辨证分型治疗慢性萎缩性胃炎随机平行对照研究

Type Differentiation and Treatment of Chronic Atrophic Gastritis Random Parallel Control Study

[目的]观察辨证分型治疗慢性萎缩性胃炎疗效。[方法]使用随机平行对照方法,将56例住院患者按抽签法简单随机分为两组。对照组28例Hp阳性选质子泵抑制剂三联疗法;或选铋剂"四联"疗法。治疗组28例辨证分型:脾胃湿热,清热化湿,连朴饮(藿香10g,苍术、半夏各6g,黄连3g,陈皮6g,厚朴5g,木香4g,丹参12g,甘草3g);脾胃虚弱,扶脾健胃,香砂六君子汤(砂仁、木香、党参各12g,云苓10g,白术12g,半夏、陈皮各10g,甘草5g);肝气犯胃,疏肝和胃,胡舒肝散(柴胡6g,川芎5g,枳实4.5g,白芍5g,香附4.5g,厚朴5g,陈皮6g,半夏、甘草2g);胃阴亏虚,清热滋阴,一贯煎合芍药甘草汤(当归10g,沙参、生地各15g,芍药10g,麦冬、川楝子、枸杞、甘草各15g);瘀阻胃络,活血散瘀,血府逐瘀汤(桃仁12g,红花9g,枳壳6g,生地、当归各9g,赤芍6g,延胡索3g);上药1剂/d,水煎200mL,早晚口服。连续治疗90d为1疗程。观测临床症状、HP根除率、不良反应。治疗1疗程,判定疗效。[结果]治疗组痊愈12例,显效9例,有效5例,无效2例,总有效率92.86%。对照组痊愈3例,显效11例,有效8例,无效6例,总有效率71.43%。治疗组疗效优于对照组(P<0.05)。HP根除率治疗组优于对照组(P<0.05)。[结论]辨证分型治疗慢性萎缩性胃炎效果显著,值得推广。

[ Objective ] To observe the differentiation and treatment of chronic atrophic gastritis. [ Methods ] Using random parallel control method, the 56 cases of hospitalized patients into two groups according to random number table method. Change bad living habit （ quit smoking, avoid excitant food and wine overeating ）, regulate mood. The control group 28 cases Hp positive proton pump inhibitors of triple therapy. Also can choose bismuth agent ＂quadruple therapy.＂ Treatment group 28 cases of syndrome differentiation treatment ： taste hot and humid, with clear heat, wet, even the park drink （ Huoxiang 10 g, Cangzhu, Banxia each 6g, Huanglian3 g, Chenpi 6 g, Houpu5g, Muxiang4 g, Danshen12 g, Gancao3 g） ;Spleen and stomach weakness, to help cure spleen and stomach, and sand 6 gentleman decoction （ Sharen, Muxiang, Dangshen 12 g, Yunlingl0 g, Baizhu12 g, Banxia, Chenpi each 10g, Gancao 5 g） . Diseases with the stomach, to cure liver and stomach, Hu Shu liver powder （ Chaihu6 g, Chuanqiong 5 g, Zhishi 4.5 g, Baishao5 g, Xiangfu 4.5 g, Houpu5g, Chenpi6 g, Banxia, Gancao 2 g ） ;Stomach Yin deficiency, with clear heat ziyin, always Fried or peony liquorice decoction （Danggui 10 g, Shashen, Shengdil5 g, Shaoyao 10 g, Maidong, Chuanjizi, Gouqi, Gancao each 15 g ）; Gastric stasis resistance, to invigorate the circulation of blood stasis, therapeutic （ Honghua9 g, Taoren 12 g, Zhike 6 g, Shengdi, Danggui each 9 g, Chishao 6 g, Yanhusuo 3 g） ;Prescription l/d, water frying, 200 ml, oral sooner or later. Continuous treatment of 90 d to 1 course of treatment. Observation of clinical symptoms, HP eradicate rate, adverse reactions. As a course treatment, judge curative effect. [ Results ] in treatment group recovered 12 cases, 9 cases were markedly effective, effective in 5 cases, 2 had no effect, the total effective rate was 92.86%. Control group recovered in 3 cases, 11 cases had marked effect, 8 cases, 6 no effect, the total effective rate was 71.43%. The treatment group curative effect is better than that of control group （ P〈0.05 ）. HP eradicate rate of treatment group is better than that of control group （ P〈0.05 ）. [ Conclusion ] The treatment of chronic atrophic gastritis, is worth promoting.