疏肝和胃护膜法治疗肝胃不和型胆汁反流性胃炎的理论及临床研究
发布时间：2019-06-28 11:17
【摘要】：目的:通过观察导师单兆伟教授在疏肝和胃护膜法基础上创制的柴芍护膜汤加减治疗肝胃不和型胆汁反流性胃炎(bile reflux gastritis,BRG)的临床疗效,为临床治疗BRG提供新的思路与方法。方法:①理论研究:分为现代医学对BRG病因及发病机制、诊断、治疗等的研究和祖国医学对BRG的病名、病因病机、辨证分型与治疗原则、治疗等的研究;②临床研究:制定肝胃不和型BRG的纳入标准,将符合条件的60例患者随机分为试验组和对照组,试验组(30例)给予柴芍护膜汤加减,对照组(30例)给予枸橼酸莫沙必利分散片和铝碳酸镁片,两组均口服治疗8周,利用SPSS16.0对患者临床资料、症状评分,胃镜下胆汁反流程度进行统计分析。结果:治疗前,两组进行性别、年龄、症状分布、胆汁反流程度分级比较,均无统计学差异(P均0.05),表明两组具有可比性,且两组均没有出现不良反应。两组患者治疗后症状均有不同程度的改善;对主要症状(脘胁胀痛或胀满、嗳气吞酸、呃逆、恶心呕吐、胃中嘈杂)的改善,两组疗效相当;对次要症状(不欲食、便溏、情绪抑郁或烦躁易怒、口干口苦)的改善方面疗效存在差异(P0.05),试验组优于对照组。试验组和对照组总有效率分别为86.7%和63.3%。两组疗效相比,试验组中医证候疗效优于对照组。结论:导师经验方柴芍护膜汤对治疗肝胃不和型BRG具有良好的临床疗效,对患者整体症状的改善有着明显优势,能更好地提高病人的整体生活质量,具有较好的临床应用前景。
[Abstract]:Objective: to observe the clinical effect of Chaishao protective membrane decoction, which was created by professor Shan Zhaowei, on the basis of soothing liver and stomach protective membrane, in the treatment of hepatogastric bile reflux gastritis (bile reflux gastritis,BRG), and to provide a new idea and method for clinical treatment of BRG. Methods: 1 theoretical research: it is divided into the study of etiology and pathogenesis, diagnosis and treatment of BRG in modern medicine and the study of disease name, etiology and pathogenesis, syndrome differentiation, treatment principle and treatment of BRG in traditional Chinese medicine. 2 Clinical study: 60 patients with hepatogastric disharmony type BRG were randomly divided into experimental group (n = 30) and control group (n = 30). The experimental group (n = 30) was treated with mosapride citrate dispersible tablet and magnesium aluminum carbonate tablet for 8 weeks. The clinical data, symptom score and bile reflux degree under gastroscopy were statistically analyzed by SPSS16.0. Results: before treatment, there was no significant difference in sex, age, symptom distribution and bile reflux degree between the two groups (P 0.05), indicating that the two groups were comparable, and there were no adverse reactions between the two groups. After treatment, the symptoms of the two groups were improved to varying degrees, and the improvement of the main symptoms (epigastric distension, pain or fullness, belching and acid ingestion, hiccup, nausea and vomiting, stomach noise) was the same between the two groups; there were differences in the improvement of secondary symptoms (lack of food, loose stools, depression or irritability, bitter mouth and mouth) between the two groups (P 0.05), and the experimental group was superior to the control group in improving the secondary symptoms (lack of food, loose stools, depression or irritability, bitter mouth, dry mouth and mouth). The total effective rates of the experimental group and the control group were 86.7% and 63.3%, respectively. Compared with the two groups, the curative effect of TCM syndrome in the experimental group was better than that in the control group. Conclusion: Fangchai Shaohumembrane decoction has a good clinical effect on the treatment of liver-stomach disharmony BRG, has obvious advantages in improving the overall symptoms of the patients, can improve the overall quality of life of the patients, and has a good clinical application prospect.
【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】：2017
【分类号】：R259
本文编号：2507258
[Abstract]:Objective: to observe the clinical effect of Chaishao protective membrane decoction, which was created by professor Shan Zhaowei, on the basis of soothing liver and stomach protective membrane, in the treatment of hepatogastric bile reflux gastritis (bile reflux gastritis,BRG), and to provide a new idea and method for clinical treatment of BRG. Methods: 1 theoretical research: it is divided into the study of etiology and pathogenesis, diagnosis and treatment of BRG in modern medicine and the study of disease name, etiology and pathogenesis, syndrome differentiation, treatment principle and treatment of BRG in traditional Chinese medicine. 2 Clinical study: 60 patients with hepatogastric disharmony type BRG were randomly divided into experimental group (n = 30) and control group (n = 30). The experimental group (n = 30) was treated with mosapride citrate dispersible tablet and magnesium aluminum carbonate tablet for 8 weeks. The clinical data, symptom score and bile reflux degree under gastroscopy were statistically analyzed by SPSS16.0. Results: before treatment, there was no significant difference in sex, age, symptom distribution and bile reflux degree between the two groups (P 0.05), indicating that the two groups were comparable, and there were no adverse reactions between the two groups. After treatment, the symptoms of the two groups were improved to varying degrees, and the improvement of the main symptoms (epigastric distension, pain or fullness, belching and acid ingestion, hiccup, nausea and vomiting, stomach noise) was the same between the two groups; there were differences in the improvement of secondary symptoms (lack of food, loose stools, depression or irritability, bitter mouth and mouth) between the two groups (P 0.05), and the experimental group was superior to the control group in improving the secondary symptoms (lack of food, loose stools, depression or irritability, bitter mouth, dry mouth and mouth). The total effective rates of the experimental group and the control group were 86.7% and 63.3%, respectively. Compared with the two groups, the curative effect of TCM syndrome in the experimental group was better than that in the control group. Conclusion: Fangchai Shaohumembrane decoction has a good clinical effect on the treatment of liver-stomach disharmony BRG, has obvious advantages in improving the overall symptoms of the patients, can improve the overall quality of life of the patients, and has a good clinical application prospect.
【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】：2017
【分类号】：R259
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