当归四逆汤治疗脾胃虚寒型慢性非萎缩性胃炎的临床观察  

A clinical observation on Danggui Sini decoction for treatment of patients with chronic non-atrophic gastritis and spleen-stomach vacuity cold syndrome

作　　者：黄玉龙 曲学华[2] 

机构地区：[1]海口市中医医院,海南海口570216 [2]哈尔滨医科大学附属第四医院,黑龙江哈尔滨150000

出　　处：《中国中西医结合急救杂志》2015年第6期569-572,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：海南省自然科学基金资助项目（813270）

摘　　要：目的：观察当归四逆汤治疗脾胃虚寒型慢性非萎缩性胃炎的临床疗效。方法采用前瞻性随机对照研究方法，选择海口市中医医院126例住院及门诊胃镜检查诊断为慢性非萎缩性胃炎、中医辨证属脾胃虚寒型的患者，按随机数字表法分为观察组65例和对照组61例。观察组服给予当归四逆汤（当归15 g，桂枝15 g，芍药15 g，细辛5 g，甘草10 g，大枣12枚，通草10 g）200 mL分2次餐前温服，每日1剂，每周服用6剂，共4周；对照组服用奥美拉唑肠溶胶囊每次20 mg，每日1次，联合多潘立酮（吗叮啉）每次10 mg，每日3次。治疗4周后观察患者的临床疗效、症状总积分、中医症状学疗效积分、胃镜下黏膜组织病理学改善疗效及胃镜下黏膜组织学表现患者数变化。结果观察组临床疗效总有效率明显高于对照组〔96.9%（63/65）比86.9%（53/61），P＜0.05〕。两组治疗后症状总积分、主要中医症状学积分均较治疗前降低，且以观察组的降低程度较对照组更显著〔症状总积分（分）为12.36±2.11比15.94±2.37，胃脘胀满积分（分）为1.23±0.72比2.12±0.78，胃脘疼痛积分（分）为1.18±0.67比2.25±0.94，喜温喜按积分（分）为1.03±0.46比1.62±0.79，纳差积分（分）为1.06±0.57比1.43±0.53，便溏积分（分）为1.36±0.43比1.67±0.58，神疲乏力积分（分）为1.24±0.32比1.65±0.42，均P＜0.05〕。观察组胃黏膜组织病理学改善总有效率明显高于对照组〔90.77%（59/65）比81.97%（50/61），P＜0.05〕；且观察组治疗后慢性炎性细胞浸润（47例比54例）、红斑渗出（28例比30例）、平坦糜烂（8例比15例）、隆起糜烂（5例比6例）、胆汁反流（2例比3例）、幽门螺杆菌阳性（20例比29例）患者数均较对照组减少（均P＜0.05）。结论当归四逆汤治疗脾胃虚寒型慢性非萎缩性胃炎疗效显著。Objective To observe the clinical effect of Danggui Sini decoction for treatment of patients with chronic non-atrophic gastritis and spleen-stomach deficiency cold syndrome.Methods A prospective randomized control trial was conducted, including 126 in- and out-patients with chronic non-atrophic gastritis diagnosed by gastroscopy and spleen-stomach deficiency cold syndrome differentiated by traditional Chinese medicine （TCM） method admitted to Chinese Medicine Hospital of Haikou City. They were randomly assigned to an observation group （65 cases） and a control group （61 cases）. The patients in observation group were given Danggui Sini decoction with addition or/with subtraction of ingredients according to individual situation （ingredients： angelica 15 g, ramulus cinnamomi 15 g, paeonia 15 g, asari 5 g, glycyrrhizae 10 g, Chinese jujube 12, medulla tetrapanacis 10 g ）. The warm 200 mL （one dose） decoction was divided into two parts, one part was taken orally before a meal, twice daily, the therapeutic course was 4 weeks and in one week only 6 doses were applied; while the patients in control group, omeprazole capsules （dissolved in intestine）, each time 20 mg, once a day combined with domperidone （bite phenanthroline） 10 mg each time, 3 times a day were given. After 4 weeks of treatment, the clinical efficacy, the total integral of symptoms, the therapeutic effect of TCM symptoms score, the improvement of the therapeutic effect of mucosal histological and changes of the number of patients with the patholoyical changes of mucosa under gastroscopy were observed.Results The total effective rate in the observation group was significantly higher than that in the control group [96.9% （63/65） vs. 86.9% （53/61）,P 〈 0.05]. After treatment, the total integral of symptoms and the integrals of main TCM symptoms after treatment were lower than those before treatment, the degree of decrease in the observation group being more marked （the total integral of symptoms score： 12.36±2.11 vs

关 键 词：当归四逆汤 慢性非萎缩性胃炎 脾胃虚寒型 

分 类 号：R573.3[医药卫生—消化系统]