基于方證相應理論探討糜爛性胃炎濁毒證用藥規(guī)律研究
發(fā)布時間：2018-11-18 06:46
【摘要】：第一部分基于方證相應理論探討化濁解毒方治療糜爛性胃炎的臨床研究目的:對糜爛性胃炎(Chronicp erosive gastritis,CEG)濁毒內蘊證的方證關系進行研究,明確化濁解毒方和糜爛性胃炎濁毒內蘊證之間的聯(lián)系,提高糜爛性胃炎的臨床療效。方法:將174例糜爛性胃炎的患者分為方證相應組、方同證不同組和證同方不同組。方證相應組64例,方同證不同組63例,口服化濁解毒方藥;證同方不同組47例,口服清熱利濕方藥。三組均以3個月為1個療程,連續(xù)觀察2個療程。2個療程之后,比較三組患者治療前后的臨床癥狀及胃鏡下變化。結果:(1)三組治療前后中醫(yī)證候表現(xiàn)改善情況:方證相應組總有效率為89.06%,證同方不同組總有效率為68.09%,方同證不同組總有效率為77.78%。方證相應組總有效率明顯高于證同方不同組和方同證不同組(P0.05),證同方不同組和方同證不同組相比無明顯統(tǒng)計學差異(P0.05)。方證相應組具有明顯優(yōu)勢。(2)三組治療前后胃鏡下粘膜改善情況:方證相應組總有效率為96.88%,證同方不同組總有效率為59.57%,方同證不同組總有效率為80.95%。方證相應組總有效率明顯高于證同方不同組和方同證不同組(P0.05),證同方不同組和方同證不同組相比無明顯統(tǒng)計學差異(P0.05)。(3)三組治療前后腸化改善情況:方證相應組總有效率為81.25%,證同方不同組總有效率為57.45%,方同證不同組總有效率為63.49%。方證相應組總有效率明顯高于證同方不同組和方同證不同組(P0.05),證同方不同組和方同證不同組相比無明顯統(tǒng)計學差異(P0.05)。結論:化濁解毒方與糜爛性胃炎濁毒內蘊證存在方證相應關系,對糜爛性胃炎患者的臨床癥狀的改善,與鏡下病理的恢復具有明顯的療效。對于非濁毒內蘊證的患者,與非化濁解毒方治療的患者臨床療效均欠佳。第二部分慢性糜爛性胃炎濁毒內蘊證用藥規(guī)律研究目的:運用頻數統(tǒng)計和聚類分析方法,通過對臨床病例的回顧性研究,探討化濁解毒方劑治療慢性糜爛性胃炎的用藥規(guī)律,以便更好的指導臨床用藥。方法:收集在河北省中醫(yī)院脾胃病二科就診的300例糜爛性胃炎患者的病例。對患者一般信息,臨床癥狀和中醫(yī)處方進行統(tǒng)計分析,將頻數在30次(包括30次)以上的中藥進行整理分析,探討糜爛性胃炎濁毒內蘊證的用藥規(guī)律。結果:通過300例糜爛性胃炎患者中醫(yī)處方的數據整理,共得到藥物182味,使用頻數在30次(包括30次)以上的中藥共計52味,并由此發(fā)現(xiàn)治療糜爛性胃炎濁毒內蘊證的5大聚類方。結論:采用聚類分析方法,對所搜集的中醫(yī)處方進行統(tǒng)計分析,從客觀上揭示了糜爛性胃炎濁毒內蘊證用藥規(guī)律。
[Abstract]:The first part discusses the clinical research on the treatment of erosive gastritis with Huazhuojiedu recipe based on the corresponding theory of prescription syndrome objective: to study the relationship between prescription and syndromes of the internal accumulation of turbid toxin syndrome of erosive gastritis (Chronicp erosive gastritis,CEG). To clarify the relationship between Huazhuojiedu recipe and the internal syndrome of erosive gastritis, improve the clinical efficacy of erosive gastritis. Methods: 174 patients with erosive gastritis were divided into three groups: the group with different syndromes, the group with different syndromes and the groups with different syndromes. There were 64 cases in the corresponding group, 63 cases in the group of different syndromes, and 47 cases in the group of different syndromes of syndromes and syndromes, taking the prescription of clearing away heat and promoting dampness. After two courses of treatment, the clinical symptoms and changes under gastroscope of the three groups were compared before and after treatment. Results: (1) the improvement of TCM syndromes before and after treatment in the three groups: the total effective rate of the corresponding group was 89.06, the total effective rate of the different syndromes group was 68.099.The total effective rate of the different syndromes group was 77.78. The total effective rate of the corresponding group was significantly higher than that of the different groups of different syndromes and different syndromes (P0.05), and there was no significant difference between the different groups of different syndromes and different syndromes (P0.05). (2) the improvement of mucosa under gastroscope in the three groups before and after treatment: the total effective rate of the corresponding group was 96.88 and the total effective rate of the different syndromes group was 59.57. The total effective rate of different groups was 80.95. The total effective rate of the corresponding group was significantly higher than that of the different groups with different syndromes and different syndromes (P0.05). There was no significant difference between different syndromes and different syndromes groups (P0.05). (3): the total effective rate of the corresponding group was 81.25 and the total effective rate of different syndromes was 57.45. The total effective rate of different groups was 63.49. The total effective rate of the corresponding group was significantly higher than that of the different groups of different syndromes and different syndromes (P0.05), and there was no significant difference between the different groups of different syndromes and different syndromes (P0.05). Conclusion: Huazhuojiedu recipe has the corresponding relationship with the syndrome of the internal accumulation of turbid toxin of erosive gastritis. It has obvious curative effect on the improvement of clinical symptoms of erosive gastritis and the recovery of pathology under microscope. For the patients with non-turbid toxin and non-Huazhuazhuojiedu decoction, the clinical efficacy was poor. The second part of the study on the law of drug use of chronic erosive gastritis. Objective: by means of frequency statistics and cluster analysis, through the retrospective study of clinical cases, to explore the treatment of chronic erosive gastritis with Huazhujiedu prescription. In order to better guide clinical medication. Methods: 300 cases of erosive gastritis were collected. The general information of patients, clinical symptoms and prescriptions of traditional Chinese medicine were statistically analyzed, and the traditional Chinese medicine whose frequency was more than 30 times (including 30 times) was arranged and analyzed, and the law of drug use of the syndrome of turbid toxin accumulation of erosive gastritis was discussed. Results: according to the data of 300 patients with erosive gastritis, 182 herbs were obtained, 52 of which were used more than 30 times (including 30 times). And thus found the treatment of erosive gastritis turbid toxin accumulation syndrome of 5 big cluster prescription. Conclusion: the method of cluster analysis was used to analyze the prescriptions of traditional Chinese medicine collected, and to reveal objectively the law of drug use of the internal syndrome of turbid toxin in erosive gastritis.
