【作者】 朱汉平；

【导师】 杨思华；

【作者基本信息】 广州中医药大学 ， 中医内科学， 2008， 硕士

【摘要】 研究背景:幽门螺杆菌(HP)相关性胃炎为临床常见病,多发病,易反复发作,难于治愈。目前已公认,HP是慢性胃炎、消化性溃疡的重要致病因子,是胃癌发生的启动因子之一。国内外对HP相关性胃炎的治疗常规采用联合用药的方案,常用的有质子泵抑制剂加两种抗生素或铋剂加两种抗生素组成的三联疗法。目前对于HP相关性胃炎的中医研究多局限在中药或中成药抗HP疗效观察上,而对HP相关性胃炎中医证型分布及现代医学三联或四联疗法治疗前后中医证型变化规律则无相关研究。为了更好地在西药治疗HP时或治疗后使用中药,减少副作用及复发率,我们观察三联疗法治疗HP相关性胃炎前后证型变化。目的:观察三联治疗疗法治疗HP相关性胃炎治疗前后患者中医证型的变化,探讨三联治疗疗法对患者中医证型变化的影响。方法:通过病历资料的收集,将符合纳入标准的HP相关性胃炎患者按标准治疗方案予三联抗HP治疗,7天为1疗程。分别治疗前、治疗后记录患者中医四诊信息,进行中医辨证分型。设定相应的证型统计表,建立证候四诊指标信息数据库,并通过统计软件统计分析研究三联疗法治疗前后患者症候分布规律及变化。计数资料的比较采用X~2检验,计量资料采用t检验(或秩和检验)。软件使用统计包(SPSS version 15.0 for XP),以P＜0.05表示有显著性意义。结果1、广州及周边地区幽门螺杆菌相关性胃炎中医证型分布规律为:脾胃虚弱型:24%;肝胃不和型:13.5%;胃阴亏虚型:6.3%;脾胃湿热型:42.7%;冒络瘀血型:5.2%;脾胃虚寒型:4.2%;其它证型4.2%。2、脾胃虚弱型、脾胃湿热型三联疗法治疗前后变化具有显著性差异,脾胃虚弱型患者治疗后较治疗前增多,脾胃湿热型患者治疗后较治疗前减少,具有统计学意义。3、三联疗法治疗后,实证证型较治疗前减少,虚证证型较治疗前增多,其结果具有统计学意义。结论:三联疗法治疗幽门螺杆菌相关性胃炎治疗前后中医证型发生了变化,具有从实证向虚证转变的规律,三联治疗疗法治疗后患者脾虚证型较治疗前增多。更多还原

【Abstract】 Background:Helicobacter pylori-associated gastritis(HpAG)is a common and frequently-occurring disease,it is easy to recur and hard to healing.Up to date,H.pylori infection was accepted as the major pathogenic factor of chronic active and peptic ulcers;Infection of H.pylori was related to the occurrence of gastric adenocarcinoma.The received method is triple therapy base on antibiotics and PPI/RBC.In recent years,the traditional Chinese medicine has made many researches on the HpAG syndrome-type and anti-Hp.There have very important significance to research the rule of the changes in traditional Chinese medicine type of syndrome of HpAG after triple therapy.Objective:Research the changes in traditional Chinese medicine types of syndromes of HpAG before and after triple therapy,and to analyze the influence of triple therapy to HpAG on traditional Chinese medicine types of syndromes.Methods:Through medical record material collection,we will conform to the HpAG patient which will bring into line with the standard.Treat according to the standard treatment,7 days for a course of treatment.Record patient’ s symptom through four diagnostic methods and differentiate syndromes,hypothesis and establish corresponding type of syndrome statistical table,the enumeration data comparison to use the X~2 examination,the rank data uses the non-parameter statistical method,the measurement data uses the t examination or rank sum test,Software use statistics package(SPSS Version 15.0 for XP),which 0.05 expression has the significance.Results:1.Syndromes distribution of HpAG in Guangzhou and its peripheral regions is following:syndrome of spleen deficiency:24.0%(23/96);syndrome of stagnation of liver qi:13.5%(13/96);syndrome of yin deficiency:6.3%(6/96); syndrome of dampness-heat:42.7%(41/96);syndrome of static blood:5.2% (5/96);syndrome of deficient cold:4.2%(4/96);others syndrome:4.2%(4/96).2.The changes of syndrome of spleen deficiency and syndrome of dampness-heat before and after triple therapy were significantly different. Syndrome of spleen deficiency had significantly aggravated after triple therapy.3.The excess syndrome had significant increased and the deficiency syndrome had significant decreased after triple therapy.Conclusion:Traditional Chinese medicine types of syndromes of HpAG had changed after triple therapy and the syndrome evolution regularity transfers from the excess syndrome to the deficiency syndrome.Syndrome of spleen deficiency had significantly aggravated after triple therapy.更多还原