胃溃疡活动期“毒热”创新病因的系统研究  

Systematic Study on“Toxin-heat”as an Innovative Etiology of Gastric Ulcer in Active State

作　　者：郑洪新[1] 王垂杰[1] 王文萍[1] 才丽平[1] 傅海燕[1] 曲怡[1] 周学文[1] 

机构地区：[1]辽宁中医药大学,沈阳110847

出　　处：《世界中医药》2014年第5期557-560,567,共5页World Chinese Medicine

基　　金：国家"973"计划课题:基于"以痈论治"胃癌前状态性疾病(胃溃疡活动期)"毒热"病因创新研究(编号:2006CB504809)

摘　　要：目的:课题以研究胃溃疡活动期的中医"毒热"病因理论为突破口,以建立中医病因学研究方法为途径,以阐明中医药治疗胃癌前状态性疾病的疗效机制为特色,丰富和发展中医病因学理论和实践。方法:通过中医胃脘病"毒热"病因理论研究、中医"毒热"实验病因学研究、"毒热"病因要素的临床流行病学调查、"毒热"病因的中药干预验证性临床试验,进行系统研究。结果:通过病例对照设计,581例胃溃疡活动期83.3%为毒热证;266例浅表性胃炎13.3%为毒热证,从而确证胃溃疡活动期"毒热"为多发、常见病因,通过多因素Logistic回归分析,辨证求因要点包括幽门螺杆菌(Hp)感染、胆汁反流、炎症因子增高、胃肠激素分泌异常等。经300例随机双盲双模拟多中心对照临床试验,试验组证候积分愈显率86.62%,胃镜愈显率80.29%。改良胃溃疡活动期胃毒热证的实验动物模型及其评价方法,验证清热解毒、消痈生肌治法中药复方疗效确切,并阐明其生物学机制。结论:"毒热"为胃溃疡活动期的主要病因,"以痈论治"胃溃疡活动期的新治法为清热解毒、消痈生肌,疗效显著。Objective：To enrich and develop the theory and practice of TCM etiology , taking “toxin-heat” etiological study of gastric ulcer in active state （ GUIAS） as a breakthrough , to establish the research methods of TCM etiology and elucidated the therapeutic mech -anism of GUIAS TCM therapy .Methods：By theoretical analyses , experiments , clinical epidemiological investigations , clinical trials of Chinese medicine , we systematically analyzed the role of “toxin-heat” etiological factor in gastric ulcer in active state .Results：Case-control studies revealed that 83.3%out of 581 patients with GUIAS presented a “toxin-heat” syndrome which was only diagnosed in 13. 3%of 266 patients with superficial gastritis .Multiple logistic regression analysis further confirmed that “toxin-heat” could lead to heli-cobacter pylori infection , bile reflux, increase of inflammatory factors and abnormal secretion of gastrointestinal hormone , etc.In a 300-patient-involved clinical trial , syndrome analyses and gastroscopy showed that the effective rate of the treatments was as high as 86.62%and 80.29%, respectively.Besides, this project modified the animal model and its evaluation method , and verified the efficacy of TCM extract and elucidated the underlying biological mechanism .Conclusion： “Toxin-heat” is a common and frequent cause of GUIAS . Treating GUIAS as carbuncle is a new and effective way for GUIAS therapy , which is capable of clearing heat , detoxifying , and elimina-ting carbuncle while growing muscle .

关 键 词：毒热 以痈论治 胃溃疡(活动期) 溃得康颗粒 

分 类 号：R256.3[医药卫生—中医内科学]