健脾和胃方联合隔姜灸治疗脾胃虚寒型慢性萎缩性胃炎临床研究

Clinical Study on Jianpi Hewei Prescription Combined with Moxibustion on Ginger for Chronic Atrophic Gastritis of Deficiency-Cold of the Spleen and Stomach Type

目的:观察健脾和胃方联合隔姜灸治疗脾胃虚寒型慢性萎缩性胃炎(CAG)疗效。方法:选取96例脾胃虚寒型CAG患者,按随机数字表法分为联合组及对照组各48例。对照组给予常规现代医学治疗,联合组在对照组基础上给予健脾和胃方联合隔姜灸治疗。连续治疗8周后,比较2组临床疗效及安全性,比较2组治疗前后中医症状积分、胃镜组织学评分、胃动力指标值的变化。结果:联合组临床疗效总有效率为93.75%,对照组为79.17%,2组临床疗效比较,差异有统计学意义(P<0.05)。治疗后,2组胃脘隐痛或胀满、喜按喜暖、神疲乏力、纳呆少食、气短懒言、大便稀溏中医症状积分均较治疗前下降(P<0.05),联合组上述6项中医症状积分均低于对照组(P<0.05)。治疗后,2组肠上皮化生、腺体萎缩、异型增生、疾病活动度、慢性炎症胃镜组织学评分均较治疗前下降(P<0.05),联合组上述5项评分均低于对照组(P<0.05)。治疗后,2组胃收缩频率、胃窦收缩幅度均较治疗前升高(P<0.05),联合组胃收缩频率、胃窦收缩幅度均高于对照组(P<0.05)。治疗期间,2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:健脾和胃方联合隔姜灸治疗脾胃虚寒型CAG效果较好,可调节异常胃黏膜组织,改善胃肠动力,安全性高。

Objective:To observe the curative effect of Jianpi Hewei Prescription combined with moxibustion on ginger for chronic atrophic gastritis(CAG)of deficiency-cold of the spleen and stomach type.Methods:A total of 96 cases of patients with CAG of deficiency-cold of the spleen and stomach type were selected and randomly divided into the combination group and the control group,with 48 cases in each group,using a random number table method.The control group was treated with conventional modern medicine,and the combination group was treated with Jianpi Hewei Prescription combined with moxibustion on ginger on the basis of the control group.After eight weeks of continuous treatment,the clinical effects and safety of the two groups were compared,and the changes in traditional Chinese medicine syndrome scores,gastroscopy histological scores,and gastric motility index values were compared before and after treatment in both groups.Results:The total clinical effective rate was 93.75%in the combination group,and 79.17%in the control group,the difference being significant(P<0.05).After treatment,the traditional Chinese medicine symptom scores of epigastric pain or fullness,liking to press and warm,feeling tired and weak,having limited appetite,shortness of breath and lazy speech,and loose stools in the two groups were declined when compared with those before treatment(P<0.05);the above six traditional Chinese medicine symptom scores in the combination group were all lower than those in the control group(P<0.05).After treatment,the histological scores of intestinal metaplasia,glandular atrophy,dysplasia,disease activity,and chronic inflammation in both groups were decreased when compared with those before treatment(P<0.05),and the combination group had lower scores than the control group(P<0.05).After treatment,the frequency and amplitude of gastric contraction in both groups were raised when compared with those before treatment(P<0.05),and the frequency and amplitude of gastric contraction in the combination group were higher than those in the control group(P<0.05).During the treatment period,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The combination of Jianpi Hewei Prescription combined with moxibustion on ginger has a higher therapeutic effect on CAG of deficiency-cold of the spleen and stomach type,which can regulate abnormal gastric mucosal tissue and improve gastrointestinal motility,with high safety.