【作者】 张贵彪；

【导师】 谢沛霖；

【作者基本信息】 湖北中医药大学 ， 中医内科学， 2010， 硕士

【摘要】 目的：观察新加左金汤治疗肝胃不和型慢性浅表性胃炎的临床疗效,探讨新加左金汤的作用机制,进一步探索中医药治疗慢性浅表性胃炎的有效方法。方法：1.64例患者均为2008年9月至2009年10月在湖北省武汉市第一医院中医脾胃专家门诊就诊病例,均经胃镜检查诊断为慢性浅表性胃炎。采用随机双盲对照的方法,将受试者按1：1的比例随机分成治疗组32例与对照组32例。两组患者在年龄、性别、病程、病情方面无明显差异,具有可比性(P>0.05)。2.对照组给于奥美拉唑肠溶胶囊,多潘立酮片,铝碳酸镁咀嚼片。奥美拉唑肠溶胶囊40 mg,每日1次,口服；多潘立酮片10mg,每日三次,口服；铝碳酸镁咀嚼片,一次1～2片,每日三次,咀嚼后咽下。治疗组服用中药汤剂一新加左金汤。主要药物：黄连,吴茱萸,广木香,旋复花,法半夏,黄芩,乌贼骨,瓦楞子。服用方法：每日一剂,水煎取汁400毫升,分早晚2次,饭后1小时温服。两周为一疗程,共用2个疗程。两组治疗期间忌酒、辛辣、过热及生冷油腻之品。3、统计学分析方法：数据应用SPSS11.5统计软件进行分析。等级资料采用Ridit分析,计数资料采用X2检验,计量资料采用t检验。结果：1.最后完成观察60例患者,其中治疗组30例,临床痊愈8例,显效14例,有效6例,无效2例,总有效率93.33%；对照组30例,临床痊愈3例,显效7例,有效13例,无效7例,总有效率76.67%。两组疗效对比总有效率有显著差异(P<0.05),治疗组疗效优于对照组。两组病例在治疗过程中均未见明显不良反应。2.治疗后在主要症状改善方面,经X2检验,总体上治疗组疗效优于对照组(P<0.05)。3.治疗后在胃镜检查疗效方面,治疗组总有效率为96.67%,对照组总有效率76.67%,经Ridit分析,治疗组疗效优于对照组(P<0.05)。4.治疗后在组织学炎症改善方面,治疗组总有效率为96.67%,对照组总有效率为80.00%,经Ridit分析,治疗组疗效优于对照组(P<0.05)。5.治疗后在Hp清除率方面,治疗组HP清除转阴率为60.87%,对照组HP清除转阴率为90.48%,经X2检验,两组疗效无明显差异(P>0.05)。结论：本课题研究提示新加左金汤是治疗肝胃不和型慢性浅表性胃炎有效的方药,在改善临床症状、消除胃粘膜炎症、修复受损胃粘膜,减少CSG的复发方面优于单纯西药组,值得进一步研究和推广应用。更多还原

【Abstract】 Objective:To observe the treatment of Incoordination between Liver and Chronic Superficial Gastritis’clinical efficacy with modified left-gin’s.Mechanism of the modified left-gin’s. Further explore the treatment of chronic superficial gastritis effective method.Method:1.64 patient were treated in Specialist out-patient Chinese medicine of First Hospital of Wuhan, from September 2008 to October 2009,each of them endoscopy diagnosed as chronic superficial gastritis.According to randomized double-blind method, The subjects were randomly divided into treatment groups and the control group according to 1:1.Two groups have no significant difference in age、sex、course of disease、condition, have comparability (P>0.05).2.The control group was given Omeprazole enteric-coated capsules、Domperidone、Aluminum magnesium carbonate chewable tablets.Omeprazole enteric-coated capsules 40 mg, qd,po; Domperidone 10mg,tid,po; Aluminum magnesium carbonate chewable tablet 1-2 tablet,tid, swallow after chewing.The treatment group were treated with traditional Chinese medicine decoction-Modified left-gin’s.Main herbs:Coprk, Evodia,Woody, Xuanfuhua,Pinellia, Scutellaria,Cuttlebone,Concha Arcae. Taking method:1,Decoction to 400 ml,taken in two after meal 1 hour, warm taking. Every two weeks as a course, and taking two courses.The two groups during treatment ban to drink、pungent、too hot or cold food and too greasy food.3, statistical analysis methods:statistical software SPSS11.5 data applications for analysis.Rating information use Ridit test,count data using X2 test,measurement data using t test.Results:1.Finally completed 60 Observed cases.The treatment group completed 30 cases, clinical recovery in 8 cases,markedly effective in 14 cases,effective in 6 cases,invalid 2 cases,the total effective rate 93.33%; the control group completed 30 cases, clinical recovery in 3 cases,markedly effective in 7 cases, effective in 13cases,invalid 7 cases,the total effective rate 76.67%. Comparative efficacy of two groups the total effective rate was no significant difference (P>0.05).Two groups of patients during treatment were no significant adverse reactions.2. After treatment,the improvement of main symptoms,after using X2 test to compare,the treatment group superior than the control group (P<0.05).3.Gastroscopy effect after the treatment,the total effective of the treatment group was 96.67%, and the total efficiency of the control group was 76.67%, after using Ridit test to compare, the treatment group superior than the control group (P<0.05).4.After treatment,improvement in histological inflammation, the total effective of the treatment group was 96.67%,and the total efficiency of the control group was 80.00%, after using Ridit test to compare,the treatment group more superior than the control group (P<0.05). 5.Hp clearance rate after treatment,the treatment group was 60.87%,and the control group was 90.48%, by the X2 test,the two groups have no significant difference (P>0.05).Conclusion:The results suggest that:The Modified left-gin’s is the effective method to teat Incoordination between Liver and Chronic Superficial Gastritis.The method of the treatment group is superior in the clinical symptom improvement、gastric inflammation Eliminatement、damaged gastric mucosa repaired and reduce the relapse. Haveing the value of further study and promoting the use of Modified left-gin’s.更多还原