摘要
目的：观察疏肝理气理气和胃法治疗慢性浅表性胃炎的临床疗效以及对患者生活质量、临床常见症状改善情况；探讨其作用机制。
方法：采用随机对照研究,将符合研究标准的80例慢性浅表性胃炎患者随机分为治疗组和对照组。治疗组以疏肝理气和胃方治疗,辅以饮食调理、心理治疗。对照组以多潘立酮片和复方铝酸铋颗粒治疗；辅以饮食调理、心理治疗。两组均以4周为1个疗程,分别于治疗前、治疗后各观察一次,共观察1个疗程。主要观察两组疗效,治疗前后症状积分比较,胃镜检查改善情况,及生活质量改变以评定疏肝理气和胃法的临床疗效。采用SPSS16.0统计软件对相关数据进行处理,得出结论。
结果：在改善各临床症状方面：两组各临床症状均能得到较大改善(P<0.05),在中医证侯疗效方面：两组中医证侯总积分均有明显改善(P<0.01),两组间比较治疗组的疗效优于对照组(P<0.05)；两组证候综合疗效比较,治疗组总有效率为91.5%,对照组总有效率为80.5%,两组比较有显著性差异(P<0.05)；在改善生活质量方面：两组多个维度的量表得分较治疗前有提高(P<0.05),而组间部分维度量表得分有明显差异(P<0.05).
结论：两组均能显著地改善慢性浅表性胃炎患者各临床症状、中医证侯及生活质量；两组间比较,治疗组的治疗效果稍优于对照组,疏肝理气和胃法在治疗慢性浅表性胃炎患者方面具有良好的临床疗效,其突出疗效与其组方严谨、切中病机有关。提示中医药在本病的治疗上有一定的优势,有进一步研究和探讨的价值。
Objective To observe the clinical curative effect of treating the type of Soothing of liver, adjusting qi and regulating stomach of chronic superficial gastritis, and the effect it caused to improve the quality of life and patient's clinical symptoms, and explore the mechanism from clinical aspects.
Methods 80 cases with CSG are divided into two groups at random. Soothing of liver, adjusting qi and regulating stomach Decoction was given to treatment group.The control group was given Much PanLi ketone and compound bismuth aluminate granules. two groups are supplemented by dietary conditioning and psychological treatment. Four weeks for a course of treatment, to observe the related symptoms symptoms gastroscopic effect and quality of life at respectively time when before treatment、after treatment, in order to assess the clinical curative effect of this method. SPSS16. statistical software will be used for processing data and drawing conclusions.
Results In improving the clinical symptoms:two groups were greatly improved (P<0.05), In the syndromes of Chinese medicine efficacy:Clinical research showed that in the treatment group the total effective rate was91.5%, patho-effective rate was 80.5%; there has statistical significancet about total effective rate (p<0.05) and patho-effective rate in two groups. In improve the quality of life:more than two-dimensional degree of scale scores has been improved compared with before treatment, while the scores for each dimension between two groups was no significant.
Conclusion Two groups are significantly improve patient's clinical symptoms、syndromes in Chinese Medicine and the quality of life; compared the clinical curative effect, the treatment group is slightly better than the control group, This method have a good clinical efficacy, its outstanding efficacy is related to its rigorous structure and stringent hit the pathogenesis. Chinese medicine have certain advantages in treating this disease, and value to give further study and exploration value.
引文
[1].刘建红.幽门螺杆菌感染与上消化道疾病的关系[J]中华医学丛刊.2004..4(1)：40-41
[2].王吉耀,廖二元,胡品津,等.内科学(供8年制及7年制临床医学等专业用)[M]北京：人民卫生出版社,2005:444—449.
[3].中华医学会消化病学分会.中国慢性胃炎共识意见.[J]现代消化及介入诊疗2007;12(1)：55
—62.孟国栋;孟彦荣;东垣补土法辨治慢性胃炎399体会[J]内蒙古中医药2002;05
[4]谢晓平慢性浅表性胃炎中西医研究进展[J]光明中医2008 6(6)：885-886
[5]张学英,邓小煌.疏肝行气汤治疗慢性浅表性胃炎50例.[J]浙江中医杂志,2006.41：279.
