疏肝和胃颗粒治疗慢性萎缩性胃炎肝胃气滞证的临床研究

发布时间：2018-06-30 06:21

本文选题：慢性萎缩性胃炎 + 肝胃气滞证　；参考：《山东中医药大学》2016年硕士论文

【摘要】：研究目的观察疏肝和胃颗粒治疗肝胃气滞型慢性萎缩性胃炎的临床疗效及作用机理,并对其安全性及有效性进行客观评价。研究方法:选择在山东省济南市中医医院脾胃病科门诊及住院病人中符合纳入标准的CAG患者共80例,按照就诊的先后顺序将受试者随机分为治疗组(疏肝和胃颗粒组)和对照组(胃苏颗粒组),两组各40例,疗程为3个月。治疗组给予疏肝和胃颗粒(药物组成:柴胡、白芍、香附、麸炒枳壳、炒白术、茯苓、川芎、砂仁、醋鸡内金、醋延胡索、炒六曲、玫瑰花等),每日一剂,分早晚两次温水冲服;对照组给予胃苏颗粒,一次15g,一日3次,温水冲服。两组疗程均为3个月。观察两组患者治疗前后临床综合疗效、中医证候疗效、胃镜病理疗效以及HP的根除疗效。采用统计软件SPSS19.0对相关观察指标进行统计学分析。研究结果1.两组患者临床综合疗效比较:治疗组总有效率为87.50%,对照组总有效率为57.50%。经统计学分析,两组临床总疗效有明显差异(P0.05)。2.两组患者中医证候疗效比较:治疗组明显优于对照组(P0.05)。其中在改善胃脘部胀满(或胀痛),胁肋部胀痛、嗳气等方面治疗组要优于对照组(P0.05甚至P0.01),在改善胸闷不适症状上两组无明显差异(P0.05)。3.两组患者胃镜疗效比较:治疗组的胃镜疗效要优于对照组(P0.05)。4.两组患者病理组织学疗效比较:治疗组萎缩有效率为77.5%,对照组52.5%,治疗组优于对照组(P0.05)。在治疗肠化及异型增生上两组没有明显差异(P0.05)。5.两组患者HP根除疗效比较:治疗组要优于对照组(P0.05)。6.安全性平价:治疗组与对照组均无明显不良反应。研究结论疏肝和胃颗粒对肝胃气滞型的CAG患者具有良好的临床效果,是治疗CAG肝胃气滞证的有效方剂,值得进一步推广运用。
[Abstract]:Objective to observe the clinical efficacy and mechanism of Shugan Hewei granule in the treatment of chronic atrophic gastritis with Qi stagnation of liver and stomach, and to evaluate its safety and effectiveness. Methods: a total of 80 CAG patients who met the inclusion criteria were selected from the Department of spleen and stomach Diseases of Jinan traditional Chinese Medicine Hospital in Shandong Province. The subjects were randomly divided into treatment group (Shugan and Wei granule group) and control group (Weisu granule group) according to the order of treatment. 40 cases in each group were treated for 3 months. The treatment group was given Shugan and Wei granules (drug composition: Bupleurum, Radix Paeoniae Alba, Radix Cyperus, bran fried Fructus Aurantii, Fried Atractylodes, Poria cocos, Ligusticum chuanxiong, Amomum seed, vinegar Chicken Inner Gold, vinegar Corydalis, Fried Six-qu, Rose, etc.) The control group was given Weisu granule, 15 g once, 3 times a day, warm water. The course of treatment was 3 months in both groups. The clinical efficacy, syndromes, gastroscopy and HP eradication were observed before and after treatment. Statistical software SPSS 19.0 was used to analyze the related indexes. Results 1. The total effective rate was 87.50 in the treatment group and 57.50 in the control group. By statistical analysis, the two groups have a significant difference in the overall clinical efficacy (P0.05). 2. Comparison of TCM syndromes between the two groups: the treatment group was significantly better than the control group (P0.05). The treatment group was superior to the control group in improving stomachache (or distending pain), flank pain, belching and so on (P0.05 or P0.01), but there was no significant difference between the two groups in improving the symptoms of chest tightness (P0.05). 3. Two groups of patients gastroscope efficacy comparison: the treatment group gastroscope efficacy is better than the control group (P0.05). 4. Comparison of histopathological effects between the two groups: the effective rate of atrophy was 77.5 in the treatment group, 52.5 in the control group, and better in the treatment group than in the control group (P0.05). There was no significant difference between the two groups in the treatment of intestinal metaplasia and dysplasia (P0.05). Comparison of HP eradication efficacy between the two groups: the treatment group was better than the control group (P0.05). 6. Safety parity: there were no significant adverse reactions in both the treatment group and the control group. Conclusion Shugan Hewei granule has a good clinical effect on CAG patients with Qi-stagnation of liver and stomach. It is an effective prescription for the treatment of Qi-stagnation of liver and stomach of CAG, and it is worth further popularizing and applying.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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