络病理论指导下应用益气活血通络方治疗慢性萎缩性胃炎临床观察

目的:观察益气活血通络方治疗慢性萎缩性胃炎的临床疗效。方法:采用随机对照研究,将66例西医诊断为慢性萎缩性胃炎及中医辨证属于脾胃虚弱合胃络瘀血证的病例分为两组,治疗组用益气活血通络方(炙黄芪30 g,桂枝10 g,炒白芍20 g,生蒲黄10 g,五灵脂10 g,制乳香3 g,醋延胡索20 g,铁树叶30 g,海螵蛸30 g,?虫10 g,制地龙20 g,炙甘草6 g)加减治疗,对照组用胃复春片治疗。两组疗程均为3个月。结果:治疗组临床总有效率为68.8%,对照组临床总有效率为43.3%,治疗组疗效优于对照组(P<0.05)。治疗后两组中医证候积分、胃镜积分、病理积分及血浆内皮素(ET)水平均较治疗前显著降低,差异有统计学意义(P<0.05),且治疗组较对照组降低更显著(P<0.05)。治疗后两组胃黏膜萎缩情况比较差异有统计学意义(P<0.05),肠化、异型增生情况及血清胃蛋白酶原Ⅰ(PGⅠ)、PGⅠ/Ⅱ水平比较差异无统计学意义(P>0.05)。结论:益气活血通络方对脾胃虚弱合胃络瘀血型慢性萎缩性胃炎有显著的临床疗效,其机制可能与改善胃黏膜血流量、促进胃固有腺体增加有关。

Clinical Observation on Treatment of Chronic Atrophic Gastritis with Yiqi Huoxue Tongluo Decoction under Guidance of Collateral Disease Theory

Objective:To observe the clinical effect of Chronic Atrophic Gastritis with Yiqi Huoxue Tongluo decoction in the treatment of Chronic Atrophic Gastritis.Methods:Sixty-six patients who were diagnosed as Chronic Atrophic Gastritis by western medicine and differentiated as spleen-stomach deficiency plus gastric stasis in the view of traditional Chinese Medicine were selected and divided randomly into two groups.The treatment group was treated with modified Yiqi Huoxue Tongluo decoction(honey-fried RADIX ASTRAGALI 30 g,cassia twig 10 g,stir-baked RADIX PAEONIAE ALBA 20 g,raw cattail pollen 10 g,excrementum pteropi 10 g,prepared frankincense 3 g,corydalis yanhusuo soaked with vinegar 20 g,sago cycad leaves 30 g,cuttlefish bone 30 g,eupolyphaga sinensis walker 10 g,prepared earthworm 20 g,prepared licorice 6 g).The control group was treated with Weifuchun tablets.The treatment duration is 3 months.Results:The total effective rate of the treatment group was 68.8%,and the total effective rate of the control group was 43.3%.The treatment group is better than the control group(P<0.05).The TCM clinical syndrome scores,gastroscopic scores,pathological scores and plasma ET levels in the two groups deceased obviously.The differencesin the two groups before and after the treatments were both statistically significant(P<0.05),and the treatment groups was more significant(P<0.05).The difference in gastric mucosal atrophy between the two groups was statistically significant(P<0.05),but the difference in intestinal metaplasia and dysplasia as well as the improvement of PG I and PG I/II were not statistically significant(P>0.05).Conclusion:The Yiqi Huoxue Tongluo decoction has significant clinical effect in the treatment of chronic atrophic gastritis with spleen-stomach deficiency plus gastric stasis.The mechanism may be related to the improving of gastric mucosal blood flows and promoting the increase of intrinsic gastric glands.