【摘要】：目的:學(xué)習(xí)運(yùn)用周學(xué)文老教授臨床經(jīng)驗(yàn)方劑“解毒清熱,消癰生肌”的方法治療毒熱蘊(yùn)胃型胃潰瘍,觀察其對(duì)患者臨床癥狀、體征、潰瘍面積、及胃鏡下表現(xiàn)的影響,為中醫(yī)臨床治療熱毒蘊(yùn)胃型胃潰瘍找到了臨床研究依據(jù)。資料與方法:選擇自2011年6月-2012年10月時(shí)間段內(nèi)來到遼寧中醫(yī)藥大學(xué)第一附屬醫(yī)院消化內(nèi)科符合納入標(biāo)準(zhǔn)的98例患者,對(duì)這98例患者運(yùn)用隨機(jī)分組法將98例患者隨機(jī)分成治療組與對(duì)照組,其中對(duì)照組人數(shù)為46例,治療組52例。給予對(duì)照組的患者餐前空腹口服奧美拉唑膠囊,20mg每次,每日早晚飯前空腹口服各一次,28天為一個(gè)療程;阿莫西林膠囊1.0g,日2次口服,克拉霉素分散片0.5g,日2次口服,14天為一個(gè)整療程;治療組的患者服周學(xué)文老教授的經(jīng)驗(yàn)湯劑治療,湯劑采用“解毒清熱,消癰生肌”的治法,藥物組成為:黃連6g苦參6g野菊花10g蒲公英10g烏賊骨10g浙貝母10g白芨10g黃芪15g,該湯劑每天一劑,分為早晚餐前兩次空腹口服,總體療程28天。將所有病例治療前后均收集并記錄中醫(yī)四診資料,治療前及療程結(jié)束4周后行電子胃鏡檢查,并記錄檢查結(jié)果。將所獲得的所有數(shù)據(jù)運(yùn)用SPSS18.0統(tǒng)計(jì)學(xué)軟件進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:1.治療4星期以后,在中醫(yī)癥候的治療效果上,治療組的患者臨床癥狀痊愈數(shù)為14例,顯效數(shù)為19例,有效數(shù)為13例,無效數(shù)為6例,總體臨床有效率為88.46%,對(duì)照組的患者臨床癥狀痊愈數(shù)為7例,顯效數(shù)為12例,有效數(shù)為18例,無效數(shù)為9例,總體臨床有效率為80.43%,治療組臨床總體有效率明顯高于對(duì)照組,兩組的比較差異有統(tǒng)計(jì)學(xué)意義(P㩳0.05)。2.對(duì)患者行胃鏡檢查比對(duì)治療效果,治療組臨床痊愈為13例,顯效為18例,有效為15例,無效為6例,總體有效率為88.46%,對(duì)照組臨床痊愈為8例,顯效為10例,有效為18例,無效為10例,總體有效率為78.26%,治療組總體有效率顯著高過對(duì)照組的總體有效率,兩組數(shù)據(jù)差異的比較擁有統(tǒng)計(jì)學(xué)意義(P㩳0.05)。結(jié)論:治療組在改善熱毒蘊(yùn)胃型胃潰瘍患者的臨床癥狀、緩解胃脘部疼痛、促進(jìn)潰瘍愈合等方面均優(yōu)于對(duì)照組,周學(xué)文教授運(yùn)用“解毒清熱、消癰生肌”的傳統(tǒng)中醫(yī)學(xué)理念,將傳統(tǒng)中醫(yī)外科的“消、托、補(bǔ)”治法接引入毒熱蘊(yùn)胃型胃潰瘍的臨床治療中,取得良好的療效,值得今后消化內(nèi)科在治療此類疾病中深入研究及臨床推廣應(yīng)用。
[Abstract]:Objective: to study the effect of professor Zhou Xuewen's clinical experience prescription "detoxification, clearing away heat, eliminating carbuncle and producing muscle" in treating stomach ulcer with toxic heat, observing its effect on clinical symptoms, signs, ulcer area and gastroscopy. It has found the clinical research basis for the treatment of stomach ulcer with heat toxin and stomach. Materials and methods: from June 2011 to October 2012, 98 patients who came to the Department of Gastroenterology, the first affiliated Hospital of Liaoning University of traditional Chinese Medicine, met the inclusion criteria. The 98 patients were randomly divided into treatment group (n = 46) and control group (n = 52). Patients in the control group were given 20 mg omeprazole capsules before meals, and once a day for 28 days before meals in the morning and evening, while amoxicillin capsules were taken orally twice a day, 1.0 g, 2 times a day. Clarithromycin dispersible tablet 0.5g, orally administered twice a day for 14 days as a whole course of treatment; patients in the treatment group were treated with the experiential decoction of Professor Zhou Xuefen, and the decoction was treated with "detoxification, clearing away heat, eliminating carbuncle and generating muscle". The drug was composed of 6 g Radix Sophorae flavescens and 6 g wild chrysanthemum 10 g dandelion 10g squid bone 10g Bletilla striata 10g astragalus 15g. The decoction was divided into two fasting oral doses before morning and evening meal and the total course of treatment was 28 days. All cases were collected and recorded before and after treatment, before and after the treatment and 4 weeks after the course of treatment, electronic gastroscopy was performed, and the results were recorded. All the obtained data were analyzed by SPSS18.0 statistical software. The result is 1: 1. After 4 weeks of treatment, there were 14 cases of clinical symptoms cured, 19 cases of marked effect, 13 cases of effective and 6 cases of ineffectiveness in the treatment group in terms of the therapeutic effect of TCM symptoms. The total clinical effective rate was 88.46. In the control group, the clinical symptoms were cured in 7 cases, the significant effective number in 12 cases, the effective number in 18 cases, the ineffective number in 9 cases, and the overall clinical effective rate in the treatment group was 80.43. The total effective rate in the treatment group was significantly higher than that in the control group. The difference between the two groups was statistically significant (P0. 05). 13 cases were cured, 18 cases were effective, 15 cases were effective, 6 cases were ineffective, the total effective rate was 88.46g in the control group, 8 cases were cured, 10 cases were effective, and 18 cases were effective. The total effective rate of the treatment group was significantly higher than that of the control group, and the difference between the two groups was statistically significant (P 0.05). Conclusion: the treatment group is superior to the control group in improving the clinical symptoms, relieving the pain in the stomach and promoting the healing of the ulcer. Professor Zhou Xuewen used the traditional Chinese medicine idea of "detoxifying heat, eliminating carbuncle and generating muscle". This paper introduces the traditional Chinese medicine surgery "Xiao, Kuo, Fu" into the clinical treatment of the gastric ulcer of the type of toxic heat and stomach, and obtains good curative effect, which is worthy of further study and clinical application in the treatment of this kind of disease in the department of peptic medicine in the future.
【學(xué)位授予單位】：遼寧中醫(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)】：R259
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本文編號(hào)：2214382