【作者】 陈妍；

【导师】 潘万瑞；

【作者基本信息】 福建中医学院 ， 中西医结合临床， 2008， 硕士

【摘要】 本课题研究分为理论研究和临床研究两部分。理论研究部分,对古今医学文献关于本病的诊断认识、病因病机的研究以及近十年来中西医治疗胆汁反流性胃炎的概况进行总结,寻找中医药在治疗中的优势。临床研究部分,将76例符合研究条件的胆汁反流性胃炎患者按1:1的比例,随机分为六味能消胶囊合达喜、莫沙比利治疗组(41例)与达喜、莫沙必利对照组(35例),经4周治疗,结果治疗组基本治愈3例,显效18例,好转17例,无效2例,总有效率90.47%:对照组分别为0例、13例、17例、5例和85.71%。两组疗效无显著性差异(P＞0.05)。同时,对两组患者的临床症状、胃镜征象、胃黏膜病理学检查及有关实验室指标等变化进行观察,并对胆汁反流胃炎的病因学、证候学进行分析,探讨六味能消胶囊的立法组方特点及疗效机制。通过研究表明:1.情志因素和吸烟是胆汁反流性胃炎的主要病因,慢性萎缩性胃炎和十二指肠球部溃疡为胃镜下最常见的伴见症,分别为79.00%和21.05%:2.胆汁反流性胃炎的证候学特点是临床以胃脘痞满(80.26%)、胃脘疼痛(78.95%)、嗳气(75.00%)与口中异味(69.74%)为四大主症,舌质多表现为红或暗红,舌苔黄腻或薄黄,脉多数:3.本病病机以热邪郁结、胆胃不和、升降失常为要点:4.清热通下、和胃降气为本病的治疗大法。六味能消胶囊在组方配伍上和、清、泄配合应用,以达和、通、降的目的:5.六味能消胶囊的疗效机理体现于:(1)改善临床症状,减轻或阻止胆汁反流;(2)改善胃肠功能,加快胃排空。更多还原

【Abstract】 This study includes mainly two parts:theoretical research and clinical research.In the part of the theoretical research. From studying the diagnosis, pathogenic factor and pathogenesis in historical documents of TCM, the author sums up the therapeutic methods of BRG in recent years so as to look for a better way to treat BRG. In the part of clinical research,76 cases of BRG were randomly divided into two groups by 1 to 1.The treatment group (taking capsules of liuweinengxiao and mosapride、Talcid) was 41 cases, and the control group (taking mosapride、Talcid) was 35 cases. The course of treatment was 4 weeks. The results showed that 3 cases were mostly cured, 18 cases were rem- arkably effective, 17 cases were improved,2 cases were ineffective, and the total effective rate was 90.47% in the treatment group. In the control group, there were 0 cases, 13 cases, 17 cases ,5 cases and 85.71% respectively. There was no statistical difference between these two groups (P>0.05). Meanwhile, the author compared the changes of primary symptoms, gastroscope, pathological examination and some related laboratory examination so as to analyze the capsules of liuweinengxiao’s mechanism.The above scientific researches indicate:1) Smoking and emotion are two main aspects of the causes of BRG.Chronic Atrophic Gastritis and Duodenal ulcer are the main accompanying diseases;2) The four primary symptoms of semiologicalc haracteristics are : stomachache (78.95%),fullness( 78.95%) ,hiccup(75%)and bitterness in mouth (69.74%). A patient of BRG often shows red or dark red tongue with yellow greasy or thin coating;3) The chief pathogenesis is disharmony between the gallbladder and stomach, hepatic depression with heat-evil and abnormal ascent and descent;4) The main treating method is Using Qingre Tongxia and Heweijiangqi.5) The mechanism of capsules of liuweinengxiao shows as follows: 1)improving clinical symtoms,lessening or resisting bile reflux; 2) promoting the gastric motilily and emptying as well.更多还原