柴百连苏饮联合四联疗法治疗慢性胃炎(肝胃不和)随机平行对照研究
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摘要
[目的]观察柴百连苏饮联合四联疗法治疗慢性胃炎(肝胃不和)疗效。[方法]使用随机平行对照方法,将84例门诊患者按就诊顺序号方法随机分为两组。对照组42例四联疗法,阿莫西林克拉维酸钾,1125mg/次,2次/d;克拉霉素,0.5g/次,2次/d;雷贝拉唑钠,20mg/次,2次/d;胶体果胶铋,150mg/次,4次/d。治疗组42例柴百连苏饮(吴茱萸3g,苏叶、白蔻仁、川黄连各5g,柴胡l0g,百合15g),水煎400mL,1剂/d,早晚分服;病程持久加丹参10g;疼痛严重加白芍10g,延胡索、甘草各5g;烧心加蒲公英10g;反酸加海螵蛸、瓦楞煅各10g;气滞加香附、青皮、川楝子、陈皮各10g;脾虚加白术、茯苓、白参各10g;阴虚加麦门冬、天门冬各15g;纳呆加谷芽、鸡内金、麦芽各10g;消食加黄芩10g;恶心呕吐加竹茹10g;溃疡严重加木蝴蝶10g;便溏加防风5g,白术、白芍、陈皮各10g;便秘去白蔻仁,加全瓜萎20g;四联疗法同对照组。连续治疗2周为1疗程。观测临床表现、不良反应。连续治疗2疗程(4周),判定疗效。[结果]治疗组显效28例,有效13例,无效1例,总有效率97.62%;对照组显效17例,有效18例,无效7例,总有效率83.33%;治疗组疗效优于对照组(P<0.05)。不良反应两组无显著差异(P>0.05)。[结论]柴百连苏饮联合四联疗法治疗慢性胃炎(肝胃不和),疗效满意,无严重不良反应,值得推广。
[Objective] To observe the curative effect of Chaibe Liansu decoction combined with quadruple therapy on chronic gastritis(Ganwei Buhe). [Method] 84 outpatients were randomly divided into two groups according to the order number of visits by randomized parallel control method. 42 patients in the control group received quadruple therapy, amoxicillin and clavulanate potassium, 1125 mg/time, twice a day; clarithromycin, 0.5 g/time, twice a day; rabeprazole sodium, 20 mg/time, twice a day; colloidal bismuth pectin, 150 mg/time, four times a day. In the treatment group, 42 cases of Chaibe Liansu decoction(Wuzhuyu 3 g, Suye, Baikouren, Chuanhuanglian each 5 g, Chaihu l0 g, Baihe 15 g) were decocted in water for400 mL, 1 dose/d, and taken separately in the morning and evening; duration of disease add Danshen 10 g;severe pain addBaishao 10 g, Yanhusuo, Gancao each 5 g; heartburn addPugongying 10 g; acid regurgitation add Haipiaoxiao, Walengzi each 10 g; stagnation of the circulation of vital energy add Xiangfu, Qingpi,Chuanlianzi, Chenpi each 10 g; insufficiency of the spleen add Baizhu, Fuling, Baishen each 10 g; Yin deficiency add Maidong, Tianmendong each 15 g; anorexia add Guya, Jineijin, Maiya each 10 g; dyspeptic retention add Huangqin 10 g; nausea and vomitting add Zhuru 10 g; ulcer add Muhudie 10 g; loose stool add Fangfeng 5 g, Baizhu, Baishao, Chenpi each 10 g; astriction remove Baikouren, add Quanguanlou20 g; quadruple therapy with the control group. Continuous treatment for 2 weeks is a course of treatment.Clinical manifestations and adverse reactions were observed. Continuous treatment for 2 courses(4 weeks)to determine the efficacy. [Result] In the treatment group, 28 cases were markedly effective, 13 cases were effective and 1 case was ineffective, the total effective rate was 97.62%. In the control group, 17 cases were markedly effective, 18 cases were effective and 7 cases were ineffective, the total effective rate was 83.33%.The curative effect of the treatment group was better than that of the control group(P<0.05). There was no significant difference in adverse reactions between the two groups(P>0.05). [Conclusion] Chaibe Liansu decoction combined with quadruple therapy for chronic gastritis(liver-stomach discord) has satisfactory curative effect and no serious adverse reactions, which is worthy of promotion.
