基于长桑君脉法运用小建中汤合大柴胡汤治疗平人型慢性萎缩性胃炎的临床观察  

Clinical Observation on Xiaojianzhong Decoction Combined with Dachaihu Decoction for the Treatment of Chronic Atrophic Gastritis of Normal-People Pulse Type Classified by Changsangjun Pulse-Taking Method

作　　者：林春梅 张双喜[2] 罗琼熙 代镇宇 LIN Chun-Mei;ZHANG Shuang-Xi;LUO Qiong-Xi;DAI Zhen-Yu(Guangzhou University of Chinese Medicine,Guangzhou 510006 Guangdong,China;Dept.of Gastroenterology,ShundeHospital,Guangzhou University of Chinese Medicine,Foshan 528300 Guangdong,China)

机构地区：[1]广州中医药大学,广东广州510006 [2]广州中医药大学顺德医院消化内科,广东佛山528300

出　　处：《广州中医药大学学报》2024年第7期1722-1729,共8页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省科技计划项目(编号:2220001004385)。

摘　　要：【目的】客观评价小建中汤合大柴胡汤治疗慢性萎缩性胃炎的临床疗效,为该方的临床应用提供科学依据。【方法】选取2020年1月~2023年12月在广州中医药大学顺德医院消化内科门诊就诊的80例平人型(根据长桑君脉法脉息术,患者1 min内脉搏与呼吸次数的比值为4~5)慢性萎缩性胃炎脾虚瘀热证患者,根据治疗方式的不同,将患者分为治疗组和对照组,每组各40例。对照组给予常规西药治疗,治疗组给予小建中汤合大柴胡汤治疗,7 d为1个疗程,共治疗6个月。观察2组患者治疗前后的中医证候积分、胃镜评分、病理积分及胃功能指标的变化情况,并评价2组患者的临床疗效和安全性。【结果】(1)疗效方面,治疗6个月后,治疗组的总有效率分别为90.00%(36/40),对照组为60.00%(24/40)。组间比较(χ^(2)检验),治疗组的疗效明显优于对照组(P<0.05)。(2)中医证候积分方面,治疗后,2组患者的中医证候积分均较治疗前明显降低(P<0.05),且治疗组的降低幅度明显优于对照组(P<0.05)。(3)胃镜评分方面,治疗后,2组患者的胃镜评分均较治疗前明显降低(P<0.05),但治疗后组间比较,差异无统计学意义(P>0.05)。(4)病理积分方面,治疗后,2组患者的病理总积分及治疗组的胃窦、胃角、胃体的胃黏膜萎缩和肠化生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);而2组患者的胃窦、胃角、胃体的胃黏膜异型增生和慢性炎症以及对照组的胃窦、胃角、胃体的胃黏膜萎缩和肠化生均较治疗前无明显改善,差异均无统计学意义(P>0.05)。(5)胃功能指标方面,治疗后,2组患者的血清胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原II(PGⅡ)、胃泌素17(G-17)水平均治疗前明显降低(P<0.05),且治疗组的降低作用均明显优于对照组(P<0.05)。(6)安全性方面,治疗过程中,2组患者均未出现明显不良反应,具有较高的安全性。【结论】Objective To evaluate the clinical efficacy of Xiaojianzhong Decoction plus Dachaihu Decoction in the treatment of chronic atrophic gastritis(CAG),and to provide scientific evidence for the clinical application of the formula.Methods The clinical observation was carried out in 80 CAG patients with spleen deficiency and stasisheat syndrome of normal-people pulse type(the ratio of patients' pulse to the number of respirations within one minute being 4-5 evaluated by Changsangjun pulse-taking method) who attended the clinic of the Department of Gastroenterology of Shunde Hospital,Guangzhou University of Chinese Medicine,from January 2020 to December 2023.According to the treatment method,the patients were divided into the treatment group and the control group,with 40 cases in each group.The control group was given conventional western medicine treatment,and the treatment group was given Xiaojianzhong Decoction plus Dachaihu Decoction.Seven days constituted one course of treatment,and the treatment covered 6 months.The changes of traditional Chinese medicine(TCM) syndrome score,gastroscopy score,pathological score and gastric function indicators in the two groups were observed before and after the treatment.After treatment,the clinical efficacy and safety of the two groups were evaluated.Results(1) After 6 months of treatment,the total effective rate of the treatment group was 90.00%(36/40),and that of the control group was 60.00%(24/40).The intergroup comparison(tested by chi-square test) showed that the efficacy of the treatment group was significantly superior to that of the control group(P<0.05).(2)After treatment,the scores of TCM syndromes in the two groups were significantly lower than those before treatment(P<0.05),and the decrease of the scores in the treatment group was superior to that in the control group(P<0.05).(3)After treatment,the gastroscopy scores of the two groups were significantly lower than those before treatment(P<0.05),but there was no significant difference between the two groups after treat

关 键 词：长桑君脉法 小建中汤 大柴胡汤 慢性萎缩性胃炎 脾虚瘀热证 胃蛋白酶原Ⅰ(PGⅠ) 胃蛋白酶原II(PGⅡ) 胃泌素17(G-17) 

分 类 号：R259.733[医药卫生—中西医结合]