益气活血法对慢性萎缩性胃炎的临床研究

发布时间：2018-07-04 17:18

本文选题：益气活血法 + 慢性萎缩性胃炎　；参考：《广西中医药大学》2017年硕士论文

【摘要】：目的:本课题通过益气活血法治疗慢性萎缩性胃炎方案与一般西医基础治疗对照,探讨健脾益气、活血化瘀法对治疗慢性萎缩性胃炎病理变化机制,为临床实践治疗慢性萎缩性胃炎寻求并推广科学、客观、有效的中医药,提供新思路与方法。方法:选取慢性萎缩性胃炎脾虚、瘀阻证患者68例,按随机数字表法分为两组,每组34例,对照组给予西医基础治疗,治疗组以益气活血法为原则(自拟益气活血方加减),给予每日中药一剂,水煎400ml,早晚分服。一疗程均为4个月。一疗程后观察两组患者治疗前后临床症状积分及胃镜、病理组织检查的疗效差异。结果:治疗4月后治疗组Hp根除率为21.74%,对照组为77.27%(P0.01),有非常显著差异,表明西医对照组在根除Hp中优于中医治疗组。两组临床总疗效比较,经治疗,治疗组总有效率为60.61%,对照组为36.36%,治疗组有效率显著高于对照组(P0.05),表明治疗组优于对照组。两组临床积分比较,治疗组与对照组治疗前后中医证候总积分比较均有非常显著差异(p0.01),表明两组均能明显改善患者临床症状。治疗组与对照组在治疗后中医证候总积分比较有非常显著差异(p0.01)。表明治疗组在改善患者临床症状方面优于对照组表明治疗组在改善患者临床症状方面优于对照组。两组治疗后胃镜下疗效比较,治疗组有效率为66.67%,对照组为42.42%,治疗组有效率高于对照组(P0.05)。胃黏膜萎缩改善总疗效比较,治疗组有效率为63.63%,对照组为39.39%,治疗组优于对照组(P0.05)。胃窦黏膜萎缩改善疗效比较,经治后,治疗组有效率为66.67%,对照组为36.36%,治疗组优于对照组(P0.05)。胃体萎缩改善疗效比较,经治后,治疗组有效率为60.87%,对照组为33.33%,治疗组优于对照组(P0.05)。胃角萎缩改善疗效比较经治后,治疗组有效率是64.00%,对照组为38.46%,优于对照组(P0.05)。胃黏膜肠化情况疗效比较,经治后,治疗组有效率为28.57%,对照组为5.00%,治疗组高于对照组(P0.05)。胃黏膜上皮内瘤变情况疗效比较,经治后,治疗组有效率为22.22%,对照组为00.00%,治疗组与对照组无明显差异(P0.05)。结论:以益气活血为法治疗慢性萎缩性胃炎脾胃虚弱、胃络瘀阻证中,不但能缓解临床症状,还能改善黏膜病变及病理学情况,疗效良好,安全,临床有较高的深入研究价值。
[Abstract]:Objective: to study the pathological changes of chronic atrophic gastritis treated by invigorating qi and activating blood circulation, and comparing with the basic treatment of western medicine, and to explore the mechanism of strengthening spleen and invigorating qi and activating blood circulation and removing blood stasis in treating chronic atrophic gastritis. To seek and promote scientific, objective and effective Chinese medicine for clinical practice in the treatment of chronic atrophic gastritis, and to provide new ideas and methods for the treatment of chronic atrophic gastritis. Methods: Sixty-eight patients with chronic atrophic gastritis with spleen deficiency and stasis syndrome were divided into two groups, 34 cases in each group. The control group was treated with western medicine. In the treatment group, one dose of traditional Chinese medicine was given daily, 400 ml water decoction, taken separately in the morning and evening according to the principle of invigorating qi and activating blood circulation method (add or subtract from self-formulation of Yiqi Huoxue recipe). One course of treatment was 4 months. After one course of treatment, the difference of clinical symptom score, gastroscopy and histopathology between the two groups before and after treatment was observed. Results: the eradication rate of HP was 21.74 in the treatment group and 77.27% in the control group (P0.01), which indicated that the western medicine control group was superior to the traditional Chinese medicine group in the eradication of HP. After treatment, the total effective rate of the treatment group was 60.61, and that of the control group was 36.36. The effective rate of the treatment group was significantly higher than that of the control group (P0.05), which indicated that the treatment group was superior to the control group. There were significant differences between the treatment group and the control group before and after treatment (p0.01), indicating that the two groups can obviously improve the clinical symptoms of patients. There was significant difference between the treatment group and the control group in the total score of TCM syndromes after treatment (p 0.01). The results showed that the treatment group was superior to the control group in improving the clinical symptoms. The effective rate was 66.67 in the treatment group and 42.42 in the control group. The effective rate in the treatment group was higher than that in the control group (P0.05). Compared with the total curative effect of gastric mucosal atrophy, the effective rate of the treatment group was 63.63 and that of the control group was 39.39. The treatment group was superior to the control group (P0.05). After treatment, the effective rate of the treatment group was 66.67 and the control group was 36.36. The treatment group was superior to the control group (P0.05). After treatment, the effective rate of the treatment group was 60.87 and that of the control group was 33.33. The treatment group was superior to the control group (P0.05). The effective rate of the treatment group was 64.00 and that of the control group was 38.46, which was better than that of the control group (P0.05). After treatment, the effective rate of the treatment group was 28.57 and the control group was 5.00. The treatment group was higher than the control group (P0.05). After treatment, the effective rate of the treatment group was 22.2222 and the control group was 0.0.00. there was no significant difference between the treatment group and the control group (P0.05). Conclusion: the treatment of chronic atrophic gastritis with deficiency of spleen and stomach and stagnation of gastric collaterals can not only relieve clinical symptoms, but also improve mucosal pathological changes and pathology.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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