基于方证相应理论探讨糜烂性胃炎浊毒证用药规律研究

发布时间：2018-11-18 06:46

【摘要】：第一部分基于方证相应理论探讨化浊解毒方治疗糜烂性胃炎的临床研究目的:对糜烂性胃炎(Chronicp erosive gastritis,CEG)浊毒内蕴证的方证关系进行研究,明确化浊解毒方和糜烂性胃炎浊毒内蕴证之间的联系,提高糜烂性胃炎的临床疗效。方法:将174例糜烂性胃炎的患者分为方证相应组、方同证不同组和证同方不同组。方证相应组64例,方同证不同组63例,口服化浊解毒方药;证同方不同组47例,口服清热利湿方药。三组均以3个月为1个疗程,连续观察2个疗程。2个疗程之后,比较三组患者治疗前后的临床症状及胃镜下变化。结果:(1)三组治疗前后中医证候表现改善情况:方证相应组总有效率为89.06%,证同方不同组总有效率为68.09%,方同证不同组总有效率为77.78%。方证相应组总有效率明显高于证同方不同组和方同证不同组(P0.05),证同方不同组和方同证不同组相比无明显统计学差异(P0.05)。方证相应组具有明显优势。(2)三组治疗前后胃镜下粘膜改善情况:方证相应组总有效率为96.88%,证同方不同组总有效率为59.57%,方同证不同组总有效率为80.95%。方证相应组总有效率明显高于证同方不同组和方同证不同组(P0.05),证同方不同组和方同证不同组相比无明显统计学差异(P0.05)。(3)三组治疗前后肠化改善情况:方证相应组总有效率为81.25%,证同方不同组总有效率为57.45%,方同证不同组总有效率为63.49%。方证相应组总有效率明显高于证同方不同组和方同证不同组(P0.05),证同方不同组和方同证不同组相比无明显统计学差异(P0.05)。结论:化浊解毒方与糜烂性胃炎浊毒内蕴证存在方证相应关系,对糜烂性胃炎患者的临床症状的改善,与镜下病理的恢复具有明显的疗效。对于非浊毒内蕴证的患者,与非化浊解毒方治疗的患者临床疗效均欠佳。第二部分慢性糜烂性胃炎浊毒内蕴证用药规律研究目的:运用频数统计和聚类分析方法,通过对临床病例的回顾性研究,探讨化浊解毒方剂治疗慢性糜烂性胃炎的用药规律,以便更好的指导临床用药。方法:收集在河北省中医院脾胃病二科就诊的300例糜烂性胃炎患者的病例。对患者一般信息,临床症状和中医处方进行统计分析,将频数在30次(包括30次)以上的中药进行整理分析,探讨糜烂性胃炎浊毒内蕴证的用药规律。结果:通过300例糜烂性胃炎患者中医处方的数据整理,共得到药物182味,使用频数在30次(包括30次)以上的中药共计52味,并由此发现治疗糜烂性胃炎浊毒内蕴证的5大聚类方。结论:采用聚类分析方法,对所搜集的中医处方进行统计分析,从客观上揭示了糜烂性胃炎浊毒内蕴证用药规律。
[Abstract]:The first part discusses the clinical research on the treatment of erosive gastritis with Huazhuojiedu recipe based on the corresponding theory of prescription syndrome objective: to study the relationship between prescription and syndromes of the internal accumulation of turbid toxin syndrome of erosive gastritis (Chronicp erosive gastritis,CEG). To clarify the relationship between Huazhuojiedu recipe and the internal syndrome of erosive gastritis, improve the clinical efficacy of erosive gastritis. Methods: 174 patients with erosive gastritis were divided into three groups: the group with different syndromes, the group with different syndromes and the groups with different syndromes. There were 64 cases in the corresponding group, 63 cases in the group of different syndromes, and 47 cases in the group of different syndromes of syndromes and syndromes, taking the prescription of clearing away heat and promoting dampness. After two courses of treatment, the clinical symptoms and changes under gastroscope of the three groups were compared before and after treatment. Results: (1) the improvement of TCM syndromes before and after treatment in the three groups: the total effective rate of the corresponding group was 89.06, the total effective rate of the different syndromes group was 68.099.The total effective rate of the different syndromes group was 77.78. The total effective rate of the corresponding group was significantly higher than that of the different groups of different syndromes and different syndromes (P0.05), and there was no significant difference between the different groups of different syndromes and different syndromes (P0.05). (2) the improvement of mucosa under gastroscope in the three groups before and after treatment: the total effective rate of the corresponding group was 96.88 and the total effective rate of the different syndromes group was 59.57. The total effective rate of different groups was 80.95. The total effective rate of the corresponding group was significantly higher than that of the different groups with different syndromes and different syndromes (P0.05). There was no significant difference between different syndromes and different syndromes groups (P0.05). (3): the total effective rate of the corresponding group was 81.25 and the total effective rate of different syndromes was 57.45. The total effective rate of different groups was 63.49. The total effective rate of the corresponding group was significantly higher than that of the different groups of different syndromes and different syndromes (P0.05), and there was no significant difference between the different groups of different syndromes and different syndromes (P0.05). Conclusion: Huazhuojiedu recipe has the corresponding relationship with the syndrome of the internal accumulation of turbid toxin of erosive gastritis. It has obvious curative effect on the improvement of clinical symptoms of erosive gastritis and the recovery of pathology under microscope. For the patients with non-turbid toxin and non-Huazhuazhuojiedu decoction, the clinical efficacy was poor. The second part of the study on the law of drug use of chronic erosive gastritis. Objective: by means of frequency statistics and cluster analysis, through the retrospective study of clinical cases, to explore the treatment of chronic erosive gastritis with Huazhujiedu prescription. In order to better guide clinical medication. Methods: 300 cases of erosive gastritis were collected. The general information of patients, clinical symptoms and prescriptions of traditional Chinese medicine were statistically analyzed, and the traditional Chinese medicine whose frequency was more than 30 times (including 30 times) was arranged and analyzed, and the law of drug use of the syndrome of turbid toxin accumulation of erosive gastritis was discussed. Results: according to the data of 300 patients with erosive gastritis, 182 herbs were obtained, 52 of which were used more than 30 times (including 30 times). And thus found the treatment of erosive gastritis turbid toxin accumulation syndrome of 5 big cluster prescription. Conclusion: the method of cluster analysis was used to analyze the prescriptions of traditional Chinese medicine collected, and to reveal objectively the law of drug use of the internal syndrome of turbid toxin in erosive gastritis.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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