中西医结合治疗不同证型胃痛的疗效及对患者生活质量的影响

Curative effect of integrated traditional chinese and western medicine in treating stomachache with different syndromes and its influence on quality of life

目的探讨中西医结合治疗不同证型胃痛的疗效以及对患者生活质量的影响。方法将82例胃痛患者参照数字表法随机分为治疗组和对照组,两组均41例;对照组分别采用对症治疗,包括慢性胃炎、胃与十二指肠溃疡及抗幽门螺杆菌(Hp)治疗;治疗组在对照组治疗基础上采取中药对证治疗,肝气犯胃证患者采取四逆散合金铃子散治疗,饮食伤胃证患者采用枳实导滞丸治疗,湿热蕴胃证者采用连朴饮合六一散,脾胃虚寒证者采用黄芪健中汤合理中汤治疗;以上方药均1剂/d,分2次煎煮,疗程均为4周;比较两组治疗前后中医症状评分和健康调查简表(SF-36)评分;分析两组疗后总有效率和Hp清除率。结果治疗组治疗后中医主要症状评分均明显低于对照组(P<0.05);治疗组总有效率为95.24%,对照组为76.19%,治疗组显著优于对照组(x2=4.783,P<0.05);治疗组Hp根除率为87.10%,对照组根除率为60%;治疗组明显高于对照组(x2=4.47,P<0.05);治疗后,治疗组SF-36量表各项评分均明显高于对照组,比较差异有统计学意义(P<0.05)。结论在常规西医辨病治疗基础上,中医辨证施治治疗胃痛可显著改善患者临床症状,提高临床治疗效果和Hp清除率,提高生活质量。

Objective To explore the curative effect of integrated traditional Chinese and western medicine in treating stomachache with different syndromes and its influence on quality of life. Methods 82 patients with stomachache were randomly divided into the treatment group and the control group according to random number table,with 41 in each.The control group was received symptomatic treatment including treatment of chronic gastritis, gastric and duodenal ulcer and anti-helicobacter pylori（Hp）.The treatment group was received symptomatic treatment of traditional Chinese medicine at the basis of the control group. Of which, patients with liver qi attacking stomach were treated by Sini powder combined with Jinlingzi powder, patients with stomach injure caused by diet were treated by zhishi daozhi pills,patients with damp heat in the stomach syndrome were treated by lianpu drink combined with Liu Yi San, patients with spleen-stomach deficiencycold syndrome were treated by Huangqi Jianzhong decoction combined with Lizhong decoction. All decoctions were with 1 dose/d. It was prepared in two times and the course was 4 weeks.Scores of TCM symptoms and health survey questionnaires（SF-36） before and after treatment were compared. Total effective rate and clearance rate of Hp after treatment in two groups were analyzed. Results After treatment,score of TCM symptoms of the treatment group was significantly lower than that of the control group（P〈0.05）. Total effective rates of treatment group and the control group were 95.24% and 76.19% respectively. Total effective rate of treatment group was significantly superior to that of the control group（x2=4.783,P0.05）. Clearance rate of Hp in treatment group was 87.10%, significantly higher than that of the control group 60%（x2=4.47, P〈0.05）.After treatment, scores of SF-36 in treatment group were all significantly higher than those of the control group.Comparative difference had statistical significance（P〈0.05）. Conclusion At the basis of conventional diagnosis and treatment of western medicine, syndrome differentiation and treatment of TCM in treatment of stomachache can significantly improve clinical symptoms of patients, effect of clinical treatment,clearance rate of Hp and quality of life.