疏肝健脾和胃法治疗肝胃不和型功能性消化不良的临床观察

发布时间：2018-08-05 18:07

【摘要】：目的：本课题通过运用自拟疏肝健脾和胃方治疗肝胃不和型功能性消化不良患者,观察其对患者临床症状、生存质量的改善情况,以客观评价疏肝健脾和胃方的疗效,以便推广其临床应用。方法：依据随机、对照的临床试验原则,选取符合该研究纳入标准的60例患者,按照其门诊就诊次序,随机分为治疗组与对照组,每组各30例。治疗组予以自拟疏肝健脾和胃方,对照组予以单纯口服枸橼酸莫沙必利片,以4周为1疗程。观察两组治疗前后各疗效指标及不良反应出现情况,并运用统计学软件进行分析比较。结果：1临床总体疗效：治疗组与对照组总有效率分别为93.33%、70.00%,差异有统计学意义(P0.05),治疗组总体疗效优于对照组。2治疗前后中医证候总积分比较：两组中医证候总积分治疗前对比无统计学差异(P0.05)。治疗后,其均较治疗前明显减少(P0.01),且治疗组证候总积分明显低于对照组(P0.01)。3主要症状单项疗效：治疗组餐后饱胀、早饱、上腹痛等主要症状的有效率依次为85.71%、87.75%、92.85%,明显高于对照组52.60%、44.44%、50.00%,对比具有统计学意义(P0.05),治疗组在主要症状的改善方面优于对照组。4治疗前后各单项症状积分比较：治疗前,两组各单项症状积分无统计学差异(P0.05)。治疗后,治疗组餐后饱胀、早饱、上腹痛、烧心反酸、两胁胀满、胸闷善太息、便溏不爽等症状积分明显低于对照组,有明显统计学差异(P0.01、P0.05)；而饮食减少、恶心嗳气等症状积分对比无统计学差异(P0.05),两组疗效相当。5治疗前后HAMA、HAMD评分比较：两组HAMA、HAMD评分治疗前对比无统计学差异(P0.05)。治疗后,其均较治疗前有显著降低(P0.01),且治疗组评分较对照组明显降低(P0.05)。结论：疏肝健脾和胃法在改善肝胃不和型功能性消化不良患者临床症状及提高生活质量等方面效果突出,且未发现不良反应,值得临床推广应用。
[Abstract]:Objective: to observe the improvement of clinical symptoms and quality of life of patients with functional dyspepsia caused by disharmony of liver and stomach by using self-made prescription of soothing liver and strengthening spleen and stomach, and to evaluate objectively the curative effect of Shugan Jianpi and Wei Fang. In order to promote its clinical application. Methods: according to the principles of randomized and controlled clinical trials, 60 patients who met the criteria of the study were randomly divided into treatment group and control group with 30 cases in each group according to the order of outpatient visits. The treatment group was treated with self-made prescription of soothing liver and strengthening spleen and stomach, while the control group was given only oral mosapride citrate tablets for 4 weeks as a course of treatment. Observe the two groups before and after treatment of the efficacy and adverse reactions, and use statistical software to analyze and compare. Results: the total effective rate of the treatment group and the control group was 93.3370.000.There was significant difference (P0.05). The total curative effect of the treatment group was better than that of the control group before and after the treatment. 2. Comparison of the total syndromes of TCM syndrome between the two groups: the total syndrome accumulation in the two groups was higher than that in the control group before and after treatment. There was no statistical difference before treatment (P0.05). The total score of syndrome in the treatment group was significantly lower than that in the control group (P0.01). The effective rate of main symptoms such as epigastric pain was 85.71and 87.757.750.85, which was significantly higher than that of the control group (52.60g / 44.4450.00). The comparison was statistically significant (P0.05). The improvement of main symptoms in the treatment group was better than that in the control group before and after treatment: before and after treatment, the scores of each single symptom in the treatment group were better than those in the control group. There was no statistical difference in symptom score between the two groups (P0.05). After treatment, the scores of symptoms such as fullness after meal, early satiety, upper abdominal pain, heart-burning regurgitation, fullness of both sides, chest tightness and good breath, loose stools in the treatment group were significantly lower than those in the control group (P0.01P05), while the diet was reduced. There was no significant difference in score of nausea and belching between the two groups (P0.05). There was no significant difference between the two groups before and after treatment (P0.05). After treatment, it was significantly lower than that before treatment (P0.01), and the score of the treatment group was significantly lower than that of the control group (P0.05). Conclusion: the method of soothing liver and invigorating spleen and stomach is effective in improving the clinical symptoms and improving the quality of life of patients with functional dyspepsia with disharmony of liver and stomach, and no adverse reactions have been found, which is worth popularizing and applying in clinic.
【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】：2016
【分类号】：R259

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