清热解毒、消痈生肌法治疗毒热蕴胃型胃溃疡病的回顾性临床研究
发布时间：2018-08-31 08:02
【摘要】：目的:学习运用周学文老教授临床经验方剂“解毒清热,消痈生肌”的方法治疗毒热蕴胃型胃溃疡,观察其对患者临床症状、体征、溃疡面积、及胃镜下表现的影响,为中医临床治疗热毒蕴胃型胃溃疡找到了临床研究依据。资料与方法:选择自2011年6月-2012年10月时间段内来到辽宁中医药大学第一附属医院消化内科符合纳入标准的98例患者,对这98例患者运用随机分组法将98例患者随机分成治疗组与对照组,其中对照组人数为46例,治疗组52例。给予对照组的患者餐前空腹口服奥美拉唑胶囊,20mg每次,每日早晚饭前空腹口服各一次,28天为一个疗程;阿莫西林胶囊1.0g,日2次口服,克拉霉素分散片0.5g,日2次口服,14天为一个整疗程;治疗组的患者服周学文老教授的经验汤剂治疗,汤剂采用“解毒清热,消痈生肌”的治法,药物组成为:黄连6g苦参6g野菊花10g蒲公英10g乌贼骨10g浙贝母10g白芨10g黄芪15g,该汤剂每天一剂,分为早晚餐前两次空腹口服,总体疗程28天。将所有病例治疗前后均收集并记录中医四诊资料,治疗前及疗程结束4周后行电子胃镜检查,并记录检查结果。将所获得的所有数据运用SPSS18.0统计学软件进行统计学分析。结果:1.治疗4星期以后,在中医症候的治疗效果上,治疗组的患者临床症状痊愈数为14例,显效数为19例,有效数为13例,无效数为6例,总体临床有效率为88.46%,对照组的患者临床症状痊愈数为7例,显效数为12例,有效数为18例,无效数为9例,总体临床有效率为80.43%,治疗组临床总体有效率明显高于对照组,两组的比较差异有统计学意义(P㩳0.05)。2.对患者行胃镜检查比对治疗效果,治疗组临床痊愈为13例,显效为18例,有效为15例,无效为6例,总体有效率为88.46%,对照组临床痊愈为8例,显效为10例,有效为18例,无效为10例,总体有效率为78.26%,治疗组总体有效率显著高过对照组的总体有效率,两组数据差异的比较拥有统计学意义(P㩳0.05)。结论:治疗组在改善热毒蕴胃型胃溃疡患者的临床症状、缓解胃脘部疼痛、促进溃疡愈合等方面均优于对照组,周学文教授运用“解毒清热、消痈生肌”的传统中医学理念,将传统中医外科的“消、托、补”治法接引入毒热蕴胃型胃溃疡的临床治疗中,取得良好的疗效,值得今后消化内科在治疗此类疾病中深入研究及临床推广应用。
[Abstract]:Objective: to study the effect of professor Zhou Xuewen's clinical experience prescription "detoxification, clearing away heat, eliminating carbuncle and producing muscle" in treating stomach ulcer with toxic heat, observing its effect on clinical symptoms, signs, ulcer area and gastroscopy. It has found the clinical research basis for the treatment of stomach ulcer with heat toxin and stomach. Materials and methods: from June 2011 to October 2012, 98 patients who came to the Department of Gastroenterology, the first affiliated Hospital of Liaoning University of traditional Chinese Medicine, met the inclusion criteria. The 98 patients were randomly divided into treatment group (n = 46) and control group (n = 52). Patients in the control group were given 20 mg omeprazole capsules before meals, and once a day for 28 days before meals in the morning and evening, while amoxicillin capsules were taken orally twice a day, 1.0 g, 2 times a day. Clarithromycin dispersible tablet 0.5g, orally administered twice a day for 14 days as a whole course of treatment; patients in the treatment group were treated with the experiential decoction of Professor Zhou Xuefen, and the decoction was treated with "detoxification, clearing away heat, eliminating carbuncle and generating muscle". The drug was composed of 6 g Radix Sophorae flavescens and 6 g wild chrysanthemum 10 g dandelion 10g squid bone 10g Bletilla striata 10g astragalus 15g. The decoction was divided into two fasting oral doses before morning and evening meal and the total course of treatment was 28 days. All cases were collected and recorded before and after treatment, before and after the treatment and 4 weeks after the course of treatment, electronic gastroscopy was performed, and the results were recorded. All the obtained data were analyzed by SPSS18.0 statistical software. The result is 1: 1. After 4 weeks of treatment, there were 14 cases of clinical symptoms cured, 19 cases of marked effect, 13 cases of effective and 6 cases of ineffectiveness in the treatment group in terms of the therapeutic effect of TCM symptoms. The total clinical effective rate was 88.46. In the control group, the clinical symptoms were cured in 7 cases, the significant effective number in 12 cases, the effective number in 18 cases, the ineffective number in 9 cases, and the overall clinical effective rate in the treatment group was 80.43. The total effective rate in the treatment group was significantly higher than that in the control group. The difference between the two groups was statistically significant (P0. 05). 13 cases were cured, 18 cases were effective, 15 cases were effective, 6 cases were ineffective, the total effective rate was 88.46g in the control group, 8 cases were cured, 10 cases were effective, and 18 cases were effective. The total effective rate of the treatment group was significantly higher than that of the control group, and the difference between the two groups was statistically significant (P 0.05). Conclusion: the treatment group is superior to the control group in improving the clinical symptoms, relieving the pain in the stomach and promoting the healing of the ulcer. Professor Zhou Xuewen used the traditional Chinese medicine idea of "detoxifying heat, eliminating carbuncle and generating muscle". This paper introduces the traditional Chinese medicine surgery "Xiao, Kuo, Fu" into the clinical treatment of the gastric ulcer of the type of toxic heat and stomach, and obtains good curative effect, which is worthy of further study and clinical application in the treatment of this kind of disease in the department of peptic medicine in the future.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259
