从瘀论治慢性萎缩性胃炎的临床研究-中医内科学(消化方向)专业论文.docxVIP

中文摘要 慢性萎缩性胃炎（Chr oni c At r ophi c Gast r i t i s, CAG）是以胃粘膜变薄，固 有腺体萎缩或伴有肠上皮化生，异型增生为其病理特点的消化系统常见的疑难 病。属中医痞症，胃脘痛等范畴。因其病因病机复杂，病势缠绵且易癌变而倍受 重视。但目前西医治疗仅局限于针对幽门螺旋杆菌感染和消化不良等对症治疗， 而中医药治疗本病时，具有辨证论治，灵活加减，毒副作用小等特点，尤其是活 血化瘀法的应用，使中医药对本病的治疗显示出独特优势。本文从以下几个方面 阐述 CAG 从瘀论治的可行性。 文献综述：回顾中医学对 CAG 病名，病因病机，诊治研究情况以及对血瘀证 的认识，阐明了从瘀论治 CAG 的理论基础及诊治方法。为本课题的临床研究和导 师从瘀论治 CAG 经验的介绍奠定了基础。 临床研究：根据导师经验，结合辨证运用活血化瘀法治疗 CAG 血瘀证患者 45 例。结果显示，活血化瘀法对胃镜示萎缩、肠化、异型增生型 CAG 有效，并 能显著降低萎缩，肠化，异型增生的积分值，对临床症状，胃镜征象及血液流变 学指标均有明显的改善作用（P0. 01，0. 05）。结论：活血化瘀是 CAG 的治疗大 法。 导师从瘀论治 CAG 经验：从 CAG 病属“胃痞”，脾胃气虚为其本、瘀血阻络 为其标，气虚血淤、互为因果，辨证辨病相互结合，活血化瘀、贯彻始终，精于 配伍、善用药对等方面总结了导师从瘀论治 CAG 的经验，对临床治疗 CAG 有一定 的指导意义。 关键词：慢性萎缩性胃炎；活血化瘀法；临床研究；诊治经验 Abstract Chronic Atrophic Gastritis（CAG）is thinning gastric mucosa, or inherent gland atrophy with intestinal metaplasia, dysplasia features for the common problems of the digestive system. TCM is in Seoul, Epigastralgia areas. Because of complex etiology and pathogenesis of disease and easy Touching potential cancer and much attention. But only confined to Western medicine for treatment of Helicobacter pylori infection and symptomatic treatment, such as dyspepsia, and in the medical treatment of this disease, a syndrome differentiation, flexible, addition and subtraction, and the characteristics of drug side effects, especially Blood Circulation of the application, Chinese medicine in the treatment of the disease demonstrated unique strengths. This paper discusses the following CAG from the stasis of the feasibility of governance. Literature Review: The Name of Medicine on CAG, Etiology, Pathogenesis, Diagnosis and treatment of blood stasis, as well as on awareness, and elaborated on the Treatment of Stasis CAG from the theoretical basis and methods of diagnosis and treatment. Clinical research-oriented topics and instructors from the Blood Stasis CAG experience laid the foundation for the introduction. Clinical study: According to instructor experience with the use Syndrome Treatment of Blood Circulatio