本文選題：益氣活血法 + 慢性萎縮性胃炎�。� 參考：《廣西中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:本課題通過益氣活血法治療慢性萎縮性胃炎方案與一般西醫(yī)基礎(chǔ)治療對照,探討健脾益氣、活血化瘀法對治療慢性萎縮性胃炎病理變化機(jī)制,為臨床實(shí)踐治療慢性萎縮性胃炎尋求并推廣科學(xué)、客觀、有效的中醫(yī)藥,提供新思路與方法。方法:選取慢性萎縮性胃炎脾虛、瘀阻證患者68例,按隨機(jī)數(shù)字表法分為兩組,每組34例,對照組給予西醫(yī)基礎(chǔ)治療,治療組以益氣活血法為原則(自擬益氣活血方加減),給予每日中藥一劑,水煎400ml,早晚分服。一療程均為4個(gè)月。一療程后觀察兩組患者治療前后臨床癥狀積分及胃鏡、病理組織檢查的療效差異。結(jié)果:治療4月后治療組Hp根除率為21.74%,對照組為77.27%(P0.01),有非常顯著差異,表明西醫(yī)對照組在根除Hp中優(yōu)于中醫(yī)治療組。兩組臨床總療效比較,經(jīng)治療,治療組總有效率為60.61%,對照組為36.36%,治療組有效率顯著高于對照組(P0.05),表明治療組優(yōu)于對照組。兩組臨床積分比較,治療組與對照組治療前后中醫(yī)證候總積分比較均有非常顯著差異(p0.01),表明兩組均能明顯改善患者臨床癥狀。治療組與對照組在治療后中醫(yī)證候總積分比較有非常顯著差異(p0.01)。表明治療組在改善患者臨床癥狀方面優(yōu)于對照組表明治療組在改善患者臨床癥狀方面優(yōu)于對照組。兩組治療后胃鏡下療效比較,治療組有效率為66.67%,對照組為42.42%,治療組有效率高于對照組(P0.05)。胃黏膜萎縮改善總療效比較,治療組有效率為63.63%,對照組為39.39%,治療組優(yōu)于對照組(P0.05)。胃竇黏膜萎縮改善療效比較,經(jīng)治后,治療組有效率為66.67%,對照組為36.36%,治療組優(yōu)于對照組(P0.05)。胃體萎縮改善療效比較,經(jīng)治后,治療組有效率為60.87%,對照組為33.33%,治療組優(yōu)于對照組(P0.05)。胃角萎縮改善療效比較經(jīng)治后,治療組有效率是64.00%,對照組為38.46%,優(yōu)于對照組(P0.05)。胃黏膜腸化情況療效比較,經(jīng)治后,治療組有效率為28.57%,對照組為5.00%,治療組高于對照組(P0.05)。胃黏膜上皮內(nèi)瘤變情況療效比較,經(jīng)治后,治療組有效率為22.22%,對照組為00.00%,治療組與對照組無明顯差異(P0.05)。結(jié)論:以益氣活血為法治療慢性萎縮性胃炎脾胃虛弱、胃絡(luò)瘀阻證中,不但能緩解臨床癥狀,還能改善黏膜病變及病理學(xué)情況,療效良好,安全,臨床有較高的深入研究價(jià)值。
[Abstract]:Objective: to study the pathological changes of chronic atrophic gastritis treated by invigorating qi and activating blood circulation, and comparing with the basic treatment of western medicine, and to explore the mechanism of strengthening spleen and invigorating qi and activating blood circulation and removing blood stasis in treating chronic atrophic gastritis. To seek and promote scientific, objective and effective Chinese medicine for clinical practice in the treatment of chronic atrophic gastritis, and to provide new ideas and methods for the treatment of chronic atrophic gastritis. Methods: Sixty-eight patients with chronic atrophic gastritis with spleen deficiency and stasis syndrome were divided into two groups, 34 cases in each group. The control group was treated with western medicine. In the treatment group, one dose of traditional Chinese medicine was given daily, 400 ml water decoction, taken separately in the morning and evening according to the principle of invigorating qi and activating blood circulation method (add or subtract from self-formulation of Yiqi Huoxue recipe). One course of treatment was 4 months. After one course of treatment, the difference of clinical symptom score, gastroscopy and histopathology between the two groups before and after treatment was observed. Results: the eradication rate of HP was 21.74 in the treatment group and 77.27% in the control group (P0.01), which indicated that the western medicine control group was superior to the traditional Chinese medicine group in the eradication of HP. After treatment, the total effective rate of the treatment group was 60.61, and that of the control group was 36.36. The effective rate of the treatment group was significantly higher than that of the control group (P0.05), which indicated that the treatment group was superior to the control group. There were significant differences between the treatment group and the control group before and after treatment (p0.01), indicating that the two groups can obviously improve the clinical symptoms of patients. There was significant difference between the treatment group and the control group in the total score of TCM syndromes after treatment (p 0.01). The results showed that the treatment group was superior to the control group in improving the clinical symptoms. The effective rate was 66.67 in the treatment group and 42.42 in the control group. The effective rate in the treatment group was higher than that in the control group (P0.05). Compared with the total curative effect of gastric mucosal atrophy, the effective rate of the treatment group was 63.63 and that of the control group was 39.39. The treatment group was superior to the control group (P0.05). After treatment, the effective rate of the treatment group was 66.67 and the control group was 36.36. The treatment group was superior to the control group (P0.05). After treatment, the effective rate of the treatment group was 60.87 and that of the control group was 33.33. The treatment group was superior to the control group (P0.05). The effective rate of the treatment group was 64.00 and that of the control group was 38.46, which was better than that of the control group (P0.05). After treatment, the effective rate of the treatment group was 28.57 and the control group was 5.00. The treatment group was higher than the control group (P0.05). After treatment, the effective rate of the treatment group was 22.2222 and the control group was 0.0.00. there was no significant difference between the treatment group and the control group (P0.05). Conclusion: the treatment of chronic atrophic gastritis with deficiency of spleen and stomach and stagnation of gastric collaterals can not only relieve clinical symptoms, but also improve mucosal pathological changes and pathology.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259

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