清热化湿、健脾和胃法治疗Hp相关性慢性非萎缩性胃炎的临床研究

发布时间：2018-09-04 10:43

【摘要】：目的:本课题为清热化湿、健脾和胃法治疗Hp相关性慢性非萎缩性胃炎的临床研究。选用中医经典方剂清中汤加味作为清热化湿、健脾和胃法的代表方剂进行研究。通过对清中汤加味治疗Hp相关性慢性非萎缩性胃炎的临床研究,明确其对本病的临床有效性、临床安全性,验证中医药对本病的治疗优势。方法:所有入组患者均来自于长春中医药大学附属医院肝脾胃病科门诊,且均属于Hp相关性慢性非萎缩性胃炎患者,采用随机对照方法,将入组病例分成两组,即治疗组与对照组,每组患者30例。其中治疗组在应用标准三联疗法(雷贝拉唑钠肠溶片10mg、阿莫西林1000mg、克拉霉素500mg均餐后日2次口服)的基础上给予清中汤加味治疗。对照组仅采用标准三联疗法治疗。各组均以2周为1个疗程,共治疗1个疗程。治疗过程中密切观察并准确记录两组患者的症状以及体征的变化。1个疗程治疗结束4周后,复查并记录Hp的变化,比较治疗前及治疗后的Hp根除情况,并进行统计学分析。治疗前及治疗后各进行安全性指标观测1次。结果:治疗组30例,对照组30例,共有60例患者按照治疗方案完成了本研究。在总疗效方面,治疗组与对照组的总有效率分别为93.33%、80.00%,经统计学分析,P=0.0040.01,说明治疗组的总疗效明显优于对照组。两组在根除Hp上,治疗组有28例患者转为阴性,2例未转阴,有效率为93.33%,对照组有22例转为阴性,8例未转阴,有效率为73.33%,经统计学分析,P=0.038(0.05),说明治疗组在Hp的根除方面明显优于对照组。中医各证候积分方面,两组在改善脘腹痞满、胃脘疼痛、烧心或灼热感、食少纳呆、口干苦及身重困倦上均有明显差异(P0.05)。在改善小便短黄方面,两组具有显著性差异(P0.01)。而在嗳气方面,治疗组与对照组则无明显差异(P0.05)。两组患者在整个实验过程中,均未有不良反应的发生。结论:清热化湿、健脾和胃法在治疗Hp相关性慢性非萎缩性胃炎方面具有显著效果,能够明显改善患者症状,有利于Hp的根除。
[Abstract]:Objective: to study the treatment of chronic non-atrophic gastritis associated with Hp by clearing heat and removing dampness, invigorating spleen and stomach. The traditional Chinese medicine prescription Qingzhong decoction was chosen as the representative prescription of clearing heat and removing dampness, invigorating spleen and stomach. Through the clinical study on the treatment of chronic non-atrophic gastritis associated with Hp with Qingzhong decoction, the clinical efficacy and clinical safety of this disease were determined, and the advantages of traditional Chinese medicine in the treatment of this disease were verified. Methods: all the patients were from the outpatient department of liver, spleen and stomach, affiliated hospital of Changchun University of traditional Chinese Medicine, and belonged to the patients with chronic non-atrophic gastritis associated with Hp. The patients were divided into two groups by randomized control method. Treatment group and control group, 30 patients in each group. The treatment group was treated with Qingzhong decoction on the basis of standard triple therapy (10 mg of Rabeprazole sodium enteric-coated tablets, 1000 mg of amoxicillin and twice a day of clarithromycin 500mg). The control group was treated with standard triple therapy only. All groups were treated with 2 weeks as a course of treatment. The changes of symptoms and signs of the two groups were observed and accurately recorded in the course of treatment. After a course of treatment for 4 weeks, the changes of Hp were rechecked and recorded, and the eradication of Hp before and after treatment was compared and analyzed statistically. The safety indexes were observed once before and after treatment. Results: the treatment group (30 cases) and the control group (30 cases) completed the study according to the treatment protocol. The total effective rate of the treatment group and the control group was 93.3380.000.The total effective rate of the treatment group was significantly better than that of the control group by statistical analysis. In the eradication of Hp in both groups, 28 patients in the treatment group turned negative, 2 cases did not turn negative, and the effective rate was 93.33. In the control group, 22 cases turned negative and 8 cases did not turn negative. The effective rate was 73.33 (P 0.038), which indicated that the treatment group was superior to the control group in the eradication of Hp. TCM syndromes integral, the two groups in the improvement of epigastric fullness, epigastric pain, heartburn or burning feeling, food less, dry mouth and heavy sleepiness were significantly different (P0.05). There was a significant difference between the two groups in improving short yellow urine (P0.01). In terms of belching, there was no significant difference between the treatment group and the control group (P0.05). There were no adverse reactions in both groups during the whole experiment. Conclusion: the methods of clearing heat and removing dampness, invigorating spleen and stomach have remarkable effect in treating chronic non-atrophic gastritis associated with Hp, and can obviously improve the symptoms of patients and help to eradicate Hp.
【学位授予单位】：长春中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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