慢性胃炎病因序贯性综合治疗效果观察

Effect of etiology combined treatment for chronic gastritis

目的观察针对病因综合治疗慢性胃炎的效果。方法采用前瞻性队列研究法，将经胃镜和病理学检查确诊的慢性胃炎149例随机分成两组，治疗组79例先进行病因分析，再针对病因进行序贯治疗，部分病例结合中医辨证施治；对照组70例仅给予对症处理。两组疗程1～2周。疗程结束后4周重复胃镜及病理活检。随访18个月或至症状复发。结果失访7例（治疗组4例，对照组3例）。治疗组和对照组的治愈率分别为57．33％和4．48％，总有效率分别为94．67％和86．57％，18个月内复发率分别为21．33％和97．01％。两组的总有效率无显著性差异（P〉0．05），治疗组的治愈率显著高于对照组（P〈0．01），复发率则显著低于对照组（P〈0．01），治疗组治疗后胃黏膜炎症程度及活动度均较对照组显著好转（P均〈0．01）。结论慢性胃炎存在多重病因，对病因序贯综合治疗能有效清除胃内炎症或减轻慢性炎症，降低复发率。

Objective To study the effect of etiology combined treatment for chronic gastritis（CG）. Methods 149 cases with CG were divided into two groups randomly by prospective cohort study, Treatment group （79 cases） were given etiology combined treatment, Some of them were given syndrome differentiation in Chinese medicine. Control group were only given symptomatic treatment. The treatment course of two groups was one. to two weeks, They were given gastroscope and pathological test fours week after treatment, They were followed up for 18 months or until the recurrence. Results The cure rate of treatment group and control group were 57.33% and 4.48% respectively,the efficiency rate were 94.67% and 86.57% respectively, recurrent rate in 18 months were 21.33 % and 97.01%. There was no significant difference between the efficiency rate of the two groups（ P 〉0.05）. The cure rate of treatment group was higher than control group （ P 〈0.01）, while recurrent rate was lower （ P 〈0.01）, The degree and activity of inflammation of gastric mucosa in treatment group was better than control group after treatment （ P 〈0.01）. Conclusion Etiology combined treatment can clean up the gastritis inflammation and decrease the chronic inflammation, it can depress the recurrent rate of CG.