化浊解毒方治疗慢性萎缩性胃炎伴肠上皮化生的临床观察-中西医结合;临床专业论文.docxVIP

摘 要 摘 要 目的： 探讨化浊解毒方治疗慢性萎缩性胃炎伴肠上皮化生的临床治疗效果和作用机理。 方法： 将 108 例诊断为慢性萎缩性胃炎伴肠上皮化生并辨证为浊毒证的病人随机分为治疗 组和对照组，系统观察。治疗组 63 例，用化浊解毒方治疗，每日 1 剂，水煎取汁 300 mL 分早、晚 2 次服；对照组 45 例，口服胃复春片，每次 4 片，饭前 30 分钟服用，每日 3 次。治疗期间均停用其它药物，避免一些生冷、刺激性食物。两组均连续服药 180 天后， 对两组症状积分、胃镜及病理疗效和 Hp 清除率进行比较。 结果： 1. 两组治疗后痞满、疼痛、嗳气、纳差等症状积分均降低，与治疗前比较有统计学 意义(P0.05)；且两组治疗后症状积分比较差异有统计学意义(P0.05)，治疗组优于对照 组。 2. 治疗组和对照组治疗后胃镜疗效总有效率分别为 84.13%和 66.67%，比较差异有 统计学意义(P0.05)，治疗组优于对照组。3. 治疗组和对照组治疗后病理疗效总有效率 分别为 82.54%和 60.00%，比较差异有统计学意义(P0.05)，治疗组优于对照组。两组小 肠型病理疗效分别为 85.42%和 63.64%，差异有统计学意义(P0.05)；两组大肠型病理疗 效分别为 73.33%和 58.33%，比较差异无统计学意义(P＞0.05)。4. 治疗组和对照组 Hp 清除总有效率分别为 81.82%和 67.74%，比较差异无统计学意义(P＞0.05)。 结论： 1. 化浊解毒方能明显改善 CAG 伴 IM 患者痞满、疼痛、嗳气及纳差等临床症状， 其对症状改善程度优于胃复春。 2. 化浊解毒方能明显减轻 CAG 伴 IM 患者胃黏膜的炎症反应，并在一定程度上减 轻或消除肠上皮化生，其胃镜病理疗效优于胃复春。 3. 化浊解毒方能够有效地清除 Hp，但与胃复春组相比较无统计学意义。 关键词 慢性萎缩性胃炎 肠上皮化生 化浊解毒方 中医药 临床研究 I Abstract Abstract Objective: To explore the therapeutic efficacy and mechanism of Huazhuojiedufang on chronic atrophic gastritis with intestinal metaplasia. Methods: 108 patients diagnosised of chronic atrophic gastritis with intestinal metaplasia and turbidity toxic syndrome were randomly divided into treatment group and control group, with systematic observation. Treatment group(63 patients)were treated by Huazhuojie dufang on, 1 agent daily, decoction of 300 mL was divided into early and late 2 times service; the control group (45 patients) were treated by restoring spring, 4 piece of daily,3 times daily, 30 min before meal. Other drugs were deactivated during treatment progress, some cold，spicy food was avoided. Medication were taken continuously 180 days in the 2 groups. Symptom score、 gastroscope 、pathological efficacy and Hp clearance rate were compared between the 2 groups . Results: The scores of fullness, pain, belching, anorexia in 2 groups were decreased after treatment , compared to which before treatment ( P 0.05 ), and the treatment group was superior to control group( P 0.05 ). 2. The effective rate of gastroscopein the