本文關(guān)鍵詞：李振華脾胃肝臟腑同治辨證方法治療慢性萎縮性胃炎脾胃氣（陽）虛型的臨床研究　出處：《河南中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 李振華脾胃肝臟腑同治辨證方法 香砂溫中湯 慢性萎縮性胃炎 脾胃氣(陽)虛

【摘要】：目的:1.觀察李振華脾胃肝臟腑同治特色辨證方法的代表方香砂溫中湯治療慢性萎縮性胃炎(CAG)脾胃氣(陽)虛患者的有效性與安全性;2.評(píng)價(jià)李振華脾胃肝臟腑同治特色辨證方法較一般辨證方法的優(yōu)勢;3.探討香砂溫中湯的部分作用機(jī)理。方法:收集符合本研究病例納入標(biāo)準(zhǔn)并除外排除標(biāo)準(zhǔn)的慢性萎縮性胃炎200例。按西醫(yī)診斷標(biāo)準(zhǔn)和中醫(yī)辨證標(biāo)準(zhǔn)分為治療組99例,對(duì)照組101例。前組以李振華脾胃肝臟腑同治辨證方法進(jìn)行治療,后組以一般辨證方法進(jìn)行治療。兩組中有查Hp陽性者,可聯(lián)合殺滅幽門螺旋桿菌四聯(lián)療法治療14天,停藥1月后可用C13呼氣試驗(yàn)復(fù)查,檢查結(jié)果無論陽性或陰性都應(yīng)繼續(xù)按治療組或?qū)φ战M方案進(jìn)行。療程均為6個(gè)月,研究期間停用本實(shí)驗(yàn)以外的藥物。于開始治療前及療程結(jié)束后統(tǒng)計(jì)兩組中醫(yī)主癥、次癥及癥狀總積分和主要癥狀積分的變化,觀察兩組治療前后的主癥減輕及消失時(shí)間、癥候及胃黏膜病理的變化,統(tǒng)計(jì)數(shù)據(jù)后進(jìn)行分析。結(jié)果:1.兩組治療后中醫(yī)主癥、次癥、癥狀總積分均較治療前減少,差異具有統(tǒng)計(jì)學(xué)意義(P0.05),提示兩組均能改善CAG患者的癥狀;治療組治療后主癥減輕及消失時(shí)間均小于對(duì)照組,且差異具有顯著性(P0.05),提示治療組在減輕及改善CAG患者主要癥狀的時(shí)間上高于對(duì)照組,尤其是胃脘脹滿、胃脘隱痛、食后不易消化等方面(P0.05);治療組癥候治愈率為67.8%,高于對(duì)照組53.5%(P0.05);總有效率為94.9%,高于對(duì)照組93.1%(P0.05)。2.治療組胃黏膜萎縮治愈率為67.8%,高于對(duì)照組53.5%(P0.05);總有效率為73.9%,高于對(duì)照組42.6%(P0.05)。3.治療組胃黏膜腸上皮化生治愈率為67.8%,高于對(duì)照組53.5%(P0.05);總有效率為47.9%,高于對(duì)照組40.7%(P0.05)。4.在所納入的全部200份病例中,胃黏膜異型增生的共計(jì)有22例,由于其樣本量少,統(tǒng)計(jì)結(jié)果缺乏可檢驗(yàn)性,故未在文中具體描述。5.在本研究觀察過程中,未見明顯不良反應(yīng)。結(jié)論:1.李振華教授脾胃肝臟腑同治辨證法可明顯改善CAG脾胃氣(陽)虛型患者的一般狀況、主要癥狀,臨床療效確切;且其在改善及治愈癥狀的時(shí)間上優(yōu)于一般辨證方法。2.李振華教授脾胃肝臟腑辨證法可明顯改善及逆轉(zhuǎn)CAG脾胃氣(陽)虛型患者胃黏膜的萎縮,其綜合療效優(yōu)于一般辨證方法。3.李振華教授脾胃肝臟腑辨證法較一般辨證方法在改善及逆轉(zhuǎn)CAG脾胃氣(陽)虛型患者胃黏膜的腸化方面無顯著差異。4.李振華教授脾胃肝臟腑同治辨證方法療效肯定、安全可靠,可廣泛應(yīng)用于臨床。5.香砂溫中湯治療CAG近期療效確切,其作用機(jī)理可能有保護(hù)、修復(fù)胃黏膜,促進(jìn)胃排空、減輕癥狀,抗炎、增強(qiáng)免疫,改善循環(huán)、抑制萎縮等。
[Abstract]:Objective: To observe the liver spleen and stomach syndrome differentiation methods 1. Li Zhenhua Fu Tongzhi characteristics representative of Xiangsha Wenzhong Decoction in treating chronic atrophic gastritis (CAG) Spleen Qi (Yang) the efficacy and safety of virtual patients; 2. Li Zhenhua stomach liver organs Tongzhi differentiation methods than the general characteristics of dialectical method; 3. to investigate the mechanism of the effect of Xiangsha Wenzhong the soup. Methods: 200 cases of chronic atrophic gastritis, which were in accordance with the standard of this study and excluded from the standard, were collected. The treatment group was divided into 99 cases in the treatment group and 101 in the control group, according to the diagnostic standard of Western medicine and the standard of TCM syndrome differentiation. The former group was treated with the method of syndrome differentiation of Li Zhenhua's spleen and stomach liver and liver, and the latter group was treated with the general method of syndrome differentiation. In the two group, Hp positive patients were found to be able to kill Helicobacter pylori quadruple therapy for 14 days. After stopping the drug in January, the C13 breath test could be used to check the results. No matter positive or negative, the results should be continued according to the treatment group or the control group. The course of treatment was 6 months, and the drug was discontinued during the study. After the beginning of treatment and after the course of treatment, the changes of TCM syndromes, secondary