本文選題：慢性糜爛性胃炎 + 失眠癥　； 參考：《湖北中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:l.觀察欣胃安神湯治療慢性糜爛性胃炎并失眠癥(肝郁脾虛型)患者在治療前后胃鏡分級,體重變化,失眠、主觀癥狀相關(guān)測評量表積分的變化,探討欣胃安神湯的臨床意義。2.總結(jié)甘愛萍教授臨床經(jīng)驗,為慢性糜爛性胃炎并失眠癥的中醫(yī)中藥治療提供新思維,提高臨床療效。方法:1.選取湖北省中醫(yī)院脾胃科甘愛萍教授專家門診,西醫(yī)確診為慢性糜爛性胃炎并失眠癥,中醫(yī)辨證分型為肝郁脾虛證的64例患者,選取就診的先后順序隨機分為治療組和對照組各32例。2.治療組服用“欣胃安神湯”加減治療,對照組服用雷貝拉唑鈉腸溶膠囊聯(lián)合艾司唑侖片,兩組均連續(xù)治療6周。3.分別于治療前(0天)和治療后(第6周±3天和6個月±3)進行評估(進行胃鏡檢查、稱重、填寫PSQI及肝郁脾虛證癥狀分級量化標準表),同時記錄試驗過程中安全性指標及不良反應(yīng)發(fā)生率。4.所有數(shù)據(jù)采用SPSS19.0統(tǒng)計軟件包進行分析處理,其中計量資料用t檢驗,計數(shù)資料采用卡方檢驗,等級資料采用Ridit分析,所有統(tǒng)計結(jié)果均以P0.05表示有統(tǒng)計學(xué)意義。結(jié)果:1.治療組未按規(guī)定服藥無法評價療效者2例,對照組服藥期間1例合并嚴重疾病,將其剔除,自行退出1例,最終完成臨床觀察病例60例。2.治療組和對照組都能促進胃黏膜糜爛愈合且兩者療效相似。3.治療組和對照組都能改善睡眠障礙,提高睡眠質(zhì)量,且改善程度沒有明顯差異。4.兩組藥物均可改善患者肝郁脾虛證癥狀,但治療組改善程度優(yōu)于對照組。5.治療組在防治患者體重減輕方面優(yōu)于對照組。6.治療組與對照組均未發(fā)生明顯不良反應(yīng)。7.治療6個月后所選患者復(fù)發(fā)情況對比,治療組在PSQI評分、中醫(yī)證候的復(fù)發(fā)率均低于對照組(P0.05),說明在遠期療效方面,治療組優(yōu)于對照組。結(jié)論:欣胃安神湯不但能促進慢性糜爛性胃炎的胃黏膜愈合,也能緩解患者的失眠癥狀,減少睡眠障礙及催眠藥物的應(yīng)用,提高患者睡眠質(zhì)量;增加患者體重,并對患者癥狀改善上比西藥有明顯的優(yōu)勢。在安全性觀測方面未發(fā)現(xiàn)明顯不良反應(yīng),遠期療效滿意,復(fù)發(fā)率低。此研究為慢性糜爛性胃炎并失眠癥的中醫(yī)中藥治療提供新思維,欣胃安神湯較單純西醫(yī)療法有明顯的優(yōu)勢,值得在臨床上推廣應(yīng)用。
[Abstract]:Objective: To observe the changes of gastroscopy, weight change, insomnia, and subjective symptom related assessment scales before and after treatment for patients with chronic erosive gastritis and insomnia (liver depression and spleen deficiency) in the treatment of chronic erosive gastritis and insomnia (liver depression and spleen deficiency) in the treatment of chronic erosive gastritis and insomnia. The clinical significance of Professor Gan Aiping's clinical experience for chronic erosive gastritis and insomnia was evaluated by L.. The treatment of Chinese medicine and Chinese medicine provides new thinking and improves clinical efficacy. Methods: 1. select the expert outpatient of Professor Ai Ping of the spleen and stomach of Hubei Provincial Traditional Chinese Medical Hospital, the western medicine is diagnosed as chronic erosive gastritis and insomnia, and the TCM syndrome differentiation is divided into 64 patients with liver depression and spleen deficiency syndrome, which are randomly divided into the treatment group and the control group with 32 cases of.2. treatment. The treatment group took "Xin Wei Anshen Decoction" plus or minus treatment, the control group took Rabeprazole Sodium Enteric-coated Capsules combined with Estazolam Tablets, the two groups were treated continuously for 6 weeks.3. before treatment (0 days) and after treatment (sixth weeks + 3 days and 6 months + 3). (gastroscopy, weight, fill in PSQI and liver depression and spleen deficiency syndrome classification standard table), At the same time, the safety index and the incidence of adverse reactions were recorded in the test process.4. all data were analyzed with SPSS19.0 software package, in which the measurement data were tested with T, counting data were checked by chi square test, and Ridit analysis was used for grade data. All the statistical results were statistically significant with P0.05. Results: 1. treatment group did not press the data. 2 cases were unable to evaluate the curative effect, 1 cases of the control group were combined with serious diseases during the period of taking medicine, and they were eliminated, and 1 cases were exited by themselves. In the final clinical observation, 60 cases of.2. treatment group and control group were all able to promote the healing of gastric mucosa erosion and both of the two groups could improve sleep disorders and improve sleep quality, and the quality of sleep was improved. There was no obvious difference in good degree between.4. two groups, but the improvement of the treatment group was better than that of the control group.5. in the control group. There was no significant adverse reaction between the control group and the control group, the.6. treatment group and the control group had no obvious adverse reaction. The treatment group was compared with the 6 months after the treatment, and the treatment group was in PS. QI score, the recurrence rate of TCM syndrome is lower than that of the control group (P0.05), indicating that in the long-term effect, the treatment group is superior to the control group. Conclusion: Xinwei Anshen Decoction can not only promote the healing of the gastric mucosa of chronic erosive gastritis, but also relieve the symptoms of insomnia, reduce the sleep barrier and the application of hypnotic drugs, and increase the quality of sleep of the patients; The patient's weight and the improvement of the patient's symptoms have obvious advantages over western medicine. There is no obvious adverse reaction in the safety observation. The long-term effect is satisfactory and the recurrence rate is low. This study provides new thinking for the treatment of chronic erosive gastritis and insomnia in traditional Chinese medicine. Clinical application.

【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R259;R256.23

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