發(fā)布時間：2018-07-07 08:15

  本文選題：慢性糜爛性胃炎 + 行氣通絡法��； 參考：《南京中醫(yī)藥大學》2017年碩士論文

【摘要】：目的:本研究旨在挖掘及整理導師運用行氣通絡方治療胃絡瘀阻型慢性糜爛性胃炎的的臨床經驗,觀察行氣通絡法治療胃絡瘀阻型慢性糜爛性胃炎的臨床療效,及內鏡、病理下改善情況,和對血清胃泌素(G-17)與血清胃蛋白酶原(PG)的影響。探究行氣通絡法治療胃絡瘀阻型慢性糜爛性胃炎可能的機理,為行氣通絡方的臨床應用及推廣提供更多證據。方法:為體現隨機化原則,采用隨機數字表法將來自昆山市中醫(yī)院門診及住院部的60例患者分為治療組組和對照組,每組各30例。這些患者都經胃鏡及病理診斷為慢性糜爛性胃炎,且中醫(yī)辨證屬于胃絡瘀阻證型。治療組給予導師擬定行氣通絡方治療,對照組給予奧美拉唑腸溶膠囊及鋁碳酸鎂治療,兩組療程均為一個月,觀察2個療程。觀察兩組在治療前后的綜合療效、中醫(yī)證候療效、癥狀積分、黏膜病變改善及治療組治療前后血清中G-17與PG的變化情況。結果:(1)在中醫(yī)療效評價中,兩組病人的中醫(yī)療效評價存在統計學差異(P0.05),兩組病人在治療前后胃脘痛、胃脘痞滿、胸脅痛、食欲減退、噯氣的評分有統計學差異(P0.05),治療后兩組病人在胸脅脹痛、食欲減退、噯氣的評分有統計學差異(P0.05)。在胃脘痛及胃脘痞滿方面評分無統計學差異(P0.05)。(2)在糜爛灶療效的評價中,治療后兩組糜爛灶療效有統計學差異(P0.05),兩組治療前后黏膜糜爛灶評分有統計學差異(P0.05),治療后兩組的黏膜糜爛灶評分有統計學差異(P0.05)。(3)在病理組織學的評價中,兩組病人經治療后萎縮及腸化評分均有統計學差異(P0.05)。(4)治療組中的胃竇萎縮組血清G-17水平在治療前后有統計學差異(P0.05),而PG水平無統計學差異(P0.05)。結論:1.行氣通絡法能顯著改善胃絡瘀阻型慢性糜爛性胃炎患者的臨床癥狀。2.行氣通絡法能顯著修復胃絡瘀阻型慢性糜爛性胃炎患者的糜爛灶及改善其腺體萎縮和腸上皮化生。3.行氣通絡法可在一定程度提升胃絡瘀阻型慢性糜爛性胃炎患者的血清G-17水平。
[Abstract]:Objective: the purpose of this study was to excavate and sort out the clinical experience of the tutor in treating chronic erosive gastritis of the type of stagnation of gastric collaterals with Xingqi Tongluo recipe, and to observe the clinical effect and endoscopy of the treatment of chronic erosive gastritis of the type of gastric meridian stasis with the method of Qi Tongluo. Pathological changes and effects on serum gastrin (G-17) and serum pepsinogen (PG). To explore the possible mechanism of treating chronic erosive gastritis with Qi Tongluo method in order to provide more evidence for clinical application and popularization of Xingqi Tongluo recipe. Methods: in order to embody the principle of randomization, 60 patients from outpatient and inpatient department of Kunshan traditional Chinese Medicine Hospital were divided into treatment group and control group with 30 cases in each group. These patients were diagnosed by gastroscopy and pathology as chronic erosive gastritis. The treatment group was treated with Qi Tongluo recipe, while the control group was treated with omeprazole enteric capsule and magnesium bicarbonate. The two groups were treated for one month and two courses of treatment were observed. To observe the comprehensive curative effect before and after treatment, the curative effect of TCM syndrome, the symptom score, the improvement of mucosal lesion and the changes of serum G-17 and PG before and after treatment in the two groups. Results: (1) in the evaluation of TCM curative effect, there was statistical difference between the two groups (P0.05). Before and after treatment, the patients in the two groups had epigastric pain, epigastric fullness, chest and hypochondriac pain, anorexia. The score of belching was statistically different (P0.05), the two groups of patients in chest and flank pain, appetite loss, belching scores were statistically different after treatment (P0.05). There was no significant difference in the scores of epigastric pain and epigastric fullness (P0.05). (2) in the evaluation of the curative effect of erosive foci. After treatment, there were significant differences in the curative effect between the two groups (P0.05), the scores of mucosal erosions in the two groups before and after treatment were statistically different (P0.05), and the scores of mucosal erosions in the two groups (P0.05). (3) were significantly different in the evaluation of histopathology after treatment. Two groups of patients after treatment atrophy and intestinal metaplasia scores were statistically different (P0.05). (4) in the treatment group antrum atrophy group serum G-17 level before and after treatment (P0.05), but no significant difference in PG level (P0.05). Conclusion 1. Qi Tongluo method can significantly improve the clinical symptoms of chronic erosive gastritis. The method of Qi Tongluo can significantly repair the erosive foci and improve the gland atrophy and intestinal metaplasia in patients with chronic erosive gastritis. The method of Qi Tongluo can improve the serum G-17 level of patients with chronic erosive gastritis.
【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R259

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