活动性胃溃疡及胆汁反流与中医毒热证的关联研究  

Association between gastric ulcer in active stage combined with bile reflux and "poison-heat" in TCM

作　　者：汤立东[1] 王垂杰[1] 周学文[1] 李慧臻[2] 时昭红[3] 董爱民 于庆功 姜巍[1] 白光[1] 李玉锋[1] 马乾章[1] 李岩[1] 黄煜[1] 刘林[1] 王辉[1] 

机构地区：[1]辽宁中医药大学附属医院消化科,辽宁沈阳110032 [2]天津中医药大学附属第二医院消化科,天津300150 [3]武汉市第一医院消化科,湖北武汉430022 [4]抚顺市中心医院消化科,辽宁抚顺113006 [5]大连大学附属中山医院消化科,辽宁大连116001

出　　处：《中国中西医结合消化杂志》2010年第6期385-388,共4页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：国家重点基础研究发展计划(973计划)资助项目(No.2006CB504809)

摘　　要：[目的]探讨消痈溃得康颗粒对胃溃疡活动期患者胆汁反流的影响,以证实"毒热"为其病因,胆汁反流为"毒热"病因要素。[方法]选取胃溃疡活动期合并胆汁反流符合中医胃毒热证患者300例,采用多中心、随机对照、双盲双模拟试验研究方法,治疗组150例,口服消痈溃得康颗粒10 g,每日2次;对照组150例,口服溃疡胶囊2粒,每日3次,观察治疗前、后胃镜下胆汁反流及中医症状积分变化,进行统计分析。[结果]治疗组脱落8例,对照组脱落6例。治疗前后2组胆汁反流的分级量化评分差异有统计学意义(P<0.01);治疗组治疗后胃脘灼痛,痛势较剧,泛酸嘈杂,口干及口苦症状改善优于对照组(P<0.01)。治疗组临床痊愈率为45.1%(64/142),总有效率为99.3%(141/142);对照组分别为6.9%(10/144),91.0%(131/144),2组比较差异有统计学意义(P<0.01)。[结论]消痈溃得康颗粒可以有效减轻胃溃疡活动期患者胆汁反流,显著改善中医症状,疗效优于对照组,证实"毒热"为胃溃疡活动期的重要病因,胆汁反流为"毒热"的内毒病因要素。[Objective]To study the effect of Xiaoyongkuidekang Granule（XG）on bile reflux in patients with gastric ulcer of active stage.[Methods]Three hundred patients of gastric ulcer with bile reflux in active stage were selected with features of gastric poison-heat syndrome in TCM and divided into treatment group and control group,employing double-blinded /simulation randomized control trial.One hundred and fifty patients in the tratment group were treated with XG and 150 patients in the control group with Kuiyang capsule.Condition of bile reflux was observed by gastroscope and symptom scores of TCM before and after the treatment were collected and analyzed.[Results]There were 8 cases loss in the treatment group and 6 cases loss in the control group.Bile reflux grade quantizing score before and after treatment in both groups showed significant difference.Cure rate and total effective rate of the treatment group were 45.1%（64/142）and 99.3%（141/142）respectively,those in the control group were 6.9%（10/144）and 91.0%（131/144）respectively,showing significant difference between the two groups（P〈0.01）.[Conclusion]XG ameliorated bile reflux in patients with gastric ulcer in active stage,improving symptoms,which provided evidence that ＂poison-heat＂ was the etiopathogenisis of gastric ulcer in active stage and bile reflux was an essential factor of ＂poison-heat＂.

关 键 词：胃溃疡 活动期 毒热证 胆汁反流 

分 类 号：R573.1[医药卫生—消化系统] R256.3[医药卫生—内科学]