利胆疏肝降逆护膜方对胆汁反流性胃炎的临床疗效观察

发布时间：2018-08-12 10:48

【摘要】：研究目的：研究探讨利胆疏肝降逆护膜方对胆汁反流性胃炎的临床疗效。通过以下几点来研究：1)观察利胆疏肝降逆护膜方对胆汁反流性胃炎患者的临床症状疗效。2)观察利胆疏肝降逆护膜方对胆汁反流性胃炎患者的内镜下表现影响。3)观察利胆疏肝降逆护膜方对胆汁反流性胃炎患者的胃粘膜病理诊断影响。4)探讨利胆疏肝降逆护膜方对胆汁反流性胃炎的疗效依据。研究方法：1)参考耐信量表,自制胆汁反流性胃炎临床信息调查表。2)临床病例收集：将60例符合纳入标准且排除排除标准的胆汁反流性胃炎患者随机分为治疗组30例,对照组30例。治疗前后在患者知情同意的基础上分别进行胆汁反流性胃炎临床信息调查表的填写和胃镜及组织学的检查。3)具体操作：对照组给予西药铝碳酸镁片500mg 3次/日、多潘立酮片lOmg 3次/日,口服；治疗组在服用对照组西药的基础上再加予利胆疏肝降逆护膜方口服,两组均以8周为1个疗程。4)分析：比较对照组及治疗组的临床症状疗效；比较对照组及治疗组的胃镜下表现；比较对照组及治疗组的病理诊断。通过这三组比较来分别反映出利胆疏肝降逆护膜方结合西药治疗胆汁反流性胃炎患者的疗效。研究成果：1)治疗组用药前后症状积分分别为(17.80±11.05)、(5.97±5.50),对照组用药前后症状积分分别为(15.50±10.24)、(8.40±5.16)。两组用药前后积分差值分别为(11.83±10.01)、(7.10±8.16)。两组用药前症状积分比较无统计学差异(P0.05)。两组用药后症状积分比较有统计学差异(P0.05)。两组用药前后症状积分差值比较有统计学差异(P0.05)。总有效率：治疗组(76%)高于对照组(50%)。2)治疗组用药前后内镜下反流程度积分分别为(1.80±0.81)、(0.73±0.69),对照组用药前后内镜下反流程度积分分别为(1.97±0.72)、(1.50±0.57)。两组用药前后积分差值为(1.07±0.83)、(0.47±0.51)。两组用药前内镜下反流程度积分比较无统计学差异(P0.05)。两组用药后内镜下反流程度积分有统计学差异(P0.05)。两组用药前后内镜下反流程度积分差值有统计学差异(P0.05)。治疗组用药前后内镜下粘膜表现积分分别为(4.43±2.22)、(2.03±1.19),对照组治疗前后内镜下粘膜表现积分分别为(4.37±2.17)、(3.13±1.66)。两组用药前后积分差值分别为(2.40±1.57)、(1.23±1.07)。两组用药前内镜下粘膜表现积分比较无统计学差异(P0.05)。两组用药后内镜下粘膜表现积分有统计学差异(P0.05)。两组用药后内镜下粘膜表现积分差值有统计学差异(P0.05)。3)治疗组与对照组用药前后病理诊断结果均无改变。即本次临床研究治疗组与对照组在8周临床观察期间内病理诊断结果均无疗效。研究结论：利胆疏肝降逆护膜方联合现有的西药疗法能够更为有效地缓解胆汁反流性胃炎患者的症状,改善胆汁反流性胃炎患者内镜下胆汁反流程度及胃黏膜的表现,临床应用值得推广。本次临床观察治疗组与对照组的胆汁反流性胃炎患者用药后均没有病理诊断结果的改变。一方面可能是因为胆汁反流性胃炎与其他慢性胃炎在组织学上没有差异性另一方面可能是因为本次研究疗程太短等主观因素,临床证实需进一步研究。
[Abstract]:Objective: To study the clinical effect of Lidanshugan Jiangni protective film Recipe on bile reflux gastritis. To observe the clinical symptoms of patients with bile reflux gastritis treated with Lidanshugan Jiangni protective film recipe. 3) To observe the effect of Lidan Shugan Jiangni Mulching Formula on pathological diagnosis of gastric mucosa in patients with bile reflux gastritis. 4) To explore the therapeutic effect of Lidan Shugan Jiangni Mulching Formula on bile reflux gastritis. Patients with bile reflux gastritis were randomly divided into treatment group (30 cases) and control group (30 cases). Before and after treatment, the patients were informed and consented to fill in the questionnaire of clinical information of bile reflux gastritis and gastroscopy and histology examination. 3) Specific operation: The control group was given western medicine magnesium aluminum carbonate tablets 50 cases. 0 mg 3 times a day, Domperidone Tablets 3 times a day, oral administration; treatment group in the control group on the basis of Western medicine plus Lidan Shugan Jiangni capsule oral treatment, two groups of 8 weeks for a course of treatment. 4) analysis: comparison of the control group and the treatment group of clinical symptoms; comparison of the control group and the treatment group of gastroscopic performance; comparison of the control group and the treatment group Results: 1) The symptom scores of the treatment group were (17.80 6550 16). The difference of symptom scores before and after treatment was (11.83 [10.01], (7.10 [8.16]. There was no significant difference between the two groups (P 0.05). The difference of symptom scores between the two groups was statistically significant (P 0.05). The total effective rate of the treatment group (76%) was higher than that of the control group (P 0.05). The scores of endoscopic reflux degree before and after treatment in the treatment group were (1.80 [0.81], (0.73 [0.69]) and (1.97 [0.72], (1.50 [0.57], respectively, in the control group. There was a significant difference in endoscopic reflux score between the two groups (P 0.05). There was a significant difference in endoscopic reflux score between the two groups before and after treatment (P 0.05). The scores of endoscopic mucosal performance before and after treatment in the treatment group were (4.43 (2.22), (2.03 (1.19). The scores of endoscopic mucosal performance before and after treatment in the control group were (4.03) respectively. There was no significant difference in the scores of endoscopic mucosal manifestations between the two groups before and after treatment (P 0.05). There was significant difference in the scores of endoscopic mucosal manifestations between the two groups (P 0.05). (05) 3) There was no change in the pathological diagnosis between the treatment group and the control group before and after treatment, that is, the treatment group and the control group had no effect on the pathological diagnosis during the 8-week clinical observation period. Symptoms, improve bile reflux gastritis patients endoscopic bile reflux degree and gastric mucosa performance, clinical application is worth promoting. This clinical observation treatment group and control group of patients with bile reflux gastritis after treatment did not change the pathological diagnosis. On the one hand may be due to bile reflux gastritis and other chronic gastritis in Histologically, there was no difference, on the other hand, because of subjective factors, such as the short course of treatment in this study, which need further study.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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