黄芪建中汤与穴位贴敷联合西药治疗慢性胃炎(脾胃虚寒)随机平行对照研究
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摘要
[目的]观察黄芪建中汤结合穴位贴敷联合西药治疗慢性胃炎(脾胃虚寒)疗效。[方法]使用随机平行对照方法,将78例门诊患者按随机数字表法随机分为两组。对照组39例奥美拉唑,2次/d,1g/次,用药14d;阿莫西林,2次/d,1g/次,用药7d;胶体果胶铋,3次/d,1.5g/次,餐前30min口服,用药7d;甲硝唑,2次/d,0.5g/次,用药7d。治疗组39例黄芪建中汤结合穴位贴敷:黄芪建中汤(黄芪、桂枝、大枣、姜~生各9g,白芍18g,甘草~炙6g,饴糖30g),水煎200mL,2次/d,1剂/d;穴位贴敷,贴敷方:姜~干、肉桂、大茴香、补骨脂、公丁香、五味子、肉豆蔻、桂枝、花椒各30g,附子~制、吴茱萸各10g,上药打粉,待调制均匀后,用生姜汁拌成糊状,分60等分,使用胶布贴敷于胃俞(双侧)、脾俞(双侧)、神阙、中脘、足三里(双侧)、肾俞(双侧)等穴位,3h/次,1次/d;西药治疗同对照组。连续治疗14d为1疗程。观测临床表现、证候积分、不良反应。治疗1疗程(14d),判定疗效。[结果]治疗组显效20例,有效15例,无效4例,总有效率89.74%;对照组显效13例,有效15例,无效11例,总有效率71.79%;治疗组疗效优于对照组(P<0.05)。证候积分两组均有改善(P<0.01),治疗组改善优于对照组(P<0.05,P<0.01)。不良反应治疗组低于对照组(P<0.05)。[结论]黄芪建中汤结合穴位贴敷联合西药治疗慢性胃炎(脾胃虚寒),疗效满意,无严重不良反应,值得推广。
[Objective] To observe the curative effect of Huangqi Jianzhong decoction combined with acupoint application and western medicine on chronic gastritis(spleen-stomach deficiency and cold). [Method] 78 outpatients were randomly divided into two groups by random number table method. In the control group,39 patients were treated with omeprazole twice a day, once a g, for 14 days; amoxicillin, twice a day, once a g, for 7 days; colloidal bismuth pectin, three times a day, 1.5 g/time, 30 minutes before meal, for 7 days;metronidazole, twice a day, 0.5 g/time, for 7 days. 39 cases in the treatment group were treated with Huangqi Jianzhong decoction combined with acupoint application: Huangqi Jianzhong decoction(Huangqi, Dazao,Shengjiang each 9 g, Baishao 18 g, Zhigancao 6 g, Yitang 30 g), 200 mL for decoction, 2 times a day, 1 dose a day; Acupoint application, application prescription: dried ginger, cinnamon, fennel, Buguzhi, clove,Schisandra chinensis, nutmeg, cinnamon branch, pepper, 30 g for aconite, 10 g for Fructus evodiamond, 10 g for powder. After being evenly prepared, ginger juice was mixed into paste, divided into 60 equal parts, and applied to Weishu(bilateral), Pishu(bilateral), Shenque, Zhongwan, Zusanli(bilateral), Shenshu(bilateral)and other acupoints with adhesive tape for 3 hours, once a day. Western medicine treatment was the same as the control group. Continuous treatment for 14 days is a course of treatment. Clinical manifestations, syndrome scores and adverse reactions were observed. One course of treatment(14 days) was used to determine the curative effect. [Result] In the treatment group, 20 cases were markedly effective, 15 cases were effective, 4 cases were ineffective, and the total effective rate was 89.74%. In the control group, 13 cases were markedly effective, 15 cases were effective and 11 cases were ineffective, the total effective rate was 71.79%. The curative effect of the treatment group was better than that of the control group(P<0.05). Syndrome scores were improved in both groups(P<0.01), and the improvement in treatment group was better than that in control group(P<0.05, P<0.01). The adverse reactions in the treatment group were lower than those in the control group(P<0.05). [Conclusion] Huangqi Jianzhong decoction combined with acupoint application combined with western medicine in the treatment of chronic gastritis(spleen and stomach deficiency and cold)has satisfactory curative effect and no serious adverse reactions, which is worthy of promotion.
