which the measurement data were tested with T, counting data were checked by chi square test, and Ridit analysis was used for grade data. All the statistical results were statistically significant with P0.05. Results: 1. treatment group did not press the data. 2 cases were unable to evaluate the curative effect, 1 cases of the control group were combined with serious diseases during the period of taking medicine, and they were eliminated, and 1 cases were exited by themselves. In the final clinical observation, 60 cases of.2. treatment group and control group were all able to promote the healing of gastric mucosa erosion and both of the two groups could improve sleep disorders and improve sleep quality, and the quality of sleep was improved. There was no obvious difference in good degree between.4. two groups, but the improvement of the treatment group was better than that of the control group.5. in the control group. There was no significant adverse reaction between the control group and the control group, the.6. treatment group and the control group had no obvious adverse reaction. The treatment group was compared with the 6 months after the treatment, and the treatment group was in PS. QI score, the recurrence rate of TCM syndrome is lower than that of the control group (P0.05), indicating that in the long-term effect, the treatment group is superior to the control group. Conclusion: Xinwei Anshen Decoction can not only promote the healing of the gastric mucosa of chronic erosive gastritis, but also relieve the symptoms of insomnia, reduce the sleep barrier and the application of hypnotic drugs, and increase the quality of sleep of the patients; The patient's weight and the improvement of the patient's symptoms have obvious advantages over western medicine. There is no obvious adverse reaction in the safety observation. The long-term effect is satisfactory and the recurrence rate is low. This study provides new thinking for the treatment of chronic erosive gastritis and insomnia in traditional Chinese medicine. Clinical 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】：R259;R256.23

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