【摘要】：研究目的:本臨床研究觀察疏肝理氣法治療功能性消化不良(functional dyspepsia,FD)上腹痛綜合征(epigastric pain syndrome,EPS)肝郁氣滯證的臨床療效,來評價和分析疏肝理氣法對EPS的作用機制,探討EPS肝郁氣滯證的辨證規(guī)律和用藥。研究方法:本研究采用隨機對照的研究方法,以江蘇省中醫(yī)院脾胃科門診EPS患者為研究對象,選取符合EPS診斷標準和中醫(yī)辨證的60例病人納入研究,隨機分為治療組和對照組,每組各30例病人。兩組患者在年齡、性別及治療前癥狀總積分上無明顯差異,具有統計學意義(P0.05)。治療組給予疏肝理氣法中藥治療,對照組給予西藥奧美拉唑腸溶膠囊治療,4周為1療程,兩組均治療1個療程。記錄治療前后患者癥狀積分變化,填寫臨床療效觀察表,運用統計學方法進行數據分析,研究治療組和對照組治療前后癥狀積分、療效指數等方面,探討疏肝理氣法中藥的臨床療效。研究結果:1.總體臨床療效:治療組總有效率為96.67%;對照組總有效率為80.00%。經統計學處理,兩組總有效率具有顯著統計學差異(P0.01),提示治療組療效優(yōu)于對照組。2.治療前后癥狀總積分方面:兩組治療前后癥狀總積分具有顯著統計學差異(P0.01),說明兩組均可改善上腹痛綜合征癥狀;治療后兩組比較,治療組療效顯著優(yōu)于對照組(P0.01)。3.臨床癥狀單項積分方面:(1)治療組能明顯改善上腹痛、上腹部燒灼感、反酸、暖氣、腹脹、食欲不振、易怒癥狀(P0.01);對照組能明顯改善上腹痛、上腹部燒灼感、反酸、腹脹、食欲不振癥狀(P0.01),但對暖氣、易怒癥狀無明顯改善作用(P0.05)。(2)兩組比較,治療組在改善噯氣、易怒、腹脹等癥狀顯著優(yōu)于對照組(P0.01);在緩解上腹痛癥狀亦有顯著性差異(P0.05),說明治療組在改善上腹痛方面療效優(yōu)于對照組;兩組在改善上腹部燒灼感、反酸、食欲不振等癥狀上無統計學差異(P0.05),說明兩組在改善上腹部燒灼感、反酸、食欲不振方面療效相當。研究結論:疏肝理氣法治療EPS肝郁氣滯證有較好的臨床療效,能夠有效緩解上腹痛綜合征的臨床癥狀,無明顯不良作用,說明疏肝理氣法是治療功能性消化不良上腹痛綜合征肝郁氣滯證的有效方法,值得進一步研究和推廣。
[Abstract]:Objective: to observe the clinical effect of the method of soothing liver and regulating qi in treating (epigastric pain syndrome,EPS of functional dyspepsia (functional dyspepsia,FD) with stagnation of liver-qi, and to evaluate and analyze the mechanism of the method of soothing liver and regulating qi on EPS. To explore the syndrome differentiation and medication of EPS liver stagnation and qi stagnation. Methods: a randomized controlled study was carried out on EPS patients in the Department of spleen and stomach of Jiangsu Provincial traditional Chinese Medicine Hospital. 60 patients who met the criteria of EPS diagnosis and TCM differentiation were selected and randomly divided into two groups: treatment group and control group. There were 30 patients in each group. There was no significant difference in age, sex and total score of symptoms before treatment between the two groups (P0.05). The treatment group was treated with traditional Chinese medicine of soothing liver and regulating qi, and the control group was treated with omeprazole enteric capsule for 4 weeks. Both groups were treated with one course of treatment. The changes of symptom score before and after treatment were recorded, the clinical curative effect observation form was filled out, the data was analyzed by statistical method, the symptom integral and curative effect index were studied before and after treatment in the treatment group and the control group, etc. To explore the clinical effect of traditional Chinese medicine for soothing liver and regulating qi. Results: 1. Overall clinical efficacy: the total effective rate of the treatment group was 96.67 and the total effective rate of the control group was 80.00. The total effective rate of the two groups was significantly different (P0.01), indicating that the curative effect of the treatment group was better than that of the control group. 2. Before and after treatment, the total symptom score of the two groups had significant statistical difference (P0.01), indicating that the two groups can improve the symptoms of epigastric pain syndrome, after treatment, the curative effect of the treatment group was significantly better than that of the control group (P0.01). The clinical symptom single integral aspect: (1) the treatment group can obviously improve the epigastric pain, the epigastric burning sensation, the reflux, the warm air, the abdominal distension, the inappetence, the irritability symptom (P0.01), the control group can obviously improve the upper abdominal pain, the upper abdomen burning sensation, the reflux acid, the abdominal distension, The symptoms of loss of appetite (P0.01), but no significant improvement on heating, irritability (P0.05). (2), treatment group in the improvement of belching, irritability, The symptoms of abdominal distention were significantly better than that of the control group (P0.01), and there were significant differences in alleviating the symptoms of epigastric pain (P0.05), indicating that the curative effect of the treatment group in improving the upper abdominal pain was better than that in the control group; the two groups were improving the burning sensation and acid regurgitation in the upper abdomen. There was no significant difference in symptoms such as loss of appetite (P0.05), indicating that the two groups had the same effect in improving burning sensation, regurgitation and loss of appetite in the upper abdomen. Conclusion: the method of soothing the liver and regulating qi has a good clinical effect on the syndrome of EPS liver depression and qi stagnation, and can effectively relieve the clinical symptoms of the upper abdominal pain syndrome without obvious adverse effects. It shows that the method of soothing the liver and regulating qi is an effective method to treat the syndrome of liver depression and qi stagnation in the patients with functional dyspepsia and epigastric pain syndrome, which is worthy of further study and popularization.
【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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