中西医治疗军人胆汁反流性胃炎的临床观察

Clinical analysis of integrated traditional Chinese and western medicine therapy in army patients with bile reflux gastritis

目的探讨中西医结合治疗军人胆汁反流性胃炎的临床疗效。方法以我院2008年1月至2013年10月间收治的132例南方某部队军人胆汁反流性胃炎为研究对象,随机分为治疗组(70例)和对照组(62例)。治疗组采用西药(多潘立酮、铝碳酸镁和枸橼酸铋钾)联合中药(胃特安片)疗法,对照组采用单纯西药治疗。疗程结束后,比较分析两组患者临床总的疗效、胃镜下改善程度、幽门螺旋杆菌(HP)根除率以及组织病理学改变。结果治疗组临床总的疗效有效率为100%,明显高于对照组的90.3%(P<0.01);治疗组胃镜下疗效有效率为92.9%,显著高于对照组的75.8%(P<0.01);治疗组HP根除率(95.5%)与对照组(88.9%)比较,差异无统计学意义(P>0.05);两组活动性炎症均取得较好疗效,无明显差异(P>0.05);治疗组胃黏膜腺体萎缩、肠上皮化生、不典型增生等病理学改善有效率为91.7%,显著高于对照组的72.5%(P<0.05)。结论西药联合中药(胃特安片)治疗军人胆汁反流性胃炎,其疗效优于单纯西药治疗。

Objective To explore the clinical efficacy of integrated traditional Chinese and western medicine therapy in army patients with bile reflux gastritis. Methods Totally 132 southern army patients diagnosed as bile reflux gastritis in our hospital from January 2008 to October 2013 were chosen as research object in this study. These patients were randomly divided into treatment group（ 70 cases） and control group（ 62 cases）. The treatment group was given combination therapy of western medicine and Chinese patent medicines（ Weitean tablets）,while the control group was treated with western medicine alone. After treatment the response of clinical syndromes and gastroscopy manifestations,Helicobacter pylori（ Hp） clearance rate,and pathological changes were evaluated and compared respectively in both groups. Results The effective rate of total clinical response in the treatment group（ 100%） was significantly higher than that in the control group（ 90. 3%）,P 〈0. 01. The effective rates of gastroscopy response in the treatment group was significantly higher than that in the control group（ 92. 9% vs 75. 8%,P〈 0. 01）. There was no significant difference in Hp clearance rate between the treatment group and the control group（ 95. 5% vs 88. 9%,P〉 0. 05）. There was obvious improvement of active gastric mucosa inflammation in both two groups,which was no significant difference（ P 〉0. 05）. The pathological improvement of glandular epithelium atrophy,intestinal metaplasia and dysplasia in the treatment group were significantly higher than those in the control group（ 91. 7% vs 72. 5%,P 〈0. 05）. Conclusion The integrated therapy of western medicine and Weitean tablets is more effective than western medicine alone in the treatment of army patients with bile reflux gastritis.