香砂六君子汤治疗慢性胃炎的中医药临床优势研究

Clinical Observation of Predominant Clinical Efficacy of Xiang Sha Liujunzi Decoction for Treatment of Chronic Gastritis

【目的】观察香砂六君子汤辨证加味治疗慢性胃炎的临床效果,以及香砂六君子汤对中医证候和胃镜检查结果的疗效区别,探讨现代医学模式下中医药的临床治疗优势并指导临床实践。【方法】将90例慢性胃炎患者随机分为对照组和治疗组,每组各45例。对照组给予奥美拉唑片联合多潘立酮片治疗,4周为1个疗程,幽门螺旋杆菌(Hp)阳性者加用阿莫西林胶囊、甲硝唑片,1周后停用抗菌素,1个疗程结束后评估证候积分及复查胃镜。治疗组在对照组方案的基础上加用香砂六君子汤辨证加味治疗。【结果】(1)中医证候疗效:治疗1个疗程后,治疗组的总有效率为93.3%,对照组为66.7%,治疗组的中医证候疗效优于对照组,差异有统计学意义(P<0.05)。(2)胃镜疗效:治疗组的总有效率为86.7%,对照组为68.9%,治疗组的胃镜疗效优于对照组,差异有统计学意义(P<0.05)。(3)2种疗效评价方法评价结果比较:经Mann-Whitney U秩和检验,治疗组的中医证候疗效优于胃镜疗效,差异有统计学意义(Z=-1.974,P<0.05),而对照组2种评价方法的疗效未表现出统计学差异(Z=-0.662,P>0.05),表明治疗组应用中医药治疗对证候的改善效果尤其明显。【结论】相对于单纯的西药治疗,香砂六君子汤辨证加味联合西药能明显提高慢性胃炎的治疗效果;中医药对证候的改善具有更好的效果,在以证候尤其是患者自我感觉不适为主要表现的情况下,中医药以及中西医结合治疗具有明显优势。

Objective To investigate the predominant clinical efficacy of syndrome differentiation treatment with Xiang Sha Liujunzi Decoction in treating chronic gastritis by observing its curative effect on traditional Chinese medicine（TCM） symptoms and gastroscopy of chronic gastritis pationts. Methods Ninety cases of chronic gastritis patients were randomly divided into control group and treatment group, each group having 45 cases.The control group received Omeprazole Tablets combined with Domperidone Tablets orally,4 weeks constituting a course of treatment. For the patients in the control group with Helicobacter pylori（HP） positive,Amoxicillin Capsules and Metronidazole Tablets were added, and the antibiotics were suspended after one week. The treatment group was given syndrome differentiation treatment with Xiang Sha Liujunzi Decoction on the basis of treatment for the control group. After one course of treatment,the scores of TCM symptoms were evaluated and the gastroscopy was re-examined. Results（1）After one course of treatment, the total effective rate for TCM symptoms in the treatment group was 93.3%, and that in the control group was 66.7%, the difference being statistically significant（P〈0.05）.（2）The total effective rate for gastroscopy in the treatment group was 86.7%,and that in the control group was 68.9%,the difference being statistically significant（P〈0.05）.（3）The results of Mann-Whitney U rank-sum test showed that the effects on TCM symptoms were superior to the effects on gastroscopy in the treatment group, the difference being statistically significant（Z =-1.974, P〈0.05）.However, the differences of the two kinds of clinical efficacy in the control group were not statistically significant（Z =-0.662,P〈0.05）,indicating that the application of Chinese medicine in the treatment group had obvious effect on relieving TCM symptoms. Conclusion Compared to western medicine alone, syndrome differentiation treatment with Xiang Sha Liujunzi Decoction plus western medicine can enhance the therapeutic effect in treating chronic gastritis. The application of Chinese medicine alone or combined with western medicine exerts predominant efficacy on relieving TCM symptoms of chronic gastritis patients,in particular for the patients mainly with the manifestations of self-perceived discomforts.