[Objective] To observe the curative effect of Chaibe Liansu decoction combined with quadruple therapy on chronic gastritis(Ganwei Buhe). [Method] 84 outpatients were randomly divided into two groups according to the order number of visits by randomized parallel control method. 42 patients in the control group received quadruple therapy, amoxicillin and clavulanate potassium, 1125 mg/time, twice a day; clarithromycin, 0.5 g/time, twice a day; rabeprazole sodium, 20 mg/time, twice a day; colloidal bismuth pectin, 150 mg/time, four times a day. In the treatment group, 42 cases of Chaibe Liansu decoction(Wuzhuyu 3 g, Suye, Baikouren, Chuanhuanglian each 5 g, Chaihu l0 g, Baihe 15 g) were decocted in water for400 mL, 1 dose/d, and taken separately in the morning and evening; duration of disease add Danshen 10 g;severe pain addBaishao 10 g, Yanhusuo, Gancao each 5 g; heartburn addPugongying 10 g; acid regurgitation add Haipiaoxiao, Walengzi each 10 g; stagnation of the circulation of vital energy add Xiangfu, Qingpi,Chuanlianzi, Chenpi each 10 g; insufficiency of the spleen add Baizhu, Fuling, Baishen each 10 g; Yin deficiency add Maidong, Tianmendong each 15 g; anorexia add Guya, Jineijin, Maiya each 10 g; dyspeptic retention add Huangqin 10 g; nausea and vomitting add Zhuru 10 g; ulcer add Muhudie 10 g; loose stool add Fangfeng 5 g, Baizhu, Baishao, Chenpi each 10 g; astriction remove Baikouren, add Quanguanlou20 g; quadruple therapy with the control group. Continuous treatment for 2 weeks is a course of treatment.Clinical manifestations and adverse reactions were observed. Continuous treatment for 2 courses(4 weeks)to determine the efficacy. [Result] In the treatment group, 28 cases were markedly effective, 13 cases were effective and 1 case was ineffective, the total effective rate was 97.62%. In the control group, 17 cases were markedly effective, 18 cases were effective and 7 cases were ineffective, the total effective rate was 83.33%.The curative effect of the treatment group was better than that of the control group(P<0.05). There was no significant difference in adverse reactions between the two groups(P>0.05). [Conclusion] Chaibe Liansu decoction combined with quadruple therapy for chronic gastritis(liver-stomach discord) has satisfactory curative effect and no serious adverse reactions, which is worthy of promotion.
引文
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[14]高学敏.中药学[M].北京:中国中医药出版社,2007.
[2]肖菲.幽门螺杆菌与慢性胃炎[J].中国基层医药,2009,16(4):744-745.
[3]中华人民共和国卫生部.涉及人的生物医学研究伦理审查办法(试行)[S].(2007-03-26)[2017-03-01].http://www.moh.gov.cn/qjjys/s3581/200804/b9f1bfee4ab344ec892e68097296e2a8.shtml.
[4]中华中医药学会.慢性胃炎诊疗指南[J].中国中医药现代远程教育,2011,9(10):123-125.
[5]张声生,唐旭东,黄穗平,等.慢性胃炎中医诊疗专家共识意见(2017)[J].中华中医药杂志,2017,32(7):238-242.
[6]中国中西医结合学会消化系统疾病专业委员会.慢性胃炎中西医结合诊疗共识意见(2011·天津)[J].现代消化及介入诊疗,201217(3):172-177.
[7]李璟,李琪,王硕硕,等.隔物灸法对慢性胃炎患者胃黏膜保护的临床效应研究[J].世界科学技术-中医药现代化,2016,18(3):361-367.
[8]张慧琴.阿莫西林和阿莫西林克拉维酸钾的不良反应对比[J].基层医学论坛,2015,19(18):2539-2540.
[9]朱静,徐彦贵,高仲阳.克拉霉素的药理特性及应用[J].中国医院药学杂志,2001,21(9):551-553.
[10]赫宗军.雷贝拉唑钠治疗胃溃疡的疗效分析[J].中国现代药物应用,2008,2(15):62-63.
[11]李明泉,毕荣,刘娟.胶体果胶铋治疗慢性胃炎和消化性溃疡的临床观察[J].中国社区医师:医学专业,2008,10(4):32.
[12]周仲瑛.中医内科学[M].北京:中国中医药出版社,2004:196.
[13]区鸿斌,陶衔,金伟孝,等.“见肝之病,知肝传脾,当先实脾”理论及其临床应用[J].中医杂志,2011,53(12):1073-1075.
[14]高学敏.中药学[M].北京:中国中医药出版社,2007.