辨证分型治疗慢性萎缩性胃炎随机平行对照研究

Chronic Atrophic Gastritis Randomized Controlled Study Differential Diagnosis and Treatment

[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136例门诊及住院患者按掷骰子法简单随机分为两组。对照组68例雷贝拉唑,20mg/次,1次/d;阿莫西林,0.5g/次,3次/d;克拉霉素,0.25g/次,2次/d;铝碳酸镁,0.5g/次,3次/d。治疗组68例辨证分型:脾胃虚弱-黄芪建中汤合香砂六君子汤(茯苓、山楂、党参、力曲、黄芪、麦芽各15g,白术炒、半夏各12g,木香、当归各10g,陈皮、砂仁各5g);胃阴不足-芍药甘草汤合一贯煎(沙参、枸杞子、白芍、生地、当归、山楂、麦芽各15g,麦冬12g,知母10g,甘草5g);肝胃不和:柴胡疏肝汤(白芍15g,香附制、郁金、陈皮、柴胡、大佛手、枳壳、川芎各10g,甘草6g);脾胃湿热-清中汤(薏苡仁20g,山楂、麦芽、茯苓各15g,黄连、栀子、半夏制、草豆蔻各10g,陈皮、甘草各6g);胃络瘀血-丹参饮合失笑散(香附、白芍、丹参、当归、苏梗、延胡索各12g,蒲黄、五灵脂、砂仁各10g,红花、陈皮、檀香各5g),1剂/d,水煎200m L,早晚口服。连续治疗30d为1疗程。观测临床症状、溃疡面积、不良反应。治疗1疗程,判定疗效。[结果]治疗组显效42例,有效22例,无效4例,总有效率94.12%。对照组显效34例,有效19例,无效15例,总有效率77.94%。治疗组疗效优于对照组(P<0.01)。[结论]辨证分型治疗慢性萎缩性胃炎疗效满意,无严重不良反应,值得推广。

[Objective]To observe syndrome treatment of chronic atrophic gastritis efficacy.[Methods] Randomized parallel controlled method,136 cases of outpatient and inpatient law by simple dice randomly divided into two groups.The control group of 68 patients rabeprazole,2Omg/second,1/d;amoxicillin,O.5g/time,3 times/ d;clarithromycin,0.25g/times,2 times/d;aluminum magnesium carbonate,0.5g/time,3 times/d.Treatment group of 68 patients dialectical type：spleen and stomach-Huangqijianzhong decoction and XiangshaLiujunzi（Fuling,Sha nzha,Dangshen,Liqu,Huangqi,Maiya 15g,Baizhu,Banxia 12g,Muxiang,Danggui 10g,Chenpi,Sharen 5g）;stomach yin deficiency-SGD Yiguan（Shashen,Gouqizi,Baishao,Shengdi,Danggui,Sahnzha,Maiya 15g,Maidong 12g,Zhimu 10g,Gancao 5g）;liver and stomach：Shugan Tang（Baishao 15g,Zhixiangfu,Yujin,Chenpi,Chaihu,Dafoushou,Zhike,C huanxiong lOg,Ganeao 6g）;spleen-Qing Tang（Yiyiren 20g,Shanzha,Maiya,Fuling 15g,Huanglian,Zhizi,Zhibanxia,C aodoukou 10g,Chenpi,Gancao 6g）;stomach meridian stasis-Salvia drink and Shixiaosan（Xiangfu,Baishao,Danshen ,Danggui,Sugeng,Yanhusuo 12g,PuhuangWulingzhi,Sharen 10g,Honghua,Chenpi,Tanxiang each 5g）,l/d,decoction 200mL,sooner or later orally.30d for a course of continuous treatment.Observation of clinical symptoms,ulcer area,adverse reactions.One course of treatment,to determine efficacy.[Results]The treatment group 42 cases,effective in 22 cases,4 cases,the total efficiency of 94.12%.The control group 34 cases markedly effective in 19 cases,15 cases,the total efficiency of 77.94%.Treatment group than the control group（P〈0.01）.[Conclusion]Differential diagnosis and treatment of chronic atrophic gastritis satisfactory efficacy,no side effects,worthy of promotion.