行气通络法治疗胃络瘀阻型慢性糜烂性胃炎的临床研究及对G-17与PG的影响

发布时间：2018-07-07 08:15

本文选题：慢性糜烂性胃炎 + 行气通络法　；参考：《南京中医药大学》2017年硕士论文

【摘要】：目的:本研究旨在挖掘及整理导师运用行气通络方治疗胃络瘀阻型慢性糜烂性胃炎的的临床经验,观察行气通络法治疗胃络瘀阻型慢性糜烂性胃炎的临床疗效,及内镜、病理下改善情况,和对血清胃泌素(G-17)与血清胃蛋白酶原(PG)的影响。探究行气通络法治疗胃络瘀阻型慢性糜烂性胃炎可能的机理,为行气通络方的临床应用及推广提供更多证据。方法:为体现随机化原则,采用随机数字表法将来自昆山市中医院门诊及住院部的60例患者分为治疗组组和对照组,每组各30例。这些患者都经胃镜及病理诊断为慢性糜烂性胃炎,且中医辨证属于胃络瘀阻证型。治疗组给予导师拟定行气通络方治疗,对照组给予奥美拉唑肠溶胶囊及铝碳酸镁治疗,两组疗程均为一个月,观察2个疗程。观察两组在治疗前后的综合疗效、中医证候疗效、症状积分、黏膜病变改善及治疗组治疗前后血清中G-17与PG的变化情况。结果:(1)在中医疗效评价中,两组病人的中医疗效评价存在统计学差异(P0.05),两组病人在治疗前后胃脘痛、胃脘痞满、胸胁痛、食欲减退、嗳气的评分有统计学差异(P0.05),治疗后两组病人在胸胁胀痛、食欲减退、嗳气的评分有统计学差异(P0.05)。在胃脘痛及胃脘痞满方面评分无统计学差异(P0.05)。(2)在糜烂灶疗效的评价中,治疗后两组糜烂灶疗效有统计学差异(P0.05),两组治疗前后黏膜糜烂灶评分有统计学差异(P0.05),治疗后两组的黏膜糜烂灶评分有统计学差异(P0.05)。(3)在病理组织学的评价中,两组病人经治疗后萎缩及肠化评分均有统计学差异(P0.05)。(4)治疗组中的胃窦萎缩组血清G-17水平在治疗前后有统计学差异(P0.05),而PG水平无统计学差异(P0.05)。结论:1.行气通络法能显著改善胃络瘀阻型慢性糜烂性胃炎患者的临床症状。2.行气通络法能显著修复胃络瘀阻型慢性糜烂性胃炎患者的糜烂灶及改善其腺体萎缩和肠上皮化生。3.行气通络法可在一定程度提升胃络瘀阻型慢性糜烂性胃炎患者的血清G-17水平。
[Abstract]:Objective: the purpose of this study was to excavate and sort out the clinical experience of the tutor in treating chronic erosive gastritis of the type of stagnation of gastric collaterals with Xingqi Tongluo recipe, and to observe the clinical effect and endoscopy of the treatment of chronic erosive gastritis of the type of gastric meridian stasis with the method of Qi Tongluo. Pathological changes and effects on serum gastrin (G-17) and serum pepsinogen (PG). To explore the possible mechanism of treating chronic erosive gastritis with Qi Tongluo method in order to provide more evidence for clinical application and popularization of Xingqi Tongluo recipe. Methods: in order to embody the principle of randomization, 60 patients from outpatient and inpatient department of Kunshan traditional Chinese Medicine Hospital were divided into treatment group and control group with 30 cases in each group. These patients were diagnosed by gastroscopy and pathology as chronic erosive gastritis. The treatment group was treated with Qi Tongluo recipe, while the control group was treated with omeprazole enteric capsule and magnesium bicarbonate. The two groups were treated for one month and two courses of treatment were observed. To observe the comprehensive curative effect before and after treatment, the curative effect of TCM syndrome, the symptom score, the improvement of mucosal lesion and the changes of serum G-17 and PG before and after treatment in the two groups. Results: (1) in the evaluation of TCM curative effect, there was statistical difference between the two groups (P0.05). Before and after treatment, the patients in the two groups had epigastric pain, epigastric fullness, chest and hypochondriac pain, anorexia. The score of belching was statistically different (P0.05), the two groups of patients in chest and flank pain, appetite loss, belching scores were statistically different after treatment (P0.05). There was no significant difference in the scores of epigastric pain and epigastric fullness (P0.05). (2) in the evaluation of the curative effect of erosive foci. After treatment, there were significant differences in the curative effect between the two groups (P0.05), the scores of mucosal erosions in the two groups before and after treatment were statistically different (P0.05), and the scores of mucosal erosions in the two groups (P0.05). (3) were significantly different in the evaluation of histopathology after treatment. Two groups of patients after treatment atrophy and intestinal metaplasia scores were statistically different (P0.05). (4) in the treatment group antrum atrophy group serum G-17 level before and after treatment (P0.05), but no significant difference in PG level (P0.05). Conclusion 1. Qi Tongluo method can significantly improve the clinical symptoms of chronic erosive gastritis. The method of Qi Tongluo can significantly repair the erosive foci and improve the gland atrophy and intestinal metaplasia in patients with chronic erosive gastritis. The method of Qi Tongluo can improve the serum G-17 level of patients with chronic erosive gastritis.
【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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