【學位授予單位】：河北醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R259
本文編號：2339194
[Abstract]:The first part discusses the clinical research on the treatment of erosive gastritis with Huazhuojiedu recipe based on the corresponding theory of prescription syndrome objective: to study the relationship between prescription and syndromes of the internal accumulation of turbid toxin syndrome of erosive gastritis (Chronicp erosive gastritis,CEG). To clarify the relationship between Huazhuojiedu recipe and the internal syndrome of erosive gastritis, improve the clinical efficacy of erosive gastritis. Methods: 174 patients with erosive gastritis were divided into three groups: the group with different syndromes, the group with different syndromes and the groups with different syndromes. There were 64 cases in the corresponding group, 63 cases in the group of different syndromes, and 47 cases in the group of different syndromes of syndromes and syndromes, taking the prescription of clearing away heat and promoting dampness. After two courses of treatment, the clinical symptoms and changes under gastroscope of the three groups were compared before and after treatment. Results: (1) the improvement of TCM syndromes before and after treatment in the three groups: the total effective rate of the corresponding group was 89.06, the total effective rate of the different syndromes group was 68.099.The total effective rate of the different syndromes group was 77.78. The total effective rate of the corresponding group was significantly higher than that of the different groups of different syndromes and different syndromes (P0.05), and there was no significant difference between the different groups of different syndromes and different syndromes (P0.05). (2) the improvement of mucosa under gastroscope in the three groups before and after treatment: the total effective rate of the corresponding group was 96.88 and the total effective rate of the different syndromes group was 59.57. The total effective rate of different groups was 80.95. The total effective rate of the corresponding group was significantly higher than that of the different groups with different syndromes and different syndromes (P0.05). There was no significant difference between different syndromes and different syndromes groups (P0.05). (3): the total effective rate of the corresponding group was 81.25 and the total effective rate of different syndromes was 57.45. The total effective rate of different groups was 63.49. The total effective rate of the corresponding group was significantly higher than that of the different groups of different syndromes and different syndromes (P0.05), and there was no significant difference between the different groups of different syndromes and different syndromes (P0.05). Conclusion: Huazhuojiedu recipe has the corresponding relationship with the syndrome of the internal accumulation of turbid toxin of erosive gastritis. It has obvious curative effect on the improvement of clinical symptoms of erosive gastritis and the recovery of pathology under microscope. For the patients with non-turbid toxin and non-Huazhuazhuojiedu decoction, the clinical efficacy was poor. The second part of the study on the law of drug use of chronic erosive gastritis. Objective: by means of frequency statistics and cluster analysis, through the retrospective study of clinical cases, to explore the treatment of chronic erosive gastritis with Huazhujiedu prescription. In order to better guide clinical medication. Methods: 300 cases of erosive gastritis were collected. The general information of patients, clinical symptoms and prescriptions of traditional Chinese medicine were statistically analyzed, and the traditional Chinese medicine whose frequency was more than 30 times (including 30 times) was arranged and analyzed, and the law of drug use of the syndrome of turbid toxin accumulation of erosive gastritis was discussed. Results: according to the data of 300 patients with erosive gastritis, 182 herbs were obtained, 52 of which were used more than 30 times (including 30 times). And thus found the treatment of erosive gastritis turbid toxin accumulation syndrome of 5 big cluster prescription. Conclusion: the method of cluster analysis was used to analyze the prescriptions of traditional Chinese medicine collected, and to reveal objectively the law of drug use of the internal syndrome of turbid toxin in erosive gastritis.
【學位授予單位】：河北醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R259
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