[Objective] To observe the curative effect of Huangqi Jianzhong decoction combined with acupoint application and western medicine on chronic gastritis(spleen-stomach deficiency and cold). [Method] 78 outpatients were randomly divided into two groups by random number table method. In the control group,39 patients were treated with omeprazole twice a day, once a g, for 14 days; amoxicillin, twice a day, once a g, for 7 days; colloidal bismuth pectin, three times a day, 1.5 g/time, 30 minutes before meal, for 7 days;metronidazole, twice a day, 0.5 g/time, for 7 days. 39 cases in the treatment group were treated with Huangqi Jianzhong decoction combined with acupoint application: Huangqi Jianzhong decoction(Huangqi, Dazao,Shengjiang each 9 g, Baishao 18 g, Zhigancao 6 g, Yitang 30 g), 200 mL for decoction, 2 times a day, 1 dose a day; Acupoint application, application prescription: dried ginger, cinnamon, fennel, Buguzhi, clove,Schisandra chinensis, nutmeg, cinnamon branch, pepper, 30 g for aconite, 10 g for Fructus evodiamond, 10 g for powder. After being evenly prepared, ginger juice was mixed into paste, divided into 60 equal parts, and applied to Weishu(bilateral), Pishu(bilateral), Shenque, Zhongwan, Zusanli(bilateral), Shenshu(bilateral)and other acupoints with adhesive tape for 3 hours, once a day. Western medicine treatment was the same as the control group. Continuous treatment for 14 days is a course of treatment. Clinical manifestations, syndrome scores and adverse reactions were observed. One course of treatment(14 days) was used to determine the curative effect. [Result] In the treatment group, 20 cases were markedly effective, 15 cases were effective, 4 cases were ineffective, and the total effective rate was 89.74%. In the control group, 13 cases were markedly effective, 15 cases were effective and 11 cases were ineffective, the total effective rate was 71.79%. The curative effect of the treatment group was better than that of the control group(P<0.05). Syndrome scores were improved in both groups(P<0.01), and the improvement in treatment group was better than that in control group(P<0.05, P<0.01). The adverse reactions in the treatment group were lower than those in the control group(P<0.05). [Conclusion] Huangqi Jianzhong decoction combined with acupoint application combined with western medicine in the treatment of chronic gastritis(spleen and stomach deficiency and cold)has satisfactory curative effect and no serious adverse reactions, which is worthy of promotion.
引文
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[13]高学敏.中药学[M].北京:中国中医药出版社,2007.
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[15]张玉会.穴位贴敷的治疗和护理[J].医学信息,2015,28(22):161.
[16]崔晨华,徐涓.深刺中脘穴临床验案4则[J].光明中医,2010,25(1):78-79.
[17]张光磊.浅谈足三里穴的效能[J].中外医疗,2008,27(19):157-158.
[18]王泽涛,欧阳亮.背俞穴的临床应用[J].中华中医药学刊,1991,20(5):30-31.
[19]刘克勤.艾灸神阙穴辅助治疗胃脘痛的效果观察[J].光明中医2017,32(8):1153-1154.
[2]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.
[3]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,2012,17(3):172-177.
[4]周仲瑛.中医内科学[M].北京:中国中医药出版社,2004:196.
[5]国家中医药管理局.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002.
[6]姚希贤.慢性胃炎的病原学与病理改变[J].现代医药卫生,2000(2):68-69.
[7]席银雪,彭挺生.慢性胃炎与胃癌组织中微血管密度和黏附分子表达的对比研究[J].中国医师进修杂志,2011,34(13):17-20.
[8]郑加嘉.奥美拉唑药理作用及其临床应用分析[J].中国中医药现代远程教育,2010,8(11):91-92.
[9]王淑丽.阿莫西林药理机制及临床应用分析[J].中国现代药物应用,2015,9(3):251-252.
[10]于淑郁,任连文.甲硝唑的药理及临床应用[J].工企医刊,1996,9(1):157-158.
[11]岂春风.胶体果胶铋胶囊临床疗效及药理毒理研究[J].黑龙江中医药,2008(4):47.
[12]张仲景.金匮要略方论[M].北京:人民卫生出版社,2012:23.
[13]高学敏.中药学[M].北京:中国中医药出版社,2007.
[14]万幸,刘倩娴,陈妙欢.黄芪建中汤和补中益气汤对脾虚模型小鼠免疫调节作用的实验研究[J].中国实验方剂学杂志,19984(5):24-27.
[15]张玉会.穴位贴敷的治疗和护理[J].医学信息,2015,28(22):161.
[16]崔晨华,徐涓.深刺中脘穴临床验案4则[J].光明中医,2010,25(1):78-79.
[17]张光磊.浅谈足三里穴的效能[J].中外医疗,2008,27(19):157-158.
[18]王泽涛,欧阳亮.背俞穴的临床应用[J].中华中医药学刊,1991,20(5):30-31.
[19]刘克勤.艾灸神阙穴辅助治疗胃脘痛的效果观察[J].光明中医2017,32(8):1153-1154.