symptoms, total symptom scores and main symptom scores of two groups were statistically analyzed. The changes of symptoms, symptoms, and gastric mucosal pathology in two groups before and after treatment were observed. Results: 1. of the two groups after treatment of TCM main symptoms and secondary symptoms, symptom scores were significantly reduced compared with before treatment, the difference was statistically significant (P0.05), suggesting that the two groups could improve the symptoms of CAG patients; the treatment group after treatment main symptoms alleviated or disappeared time were less than the control group, and the difference is significant (P0.05), the treatment group in reducing and improving the main symptoms of the patients with CAG time higher than that of control group, especially epigastric fullness, epigastric pain, after the food is not easy to digest and other aspects (P0.05); syndrome treatment group cure rate was 67.8%, 53.5% higher than the control group (P0.05); the total effective rate was 94.9%, higher than that of the control group 93.1% (P0.05). 2. the cure rate of gastric mucosa atrophy in the treatment group was 67.8%, higher than that of the control group (53.5% (P0.05)), and the total effective rate was 73.9%, higher than that of the control group (42.6% (P0.05)). 3. the cure rate of intestinal metaplasia in gastric mucosa was 67.8% in the treatment group, higher than that of the control group (53.5% (P0.05)), and the total effective rate was 47.9%, higher than that of the control group (40.7% (P0.05)). 4. in all the 200 cases of gastric dysplasia, a total of 22 cases, because of the small sample size, the lack of statistical test, it is not at the specific description. 5. in the study of this study, no obvious adverse reaction was found. Conclusion: 1. professor Li Zhenhua spleen liver organs Tongzhi dialectical method can obviously improve the CAG Spleen Qi (Yang) deficiency symptoms of general conditions and type of patients, clinical curative effect; and its superior in improvement and cure time of the symptoms on the general methods of syndrome differentiation. 2. professor Li Zhenhua spleen liver organs dialectical method can significantly improve the CAG and reversion of Spleen Qi (Yang) deficiency type in patients with gastric mucosal atrophy, the overall effect is better than the general method of differentiation. 3. professor Li Zhenhua spleen liver organs dialectical method than general dialectical method in improving CAG and reversion of Spleen Qi (Yang) no significant difference of intestinal mucosa in patients with type of deficiency of stomach. 4. professor Li Zhenhua's spleen and stomach liver and liver syndrome differentiation method is effective, safe and reliable, and can be widely used in clinical practice. The recent curative effect of 5. Xiangsha Decoction in the treatment of CAG precise temperature, its mechanism may protect and repair the gastric mucosa, promoting gastric emptying, reduce symptoms, anti-inflammatory, enhancing immunity, improving blood circulation, inhibit atrophy.
【學(xué)位授予單位】：河南中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R249;R259

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