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  本文選題：護膜生肌散 + 泮托拉唑�。� 參考：《南京中醫(yī)藥大學》2014年碩士論文

【摘要】：目的：觀察護膜生肌散聯(lián)合質子泵抑制劑治療消化性潰瘍的臨床治療效果,并從理論與臨床研究兩方面系統(tǒng)的探討護膜生肌散的作用機理。方法：選擇2013年1月-2013年7月江蘇省第二中醫(yī)院消化內(nèi)科門診治療的59例消化性潰瘍病例,所有病例在我院確診為消化性潰瘍,按照患者就診順序隨機分為觀察組和對照組,觀察組30例,對照組29例。其中對照組患者給予泮托拉唑40mg靜滴BID 10天,后改雷貝拉唑 10mg BID口服6周。觀察組在對照組基礎上給予導師經(jīng)驗方護膜生肌散治療,五味子粉、三七粉、白芨粉、山藥粉、煅烏賊骨粉,上方每藥2g共l0g研粉后每次10g每天服用3次。所有測量結果采用SPSS17.0進行統(tǒng)計分析。比較兩組治療前后綜合治療效果,胃鏡治療效果,中醫(yī)癥候總積分和潰瘍面積大小變化情況,比較治療前后兩組中醫(yī)癥候各項積分變化情況,對兩組患者進行隨訪1年,觀察兩組6個月和12個月潰瘍復發(fā)情況。觀察治療期間兩組患者出現(xiàn)的服藥不良反應和安全性評價。結果：(1)觀察組中醫(yī)證候療效總有效率為93.33%,對照組為65.52%,組間對比差異有統(tǒng)計學意義(P0.05)。(2)觀察組胃鏡治療總有效率為86.67%；對照組治療總有效率為62.07%,組間對比差異有統(tǒng)計學意義(P0.05)。(3)觀察組治療后中醫(yī)證候評分(7.43±1.24)分,潰瘍面積大小(19.89±6.75)mm2；對照組治療后中醫(yī)證候評分(9.89±2.31)分,潰瘍面積大小(34.03±10.95)mm2,組間對比差異有統(tǒng)計學意義(P0.05)。(4)對中醫(yī)癥狀從胃脘部疼痛、脘腹脹滿、暖氣呃逆、納差食少、情緒抑郁或者煩躁易怒、胸悶、乏力倦怠和大便溏薄8個項目進行觀察,兩組治療后各項癥狀評分均低于治療前,經(jīng)統(tǒng)計學分析差異有統(tǒng)計學意義(P0.05)。觀察組治療后中醫(yī)癥狀各項評分低于對照組,組間對比差異有統(tǒng)計學意義(P0.05)。(5)對兩組患者隨訪1年,采用胃鏡評定患者治療后復發(fā)情況,其中觀察組6個月復發(fā)率為6.67%,對照組6個月復發(fā)率為27.59%；觀察組12個月復發(fā)率為26.67%,對照組12個月復發(fā)率為51.72%,組間對比差異有統(tǒng)計學意義(P0.05)。(6)兩組患者治療期間均未發(fā)生不良反應。結論：本課題研究提示了中西醫(yī)結合治療消化性潰瘍的效果優(yōu)于單純西藥治療,護膜生肌散可以明顯的改善消化性潰瘍患者各項臨床體征,減輕患者的痛苦,提高患者生活質量；該方的作用機制可能是通過提高消化性潰瘍患者免疫功能,增強胃黏膜屏障保護能力與上皮細胞再生功能；根除幽門螺旋桿菌增加了胃黏膜前列腺素合成保護胃黏膜受到胃酸的侵蝕,能夠增加胃黏膜循環(huán)、灌注促進了患者機體的能量代謝,保證粘膜上皮與潰瘍的底部及邊緣迅速增生保證粘膜微循環(huán)酸堿平衡,提高了潰瘍的愈合效果,降低了潰瘍的復發(fā)情況。通過中醫(yī)藥優(yōu)勢更好地開展中西醫(yī)結合治療,優(yōu)化臨床消化性潰瘍治療方案,降低了臨床復發(fā)率,促進了中醫(yī)藥學術水平發(fā)展并改善國人健康衛(wèi)生水平。
[Abstract]:Objective: to observe the clinical effect of HuimenshengmySan combined with proton pump inhibitor in the treatment of peptic ulcer. Methods: 59 cases of peptic ulcer were selected from the outpatient department of Department of peptic Medicine, second traditional Chinese Medicine Hospital of Jiangsu Province from January 2013 to July 2013. All the cases were diagnosed as peptic ulcer in our hospital. The patients were randomly divided into observation group and control group. There were 30 cases in the observation group and 29 cases in the control group. Patients in the control group were given pantazol 40mg intravenously for 10 days and then treated with rabeprazole 10mg BID for 6 weeks. The observation group was treated with Schisandra powder, Panax notoginseng powder, Bletilla striata powder, mountain medicine powder and calcined squid bone powder on the basis of experimental group. All the measured results were analyzed by SPSS17.0. The effects of comprehensive treatment, gastroscopy, the total score of TCM symptom and the area of ulcer were compared between the two groups before and after treatment. The patients in the two groups were followed up for 1 year. The recurrence of ulcer was observed at 6 and 12 months in both groups. Adverse drug reactions and safety evaluation were observed in the two groups during treatment. Results the total effective rate of TCM syndromes in the observation group was 93.33 and that in the control group was 65.52. The difference between the two groups was statistically significant (P 0.05). The total effective rate of the observation group was 86.677.The total effective rate of the control group was 62.07, and the difference between the two groups was statistically significant. Significance: P0.05A) after treatment, the TCM syndrome score of the observation group was 7.43 鹵1.24). The area of ulcer was 19.89 鹵6.75 mm ~ 2, the score of TCM syndromes was 9.89 鹵2.31) and the area of ulcer was 34.03 鹵10.95 mm ~ (2) in the control group. The difference between the two groups was statistically significant (P < 0.05). Eight items of depression or irritability, chest tightness, fatigue, fatigue and loose stool were observed. After treatment, the scores of symptoms in the two groups were lower than those before treatment, and the difference was statistically significant (P 0.05). After treatment, the scores of TCM symptoms in the observation group were lower than those in the control group, and the difference between the two groups was statistically significant (P 0.05). The patients in the two groups were followed up for one year. The recurrence of the patients after treatment was assessed by gastroscopy. The recurrence rate was 6.67 in the observation group and 27.59in the control group, 26.67 in the observation group and 51.72 in the control group. Conclusion: this study indicates that the effect of integrated traditional Chinese and western medicine in the treatment of peptic ulcer is better than that of western medicine alone, and the clinical signs of peptic ulcer patients can be obviously improved and the pain of peptic ulcer can be alleviated. The mechanism of the prescription may be to improve the immune function of patients with peptic ulcer and enhance the ability of gastric mucosal barrier protection and epithelial cell regeneration. Eradication of Helicobacter pylori increased prostaglandin synthesis in the gastric mucosa to protect gastric mucosa from gastric acid erosion, increased gastric mucosal circulation, and increased energy metabolism in the patient's body. To ensure the rapid proliferation of mucosal epithelium and the bottom and edge of ulcer, to ensure the mucosal microcirculation acid-base balance, to improve the healing effect of ulcer, and to reduce the recurrence of ulcer. Through the advantage of traditional Chinese medicine, the combination of traditional Chinese medicine and western medicine can improve the treatment of peptic ulcer, reduce the rate of clinical recurrence, promote the development of academic level of traditional Chinese medicine and improve the health level of Chinese people.
【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R573.1

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相關期刊論文 前2條

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本文編號：1959837