[6]孟国栋;孟彦荣;东垣补土法辨治慢性胃炎399体会[J]内蒙古中医药2002；05
[7]王奎平从气论治疗慢性浅表性胃炎六法[J]江苏中医药2003.24(57)：50-51
[8]胡一莉慢性胃炎从湿热论治[J]光明中医2002.17(5)：19-20
[9]卫永琪辨证治疗慢性浅表性胃炎81例[J].实用中医药杂志2005,21(1)：12-13
[10]吴俊良辨证治疗慢性浅表性胃炎200例[J].辽宁中医杂志.1994.21(9)：405
[11]李培君 中医辨证治疗慢性浅表性胃炎300例[J]新消化病学杂志,1997.5(8)：484
[12]赵崇信 辨证治疗慢性浅表性胃炎92例[J]河南中医学院学报,2003.18(5)：48—49
[13]杨郎 辨证治疗慢性浅表性胃炎119例[J]山西中医2004.20(1)：16-17
[14]薛堂语.柴胡疏肝散合金铃子散治疗慢性浅表性胃炎60例临床观察.[J]四川中医,2003,21(9)：40-41.
[15]韦麟 半夏泻心汤合四逆散加减治疗慢性浅表性胃炎[J]现代中西医结合杂志2009,18(9)
[16]王钢 刘红玉.温胆汤加减方治疗慢性浅表性胃炎58例[J]现代中西医结合杂志,2004,13(3)
[17]李宏艳 宋书宁.半夏泻心汤加减治疗慢性浅表性胃炎39例临床观察[J]北京中医药2010,29(9)：691-692
[18]李建松黄连汤加味治疗慢性浅表性胃炎80例临床观察[J]光明中医,2009,24(6).
[19]王拥军,王志恒加味香苏饮治疗慢性浅表性胃炎90例临床观察[J]第三届世界中西医结合大会论文摘要集,2007,09
[20]张正元胃宁颗粒治疗慢性浅表性胃炎120例临床观察[J]中医药临床杂志,2004,16(2)：122—123.
[21]刘浩端.中药和胃方治疗慢性浅表性胃炎临床观察[J]亚太传统医药,2010,06(8).
[22]里震,徐洪军黄芪建中汤加吴茱萸治疗慢性浅表性胃炎38例[J]中国中医药现代远程教育2009,12：195
[23]符少杨逍遥汤治疗慢性浅表性胃炎56例观察[J]实用中医药杂志2003,05：524-525
[24]卫立全.董楠周云松中西医结合治疗慢性浅表性胃炎80例临床观察[J]基层医学论坛,2010,14(22)：739-740
[25]朱红梅.中西医结合治疗慢性浅表性胃炎126例疗效观察[J]齐齐哈尔医学院学报2010.17：2728
[26]欧琴何坚中西医结合治疗肝气郁结型慢性浅表性胃炎临床疗效观察[J]广西中医药2002.25(6)：14-15
[27]何泽成中西医结合治疗慢性浅表性胃炎临床观察[J]基层医学论坛2010,14：440-441
[28]孙从业.黄亚娟幽门螺杆菌感染与上消化道疾病研究进展见：中国幽门螺杆菌研究.北京：科学技术文献出版社1997:41
[29]Lahner E, Bordi C, Cattaruzza MS, et al. Long-term follow-up in atrophic body gastritis patients; atrophy and intestinal meta-plasia are persistent lesions irrespective of Helicobacter pylorinfection. Aliment Pharmacol Ther,2005,22:471-481
[30]王见义,康正祥.幽门螺旋杆菌致病机制与治疗研究进展[J].甘肃中医学院学报,2000：17(4)：36-39.
[31]张万岱,曾锦章 胆汁反流性胃炎的病因病机和诊治进展[J].现代消化及介入诊疗,2004,9(1)：31-33
[32]刘文忠幽门螺杆菌感染、慢性胃炎和功能性消化不良[J]中华消化杂志2002,22：581-582
[33]Talley NJ, Vakil NB, Moayyedi P A American gastroenterological association technical review on the evaluation of dyspepsia. Gastroenterology 2005;129:1756-1780
[34]杜娟,王秀琴.胃泌素的生物活性及其信号传导通路.解剖科学进展,2003,9：347-352.
