半夏消痞汤治疗脾胃湿热型痞满病（慢性非萎缩性胃炎）的临床观察

发布时间：2018-05-26 02:03

本文选题：半夏消痞汤 + 脾胃湿热　；参考：《山西中医学院》2016年硕士论文

【摘要】：目的:通过观察半夏消痞汤联合雷贝拉唑钠肠溶片治疗脾胃湿热型痞满病(慢性非萎缩性胃炎)的临床疗效及安全性,为运城地区脾胃湿热型痞满病(慢性非萎缩性胃炎)提供比较有效的治疗方案。方法:本课题共收集79例符合纳入标准的合格受试对象,按随机、对照的原则将其分为两组,减去脱落病例,试验组最终收集33例,对照组最终收集35例。试验组给予半夏消痞汤联合雷贝拉唑钠肠溶片,对照组给予雷贝拉唑钠肠溶片,疗程均为4周。比较分析两组患者治疗前后的中医证候、胃镜及病理组织学变化。结果:1、中医证候疗效评价(1)两组中医证候疗效比较,经秩和检验,试验组疗效高于对照组(P0.05)。(2)中医证候总积分比较,与治疗前组内比较,两组治疗后均取得疗效(P0.01);治疗后进行组间比较,试验组症状改善优于对照组(P0.01)。2、单项中医症状积分比较(1)与治疗前组内比较,试验组和对照组各项中医症状均有显著改善(P0.05)。(2)试验组在“脘腹痞满”、“口苦口干”、“身重困倦”、“小便短黄”和“大便不畅”这五项的疗效优于对照组(P0.05)。3、胃镜疗效评价(1)内镜总积分比较,两组治疗后均优于治疗前(P0.01);治疗后进行组间比较,试验组胃镜疗效优于对照组(P0.01)。(2)两组对胃黏膜红斑、糜烂、出血均有疗效(P0.01)。试验组对黏膜糜烂的疗效优于对照组(P0.05),两组在黏膜红斑和黏膜出血的疗效无差异(P0.05)。4、病理组织学疗效评价(1)病理组织学积分比较,两组在慢性炎症和活动性炎症方面均有改善(P0.01),试验组对慢性炎症的疗效优于对照组(P0.05),两组对活动性炎症的疗效无差异(P0.05)。(2)两组对慢性炎症和活动性炎症的临床疗效经秩和检验,无统计学差异(P0.05)。5、安全性评价通过安全性指标的观测,两组治疗期间未见明显不良反应。结论:1、在疗效和中医证候改善方面,半夏消痞汤联合雷贝拉唑钠肠溶片治疗脾胃湿热型痞满病(慢性非萎缩性胃炎)优于单纯使用雷贝拉唑钠肠溶片。2、在胃镜检查方面,半夏消痞汤联合雷贝拉唑钠肠溶片可改善患者胃黏膜红斑、糜烂、出血,且在胃黏膜糜烂方面疗效优于单纯使用雷贝拉唑钠肠溶片。3、在病理组织学方面,半夏消痞汤联合雷贝拉唑钠肠溶片可降低慢性炎症和活动性炎症反应程度,且在慢性炎症方面疗效优于单纯使用雷贝拉唑钠肠溶片。4、半夏消痞汤联合雷贝拉唑钠肠溶片治疗运城地区脾胃湿热型痞满(慢性非萎缩性胃炎),安全有效,值得临床推广。
[Abstract]:Objective: to observe the clinical efficacy and safety of Banxia Xiaopi decoction (Banxia Xiaopi decoction) combined with rabeprazole sodium enteric-coated tablets in the treatment of chronic non-atrophic gastritis (chronic non-atrophic gastritis) with damp-heat type of spleen and stomach. To provide a more effective treatment for chronic non-atrophic gastritis in Yuncheng area. Methods: a total of 79 eligible subjects were collected and divided into two groups according to the principle of randomization and control. 33 cases were collected in the experimental group and 35 cases in the control group. The experimental group was given Banxia Xiaopi decoction combined with rabeprazole sodium enteric-coated tablets, and the control group was given rabeprazole sodium enteric-coated tablets for 4 weeks. The changes of TCM syndromes, gastroscopy and histopathology before and after treatment were compared between the two groups. Results: (1) the curative effect of TCM syndromes was compared between the two groups. By rank sum test, the curative effect of the experimental group was higher than that of the control group (P0.05. 0. 2) the total score of TCM syndromes was higher than that of the control group, and was compared with that before treatment. After treatment, the symptoms of the experimental group were improved better than that of the control group (P 0.01g 路2), and the scores of single TCM symptom were compared with those of the control group before and after the treatment (P 0.01), and compared with the control group (1) after the treatment, the improvement of symptoms in the experimental group was better than that in the control group. Each TCM symptom of the trial group and the control group were significantly improved (P0.05, P0.05, P0. 05, P < 0. 05).) in the experimental group, the abdominal distension was full, the mouth was bitter and the mouth was dry, and the body was heavy and sleepy. The curative effect of "short yellow urine" and "unobstructed stool" were better than that of the control group (P0.05J. 3) the total score of endoscopy was compared, and the two groups were better than P0.01before and after treatment. The effect of gastroscopy in the experimental group was better than that in the control group (P 0.01). The curative effect of the experimental group on mucosal erosion was better than that of the control group (P 0.05). There was no difference between the two groups in the curative effect of mucosal erythema and mucosal hemorrhage. There was no difference between the two groups in the treatment of chronic inflammation and active inflammation. The clinical efficacy of the two groups in chronic inflammation and active inflammation was tested by rank sum test. There was no significant difference between the two groups (P0.05. 5). The safety evaluation showed that there was no significant adverse reaction during the treatment period of the two groups. Conclusion in terms of curative effect and improvement of TCM syndromes, Banxia Xiaopi decoction combined with rabeprazole sodium enteric-coated tablet is superior to rabeprazole sodium enteric-coated tablet in the treatment of spleen and stomach damp-heat type fullness disease (chronic non-atrophic gastritis). Banxia Xiaopi decoction combined with rabeprazole sodium enteric-coated tablet can improve the gastric mucosal erythema, erosion and bleeding, and the curative effect in gastric mucosal erosion is better than that of rabeprazole sodium enteric-coated tablet .3. in histopathology, Banxia Xiaopi decoction is better than rabeprazole sodium enteric-coated tablet. Banxia Xiaopi decoction combined with rabeprazole sodium enteric-coated tablets can reduce the degree of chronic inflammation and active inflammatory reaction. The curative effect of chronic inflammation is better than that of rabeprazole sodium enteric-coated tablet. Banxia Xiaopi decoction combined with rabeprazole sodium enteric-coated tablet is safe and effective in treating spleen and stomach dampness and heat type (chronic non-atrophic gastritis) in Yuncheng area, and it is worth popularizing clinically.
【学位授予单位】：山西中医学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R256.32

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