，
本文编号：2214382
[Abstract]:Objective: to study the effect of professor Zhou Xuewen's clinical experience prescription "detoxification, clearing away heat, eliminating carbuncle and producing muscle" in treating stomach ulcer with toxic heat, observing its effect on clinical symptoms, signs, ulcer area and gastroscopy. It has found the clinical research basis for the treatment of stomach ulcer with heat toxin and stomach. Materials and methods: from June 2011 to October 2012, 98 patients who came to the Department of Gastroenterology, the first affiliated Hospital of Liaoning University of traditional Chinese Medicine, met the inclusion criteria. The 98 patients were randomly divided into treatment group (n = 46) and control group (n = 52). Patients in the control group were given 20 mg omeprazole capsules before meals, and once a day for 28 days before meals in the morning and evening, while amoxicillin capsules were taken orally twice a day, 1.0 g, 2 times a day. Clarithromycin dispersible tablet 0.5g, orally administered twice a day for 14 days as a whole course of treatment; patients in the treatment group were treated with the experiential decoction of Professor Zhou Xuefen, and the decoction was treated with "detoxification, clearing away heat, eliminating carbuncle and generating muscle". The drug was composed of 6 g Radix Sophorae flavescens and 6 g wild chrysanthemum 10 g dandelion 10g squid bone 10g Bletilla striata 10g astragalus 15g. The decoction was divided into two fasting oral doses before morning and evening meal and the total course of treatment was 28 days. All cases were collected and recorded before and after treatment, before and after the treatment and 4 weeks after the course of treatment, electronic gastroscopy was performed, and the results were recorded. All the obtained data were analyzed by SPSS18.0 statistical software. The result is 1: 1. After 4 weeks of treatment, there were 14 cases of clinical symptoms cured, 19 cases of marked effect, 13 cases of effective and 6 cases of ineffectiveness in the treatment group in terms of the therapeutic effect of TCM symptoms. The total clinical effective rate was 88.46. In the control group, the clinical symptoms were cured in 7 cases, the significant effective number in 12 cases, the effective number in 18 cases, the ineffective number in 9 cases, and the overall clinical effective rate in the treatment group was 80.43. The total effective rate in the treatment group was significantly higher than that in the control group. The difference between the two groups was statistically significant (P0. 05). 13 cases were cured, 18 cases were effective, 15 cases were effective, 6 cases were ineffective, the total effective rate was 88.46g in the control group, 8 cases were cured, 10 cases were effective, and 18 cases were effective. The total effective rate of the treatment group was significantly higher than that of the control group, and the difference between the two groups was statistically significant (P 0.05). Conclusion: the treatment group is superior to the control group in improving the clinical symptoms, relieving the pain in the stomach and promoting the healing of the ulcer. Professor Zhou Xuewen used the traditional Chinese medicine idea of "detoxifying heat, eliminating carbuncle and generating muscle". This paper introduces the traditional Chinese medicine surgery "Xiao, Kuo, Fu" into the clinical treatment of the gastric ulcer of the type of toxic heat and stomach, and obtains good curative effect, which is worthy of further study and clinical application in the treatment of this kind of disease in the department of peptic medicine in the future.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259
，
本文编号：2214382
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