消痞愈萎汤联合胃复春片治疗慢性萎缩性胃炎伴胃黏膜肠上皮化生或异型增生64例临床观察  

Clinical Observation on Xiaopi Yuwei Decoction with Weifuchun Tablets in the Treatment of 64 cases of Chronic Atrophic Gastritis with Intestinal Metaplasia or Dysplasia

作　　者：郑逢民 郑乐乐 郑中坚 

机构地区：[1]瑞安市中医院

出　　处：《中医杂志》2015年第4期311-314,共4页Journal of Traditional Chinese Medicine

基　　金：浙江省中医药科技计划(2013ZB124);2012年浙江省中医药重点学科建设计划(2012-XK-D07)

摘　　要：目的观察消痞愈萎汤联合胃复春片治疗慢性萎缩性胃炎(CAG)伴胃黏膜肠上皮化生(IM)或异型增生(Dys)的临床疗效。方法将114例患者随机分为治疗组64例与对照组50例,对照组给予胃复春片,每片0.359g,每次4片,每日3次;治疗组在对照组基础上加服消痞愈萎汤,每日1剂,两组均4周为1个疗程,连续3个疗程后观察临床疗效。比较两组患者治疗前后中医症状积分、胃黏膜病理积分情况及幽门螺杆菌(Hp)转阴率。结果治疗组、对照组的总有效率分别为92.2%、72.0%,治疗组疗效优于对照组(P<0.05)。治疗组治疗后胃脘胀满、胃脘疼痛、嗳气泛酸、胃中嘈杂、饮食减少症状积分均明显下降(P<0.01);对照组治疗后除胃脘疼痛、嗳气泛酸、胃中嘈杂症状积分下降外(P<0.05),胃脘胀满及饮食减少积分无明显变化(P>0.05);治疗组治疗后在改善胃脘胀满和饮食减少方面明显优于对照组(P<0.05)。两组治疗后胃黏膜萎缩、肠上皮化生、异型增生积分与本组治疗前比较均明显降低(P<0.05或P<0.01)。治疗组Hp转阴率为46.9%明显高于对照组的16.7%(P<0.05)。结论消痞愈萎汤联合胃复春片治疗CAG伴IM或Dys能明显改善患者临床症状,在一定程度上可逆转胃黏膜病理改变。Objective To observe the clinical curative effect of Xiaopi Yuwei Decoction combined with Weifuchun Tablets in treatment of chronic atrophic gastritis with intestinal metaplasia or dysplasia. Methods In total 114 patients were randomly divided into a treatment group of 64 cases and a control group of 50 cases. Both groups were given Weifuchun Tablets orally,0. 359 g per tablet,4 tablets each time,3 times a day,while the treatment group was added with Xiaopi Yuwei Decoction,one dose daily. Both groups were treated for 3 courses,with 4 weeks as one course. The TCM symptom scores,pathological scores of gastric mucosa and Helicobacter pylori（ Hp） negative rates were compared before and after treatment to determine the clinical efficacy. Results The effective rate of the treatment group was 92. 2%,which was better than the 72% of the control group（ P〈0. 05）. After the treatments,the scores of epigastric fullness,epigastric pain,belching,acid reflux,stomach noises,and food intake were significantly improved in the treatment group（ P〈0. 01）; the scores of epigastric pain,belching,acid reflux,and stomach noises were improved but the scores of epigastric fullness and food intake showed no changes in the control group（ P〉0. 05）,with the significant differences in scores of epigastric fullness and food intake between the two groups. The scores of gastric atrophy,intestinal metaplasia and dysplasia were significantly better after treatement in both groups（ P〈0. 05 or P〈0. 01）. Hp negative rate of the treatment group（ 46. 9%） was significantly higher than the control group（ 16. 7%,P〈0. 05）. Conclusion Xiaopi Yuwei Decoction with Weifuchun Tablets could significantly improve the symptoms,as well as reduce the gastric mucosal injuries in the treatment of chronic atrophic gastritis with intestinal metaplasia or dysplasia.

关 键 词：慢性萎缩性胃炎 肠上皮化生 异型增生 消痞愈萎汤 

分 类 号：R259[医药卫生—中西医结合]