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1、提要目的:觀察清中降逆湯治療膽胃郁熱型膽汁反流性胃炎(bilerefluxgastritisBRG)的臨床療效,并從臨床和理論兩個(gè)角度探討清中降逆湯治療BRG的機(jī)制。方法:選擇臨床上符合納入標(biāo)準(zhǔn)的BRG患者60例,隨機(jī)分成兩組,治療組(30例)給予口服清中降逆湯水煎劑,對(duì)照組(30例)給予多潘立酮片(商品名嗎丁啉,西安楊森制藥有限公司生產(chǎn))10mg和鋁碳酸鎂(商品名:胃達(dá)喜,德國(guó)拜耳公司生產(chǎn))500mg,療程四周,療程結(jié)束后觀察兩組的臨床療效及復(fù)發(fā)率。結(jié)果:臨床研究顯示,按照中醫(yī)證候療效評(píng)定標(biāo)準(zhǔn),治
2、療組30例中,8例臨床治愈,13例顯效,8例有效,1例無效,顯效以上占70.00%,總有效率96.67%;對(duì)照組30例中,2例臨床痊愈,5例顯效,15例有效,8例無效,顯效以上占23.332%,總有效率73.33%;經(jīng)X檢驗(yàn),兩組痊愈率+顯效率有非常顯著性差異(P﹤0.01),總有效率有顯著性差異(P﹤0.05);按照胃鏡療效評(píng)定標(biāo)準(zhǔn),治療組30例患者,其中痊愈13例,顯效5例,有效11例,無效1例,顯效以上占60.00%,總有效率為96.67%;對(duì)照組30例患者,痊愈10例,顯效7例,有效5例,無
3、效8例,顯效以2上占56.67%,總有效率為73.33%。經(jīng)X檢驗(yàn),兩組痊愈率+顯效率無明顯差異(P>0.05),而兩組總有效率有顯著性差異(P﹤0.05)治療組在中醫(yī)證侯總積分與胃鏡療效總有效率和消除或改善在胃脘疼痛、有灼熱感,腹脹,口干而苦,舌紅、苔黃或黃膩,脈弦滑;噯氣,嘈雜;煩躁易怒,納呆食少,體重減輕,便秘等癥狀上,療效優(yōu)于對(duì)照組。雖然治療組復(fù)發(fā)率低于對(duì)照組,但是并無統(tǒng)計(jì)學(xué)意義。結(jié)論:清中降逆湯是臨床上治療膽胃郁熱型膽汁反流性胃炎的有效方劑,其機(jī)理的可能與調(diào)節(jié)胃腸動(dòng)力、調(diào)節(jié)胃腸激素的分泌、
4、增強(qiáng)抗反流屏障,以及抑酸、抗炎等作用有關(guān)。關(guān)鍵詞清中降逆湯;膽汁反流性胃炎(bilerefluxgastritisBRG);膽胃郁熱;臨床研究ClinicalStudyofTreatingBileRefluxGastritisofbiliaryandgastricheatstagnationsyndromeWithQing-Zhong-Jiang-Ni-TangSpecialty:GastroenterologyInternalMedicineofTCM.Author:ZhanglingyanTut
5、or:ProfessorLuGuangchaoAbstractObjectiv:ToobservetheclinicalcurativeeffectofQing-Zhong-Jiang-Ni-Tangonbilerefluxgastritisofbiliaryandgastricheatstagnationsyndromeandexplorethemechanismofwhichfromtheoreticalandclinicalaspects.Methods:60caseswithbilerefl
6、uxgastritisweredividedintotwogroupsatrandom:thetreatmentgroup(30cases)andthecontrolgroup(30cases).TheformerwasgivenQing-Zhong-Jiang-Ni-TangwhilethelatterwasgivenDomperidoneandTalcid.Symptomsandsignsofeachgroupwereobservedbeforeandafterthetreatment,incl
7、udinggastroscopyobserving.Results:Afteronecourseoftreatment,significantdifferencewasapparentintheclinicaleffects:Inthetreatmentgroup,8casesrecoveredand13casessignificantlyimproved,(thustheeffectualrateis70.00%),8casesimproved.Thetotaleffectiverateinthe
8、treatmentgroupis96.67%..Theeffectiverateofgastroscopeobservingwas96.67%.Inthecontrolgroup,2casesrecoveredand5casessignificantlyimproved,(thustheeffectualrateis23.33%),15casesimproved.Thetotaleffectiverateinthecontrolgroupis73.33%.Theeff