發(fā)布時(shí)間：2018-11-24 12:57

【摘要】：目的:觀察復(fù)方臺(tái)烏片治療慢性萎縮性胃炎肝胃不和證的臨床療效,并探討其可能的作用機(jī)制,為臨床治療慢性萎縮性胃炎肝胃不和證提供有效的藥物。方法:選擇符合病例納入標(biāo)準(zhǔn)的慢性萎縮性胃炎肝胃不和證門(mén)診及住院患者53例,隨機(jī)的分為治療組和對(duì)照組,治療組26例,對(duì)照組27例。治療組給予復(fù)方臺(tái)烏片治療,每次5片,每日3次;對(duì)照組給予摩羅丹治療,每次8丸,每日3次;合并幽門(mén)螺桿菌感染時(shí)同時(shí)給予抗幽門(mén)螺桿菌治療。連續(xù)服藥12周為一個(gè)療程,共觀察兩個(gè)療程。評(píng)價(jià)治療效果及藥物不良反應(yīng)。結(jié)果:1.臨床癥狀:對(duì)臨床癥狀改善有效率,復(fù)方臺(tái)烏片組為88.46%,摩羅丹組為81.48%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。2.胃鏡:對(duì)胃鏡下黏膜改善有效率,復(fù)方臺(tái)烏片組為84.62%,摩羅丹組為77.78%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。3.病理:對(duì)胃黏膜慢性炎癥改善有效率,復(fù)方臺(tái)烏片組為76.92%,摩羅丹組為70.37%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05);對(duì)胃黏膜萎縮改善有效率,復(fù)方臺(tái)烏片組為34.62%,摩羅丹組為37.04%,兩組比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);對(duì)胃黏膜腸化改善有效率,復(fù)方臺(tái)烏片組為15.38%,摩羅丹組為22.22%,兩組比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);對(duì)胃黏膜異型增生改善有效率,復(fù)方臺(tái)烏片組為7.69%,摩羅丹組為11.11%,兩組比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。4.中醫(yī)癥候:對(duì)中醫(yī)癥候改善有效率,復(fù)方臺(tái)烏片組為92.31%,摩羅丹組為85.19%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。5.中醫(yī)癥候積分:對(duì)中醫(yī)癥候積分改善有效率,復(fù)方臺(tái)烏片組中胃脘痞滿、胃脘脹痛、脅肋脹痛、口干、食少單項(xiàng)癥候積分改善均優(yōu)于摩羅丹組,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05),余單項(xiàng)癥候積分的比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。6.幽門(mén)螺桿菌根除情況:對(duì)Hp根除有效率,復(fù)方臺(tái)烏片組為75%,摩羅丹組為73.68%,兩組比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。7.兩組治療期間均未發(fā)現(xiàn)明顯的不良反應(yīng)。結(jié)論:1.復(fù)方臺(tái)烏片在改善臨床癥狀、胃鏡下胃黏膜表現(xiàn)、胃黏膜慢性炎癥及中醫(yī)癥候要優(yōu)于摩羅丹。2.復(fù)方臺(tái)烏片在改善胃脘痞滿、胃脘脹痛、脅肋脹痛、口干、食少方面要優(yōu)于摩羅丹。3.復(fù)方臺(tái)烏片在改善腺體萎縮、腸上皮化生、異型增生及根除Hp方面與摩羅丹療效相當(dāng)。4.復(fù)方臺(tái)烏片為臨床安全、有效藥物,值得進(jìn)一步推廣。
[Abstract]:Objective: to observe the clinical effect of compound Taiwu tablet in the treatment of chronic atrophic gastritis with liver and stomach disharmony, and to explore its possible mechanism so as to provide effective medicine for clinical treatment of chronic atrophic gastritis with liver and stomach disharmony. Methods: 53 patients with chronic atrophic gastritis were randomly divided into treatment group (n = 26) and control group (n = 27). The treatment group was treated with compound Tiewu tablet, 5 tablets per day, 3 times a day; the control group was treated with 8 pills, 3 times a day; and the patients with Helicobacter pylori infection were treated with anti-Helicobacter pylori at the same time. A course of treatment was taken for 12 weeks, and two courses of treatment were observed. To evaluate the therapeutic effect and adverse drug reactions. Results: 1. Clinical symptoms: the effective rate of improving clinical symptoms was 88.46 in compound Taiwu tablet group and 81.48 in Moro Dan group. The difference between the two groups was statistically significant (P0.05). Gastroscope: the effective rate of mucosal improvement under gastroscope was 84.62 in compound Taiwu tablet group and 77.78 in Moro Dan group. The difference between the two groups was statistically significant (P0.05). Pathology: the effective rate of improving chronic inflammation of gastric mucosa was 76.92in the compound Taiwu tablet group and 70.37in the Moro Dan group. The difference between the two groups was statistically significant (P0.05). The effective rate of improving gastric mucosal atrophy was 34.62 in compound Taiwu tablet group and 37.04am in Moro Dan group. There was no significant difference between the two groups (P0.05). The effective rate of improving intestinal metaplasia of gastric mucosa was 15.38 in compound Taiwu tablet group and 22.22 in Moro Dan group. There was no significant difference between the two groups (P0.05). The effective rate of improving gastric mucosal dysplasia was 7.69g in compound Taiwu tablet group and 11.11m in Moro Dan group. There was no significant difference between the two groups (P0.05). TCM symptoms: improve the effective rate of TCM symptoms, compound Taiwu tablet group is 92.31, Moro Dan group is 85.19, the difference between the two groups was statistically significant (P0.05). TCM symptom integral: improve the effective rate of TCM symptom integral, compound Taiwu tablet group is superior to Moro Dan group in improving the integral of stomachache, stomach distended pain, hypochondria pain, dry mouth and less food single symptom. The difference between the two groups was statistically significant (P0.05), while there was no significant difference between the remaining single symptom score (P0.05). The eradication rate of Helicobacter pylori: the effective rate of Hp eradication was 75 in the compound Tiewu tablet group and 73.68 in the Moro Dan group. There was no significant difference between the two groups (P0.05). No significant adverse reactions were found during treatment in both groups. Conclusion: 1. Compound Taiwu tablet is superior to Moro Dan in improving clinical symptoms, gastric mucosal manifestations, chronic inflammation of gastric mucosa and symptoms of traditional Chinese medicine. Compound Taiwu tablet is superior to Moro Dan in improving epigastric fullness, stomachache, flank pain, dry mouth and little food. The curative effect of Fufang Taiwu tablet on improving gland atrophy, intestinal metaplasia, dysplasia and Hp eradication was equivalent to that of Moro Dan. 4. 4. Compound Taiwu tablet is a safe and effective drug in clinic, and it is worth further popularizing.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R259

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