[35]Guslandi M, Ferrero S, Fusillo M. Sucralfate gel for sympto-matic chronic gastritis: multicentre comparative trial versussucralfate suspension. Ital J Gastroenterol,1994, 26:442-445.
[36]Haruma K, Ito M. Review article:clinical significance of mucosal-protective agents: acid, inflammation, carcinogenesis and rebamipidc. Aliment Pharmacol Thcr,2003,18(Suppl 1):153-159
[37]Ohta Y, Kobayashi T, Imai Y, et al. Effect of gefarnate on acute gastric mucosal lesion progression in rats treated with compound 48/80, a mast cell degranulator, in comparison with that of teprenone. Biol Pharm Bull,2005,28:1424-1430.
[38]Pearson JP, Roberts NB. Mucosal protective effects of ecabet sodium:pepsin inhibition and interaction with mucus. Clin Sci(Lond),2001,100:411-417.
[39]Aktas A, Caner B, Ozturk F, et al. The effect of trimebutine maleate on gastric emptying in patients with non-ulcer dyspepsia. Ann Nucl Med,1999.13:231-234.
[40]Taylor KM,Harris AW. Itopride for functional dyspepsia. N Engl J Med,2006,354; 2392.
[41]Seno H, Nakase H, Chiha T. Usefulness of famotidine in functional dyspepsia patient treatment:comparison among prokinetic, acid suppression and antianxiety therapies. Aliment Pharmacol Ther,2005,21(Suppl2):32-36.
[42]方积乾,郝元涛,等.生存质量测定方法及应用[M].北京：北京医科大学出版社,2000：263-268.
[43]Ware JE, Snow KK, Kosinski M, etal. SF-36 Health Survey Manual and interpretation guide. Boston[J]. MA:New England Medical Center, The Health Institute,1993.
[44]王晓南,高鹏,刘文娟,等.柴胡在消化系统疾病中应用现状[J].中国现代药物应用,2008,2(20)：114-115.
[45]李岩,陈苏宁.芍药甘草汤、四逆散对胃排空及小肠推进功能影响的拆方研究[J].中华消化杂志,1996,16(1)：25.
[46]沈映君.中药药理学[M].上海：上海科技出版社,1997,107.
[47]王志强,李炳超,半夏药理研究进展[J].山西医药杂志2009,1(38)：65-67
[48]林红,唐静芬.枳实消痞丸对大鼠胃排空影响的实验研究[J].中华消化杂志,1999,19(1)：46-47.
[49]朱自平,张明发,沈雅琴等,厚朴对消化系统的药理作用[J].中医研究2004,17(2),21
[50]宿树兰,枳壳的研究进展[J]中药材,2001,3(24)：222-224
[51]Kimura-M, Kimura-I, et al. Blocking effects of a new component, paeoniflorigenone,
in paeony root on neuromuscular junctions of frogs and mice[J]. Jpn-J-Pharmacol,1984,35(1): 61.
[52]朱金照等.15味中药促胃肠动力作用的筛选研究[J].第三军医大学学报,2000,22(5)：436.
[53]王小英,木香对大鼠实验性急性胃粘膜损伤的影响[J]中医研究2004,17(2),21
[54]高学敏.中药学[M].北京：中国中医药出版社,2005：56.
[55]纪贤凯,谢如华.蒲公英冲剂治疗幽门螺旋杆菌的临床疗效观察,实用中西医结合杂志,1995,8(1)：17.
[56]黄玲,黄萍,王建华等.党参川芍蒲公英及其配伍抗胃溃疡及抗胃粘膜损伤作用与机制研究.中药药理与临床,1991,7(5)：10.
[57]徐艺,叶柏,单兆伟,等.中草药单味与复方对幽门螺杆菌抑菌作用研究[]].中国中西医结合脾胃杂志,2000,8(5)：292-293.
[58]赵敏华,吴清和.木香肠胃康胶囊对肠道功能的影响[J].中药材,2001,24(8)：590-591