【作者】 赵静；

【导师】 杨洁；

【作者基本信息】 广州中医药大学 ， 中医内科学， 2011， 硕士

【摘要】 目的：观察六君子加味方治疗慢性萎缩性胃炎(脾虚肝郁型)的临床疗效,并探讨其可能的作用机理,为临床治疗慢性萎缩性胃炎提供有效的方药。方法：按照随机对照的原则,将经诊断标准、纳入标准、排除标准筛选的60例慢性萎缩性胃炎脾虚肝郁型患者,分为治疗组30例、对照组30例,两组在性别、年龄、病程、主要症状、体征、胃镜、病理方面均无明显差异(P>0.05)。治疗组予六君子加味方,200ml/次,Bid；对照组予胃复春片,4片/次,Tid,两组均以2个月为1个疗程。1个疗程结束后进行疗效判定,观察两组患者治疗前后症状、体征、胃镜、病理疗效。结果：1.治疗组：临床治愈3例,显效10例,有效9例,无效8例,总有效率73.33%；对照组：临床治愈2例,显效9例,有效8例,无效11例,总有效率63.33%。两组比较差异无显著性(P>0.05)。两组病例在治疗过程中均未见不良反应。2.镜下胃粘膜改善情况治疗组优于对照组(P<0.05)。3.治疗组能明显改善患者胃痛,胸胁胀闷,反酸,纳少等症状,其疗效优于对照组(P<0.05),对于胃胀,便溏,乏力,气短懒言的改善与对照组疗效相当。4.治疗组组织病理学积分的改善优于对照组(P<0.05)。结论：通过相关分析,表明六君子加味方治疗慢性萎缩性胃炎脾虚肝郁型不但有较好的临床疗效,而且能明显逆转慢性萎缩性胃炎的病理状态,并对复发患者再次治疗后对于改善胃粘膜萎缩情况仍提示此方有效,从而进一步揭示了六君子加味方治疗慢性萎缩性胃炎的合理性,并提示其机理可能与抗病原微生物、调节免疫、抗炎、镇痛、改善胃粘膜微循环、增强胃粘膜屏障、清除氧自由基、抗肿瘤、促进胃肠动力,抗胆汁反流等功能有关。更多还原

【Abstract】 Objective:To observe the clinical curativate effect to treat of chronic atrophic gastritis (type of defieiency of the Spleen and stagnancy of Liver Qi) by Zhichai Liujunzi Jiawei and to explore possible mechanism and to provide effective preseriptions for the clinical treatment of atrophic gastritis.Methods:According to diagnosis standards, inclusion standards and climination standards,60 cases with Chronic Atrophic Gastritis are selected. They are separated into two groups with random and comparison method, treatment group and control group, which each group has 30 cases, the two groups in gender, age, main symptoms, signs, endoseopy and pathology has no significant differences(P>0.05). Of which 30 are in the treatment group with the administration of Zhichai Liujunzi Jiawei Deeoetion, a day one dose which is Divided into two times,30 are in the control group with the administration of Weifuchun, a day twelve chips which is divided into three times, two groups are two months of a course of treatment. After the end of a course of treatment, we observed the effect of symptoms, signs, endoscopy and pathology both two groups before and after the treatment.Results:1. The treatment group:3 cases were clinically cured,10 markedly improved,9 effective,8 ineffective, the total effective rate was 73.33%; the control group:2 cases were clinically cured,9 markedly improved,8effective, 11 ineffective, the overall effective rate was 63.33%. There was not significant difference between two groups(P>0.05). All participants in the trial have not suffer adverse reactions.2. In improving endoscopic mucosal in treatment group is significantly better than the control group (P<0.05).3. The treatment group in the stomach pain, vomiting of water, eating, is better than the colltrol group(P<0.05), no significant difference efficacy between the two in the distention, loose stools, shortness of speaking, ete(P<0.05).4. The improvement of histopathologic integral was better than the control group(P<0.05).Conclusion:The correlation analysis shows that not only Zhichai Liujun Jiawei Decoction in treatment of CAG of type of deficiency of the defieiency of the Spleen and stagnancy of Liver Qi, but also significantly reverse chronic atrophic gastritis of the pathological state, which further reveals that the Zhichai Liujun Jiawei Decoction treats chronic atrophic gastritis is reasonable, and prompt the mechanism which may be relate to resisting pathogens micro-organisms, regulating immunity, eliminating of inflammatory and pain, improving gastric mucosal microcirculation, enhancing gastric mucosal barrier removing oxygen free radieals, resisting tumor, promoting gastroiniestinal motility, and anti-bile reflux.更多还原