胃癌前期病变中医综合治疗疗效评估

Therapeutic Efficacy Evaluation of Comprehensive Treatment for Precancerous Lesion

目的观察中医综合治疗方案治疗胃癌前期病变(PLGC)的临床疗效。方法通过对2011年3月—2013年9月就诊于厦门市中医院的PLGC患者中随机选取203例进行随机分组和辩证分组,分为肝胃不和证、脾胃湿热证、脾胃虚寒证、胃阴不足证、胃络瘀血证、脾虚湿热血瘀证6个治疗组和1个西药对照组。每组30例,根据辩证施治给予中医综合治疗(内服、外治、食疗、护理),西药对照组23例,给予叶酸口服治疗,HP阳性者西药组加用三联疗法抗HP治疗,对PLGC治疗前后的临床症状改善情况进行观察。结果治疗组各证型临床疗效有效率分别为:肝胃不和证90.00%,脾胃湿热证90.00%,脾胃虚寒证83.33%,胃阴不足证83.33%,胃络瘀血证90.00%,脾虚湿热血瘀证93.33%,故治疗组临床疗效总有效率为88.33%,各组治疗前后症状积分差异有统计学意义(P<0.05),对照组临床疗效有效率为52.17%,治疗前后症状积分差异无统计学意义(P>0.05),治疗组与对照组有效率比较差异有统计意义(χ~2=20.081,P<0.05)。结论中医综合治疗PLGC在临床疗效方面较西药治疗有明显的优势。

Objective This paper tries to observe the clinical effect of comprehensive treatment of traditional Chinese medicine in the treatment of PLGC. Methods 203 cases of PLGC patients who visited Xiamen City Hospital from March2011 to September 2013 were randomly selected and divided into groups and dialectically grouped into liver-gastric disharmony, spleen-stomach damp-heat syndrome, spleen-stomach asthenia syndrome, and stomach yin. Insufficiency syndrome,stomach collaterals blood stasis, spleen deficiency dampness blood stasis syndrome 6 treatment groups and 1 western medicine control group. each group of 30 people, according to dialectical treatment given to Chinese medicine comprehensive treatment（internal and external treatment, diet）, In the western medicine control group, 23 were given oral folic acid treatment, and the HP-positive western medicine group was treated with triple therapy anti-HP treatment, and the improvement of clinical symptoms before and after PLGC treatment was observed. Results The clinical efficacy of each syndrome in the treatment group was as follows： 90.00% for liver-stomach disharmony, 90.00% for spleen-stomach damp-heat syndrome,83.33% for spleen-stomach deficiency syndrome, 83.33% for stomach-yin deficiency syndrome, 90.00% for Weiluoqi-blood syndrome, and spleen deficiency The total effective rate of the treatment group was 93.33%, so the total effective rate of the treatment group was 88.33%. There was a statistically significant difference between the symptom scores before and after treatment in each group（P〈0.05）, and the effective rate was 52.17% in the control group. There was no difference in symptom scores before and after treatment. Statistically significant（P〉0.05）, the difference between the treatment group and the control group was statistically significant（χ~2=20.081, P〈0.05）. Conclusion The comprehensive treatment of PLGC in Chinese medicine has obvious advantages in clinical curative effect compared with western medicine treatment.