基于食伤理论治疗肝胃气滞型慢性萎缩性胃炎的疗效观察  

Clinical Observation on the Treatment of Chronic Atrophic Gastritis with Liver and Stomach Qi Stagnation of Therapeutic Effect Based on Dietary Injury Theory

作　　者：江华娣 董明国[1] JIANG Hua-Di;DONG Ming-Guo(Dongguan Hospital of Guangzhou University of Chinese Medicine,Dongguan 523000 Guangdong,China)

机构地区：[1]广州中医药大学东莞医院,广东东莞523000

出　　处：《广州中医药大学学报》2022年第10期2255-2262,共8页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省基础与应用研究基金项目(编号:2019A1515110653);2020年董明国广东省名中医传承工作室建设项目;东莞市社会科技发展项目(编号:201950715002659)。

摘　　要：【目的】观察基于食伤理论,应用香苏饮加味方联合消食方治疗肝胃气滞型慢性萎缩性胃炎(CAG)患者的临床疗效。【方法】将68例肝胃气滞型CAG患者随机分为治疗组和对照组,每组各34例。对照组给予香苏饮加味方治疗,治疗组给予香苏饮加味方联合消食方治疗,疗程为6个月。观察2组患者治疗前后中医证候积分和胃黏膜病理组织学评分的变化情况,评价2组患者的中医证候疗效、胃镜及病理疗效、临床综合疗效。【结果】(1)治疗过程中,2组各有4例患者脱落,最终共有60例患者纳入统计,其中对照组和治疗组各30例。(2)治疗6个月后,治疗组的中医证候疗效、胃镜及病理疗效、临床综合疗效的总有效率分别为93.3%(28/30)、80.0%(24/30)、83.3%(25/30),对照组分别为86.7%(26/30)、63.3%(19/30)、66.7%(20/30);组间比较(秩和检验),治疗组的中医证候疗效、胃镜及病理疗效、临床综合疗效均优于对照组(P<0.05)。(3)治疗后,2组患者的胃脘胀满或胀痛、胁肋胀痛、症状因情绪因素诱发或加重、嗳气频作、胸闷不舒等各项中医证候积分及总积分均较治疗前明显改善(P<0.05),且治疗组的改善作用均明显优于对照组(P<0.05)。(4)治疗后,2组患者的炎症、萎缩、肠上皮化生、异型增生等各项胃黏膜病理组织学评分均较治疗前改善(P<0.05),且治疗组的改善作用均明显优于对照组(P<0.05)。【结论】基于食伤理论,应用香苏饮加味方联合消食方治疗肝胃气滞型CAG患者疗效确切,对改善甚至逆转CAG的病理发展也具有一定疗效,且其疗效明显优于单纯应用香苏饮加味方治疗。Objective To observe the clinical efficacy of applying the flavored Xiangsu Decoction combined with Xiaoshi Formula based on the dietary injury theory in treating patients with chronic atrophic gastritis(CAG)of liver and stomach qi stagnation type.Methods Sixty-eight cases of CAG with liver and stomach qi stagnation syndrome were randomly divided into the treatment group and the control group,with 34 cases in each group.The control group was given flavored Xiangsu Decoction,while the treatment group was given flavored Xiangsu Decoction combined with Xiaoshi Formula.The treatment for both groups lasted for 6 months.The changes in the traditional Chinese medicine(TCM)syndrome scores and the scores of gastric mucosa histopathology in the two groups before and after treatment were observed.After treatment,the TCM syndrome efficacy,gastroscopic and pathological efficacy,and comprehensive clinical efficacy of the two groups were evaluated.Results(1)During the treatment,4 patients in each of the two groups fell off,and a total of 60 patients were eventually included in the statistics,30 patients from the control group and 30 patients from the treatment group.(2)After 6 months of treatment,the total effective rates of TCM syndrome efficacy,gastroscopic and pathological efficacy,and comprehensive clinical efficacy were 93.3%(28/30),80.0%(24/30)and 83.3%(25/30)in the treatment group,and were 86.7%(26/30),63.3%(19/30)and 66.7%(20/30)in the control group,respectively.The intergroup comparison by rank sum test showed that the TCM syndrome efficacy,gastroscopic and pathological efficacy,and comprehensive clinical efficacy of the treatment group were all superior to those of the control group(P<0.05).(3)After treatment,the scores of TCM syndromes of epigastric flatulence or distending pain,hypochondriac distending pain,symptoms triggered or aggravated by emotional factors,frequent belching and chest distress as well as the total TCM syndrome scores in the two groups were all significantly improved compared with those before tre

关 键 词：食伤理论 肝胃气滞 慢性萎缩性胃炎 香苏饮加味方 消食方 中医证候积分 胃黏膜病理组织学评分 

分 类 号：R259.733[医药卫生—中西医结合]