益气化瘀解毒汤结合微观辨证用药治疗慢性萎缩性胃炎

目的:观察益气化瘀解毒方结合胃镜下微观辨证用药治疗慢性萎缩性胃炎的临床疗效,并探讨其作用机制。方法:将120例经胃镜检查并病理活检确诊为慢性萎缩性胃炎的患者,随机分为治疗组和对照组,各60例。对照组口服胃复春片,4片/次,3次/d;治疗组采用益气化瘀解毒方治疗,在此基础上根据胃镜下微观征象辨证加味用药,1剂/d。16周为1个疗程,观察治疗前后两组患者临床症状总积分、主要中医症状疗效、胃黏膜病理组织学及胃镜下微观征象的变化。结果:治疗组与对照组临床疗效总有效率分别为83.3%,70%,内镜总有效率分别为73.3%,60%,治疗后治疗组的症状总积分和主要中医症状积分改善优于对照组(P0.05)。与对照组比较,治疗组能显著改善胃黏膜组织病理学及内镜下微观征象,且有较好的抗幽门螺杆菌作用(P0.05)。结论:结合胃镜下微观辨证治疗慢性萎缩性胃炎的疗效确切,值得在临床上推广应用。

Effect of Yiqi Huayu Jiedu Decoction Combined with Endoscopic Microcosmic Syndrome Differentiation in Treating Chronic Atrophic Gastritis

Objective: To observe the effect of Yiqi Huayu Jiedu decoction combined with endoscopic microcosmic syndrome differentiation in treating chronic atrophic gastritis, and discuss its action mechanism. Method: Totally 120 cases of chronic atrophic gastritis patients were randomly divided into two groups, with 60 in each group. The control group was orally given Weifuchun table (4 pills/time, tid), Treatment group was orally given Yiqi Huayu Jiedu decoction and other traditional Chinese medicines(TCM) on the basis of endoscopic microcosmic syndrome differentiation. The treatment of both groups lasted for 16 weeks to observe clinical symptoms, score of symptoms, mucosal lesions and microscopic signs of both groups under gastroscope before and after treatment. Result: At the end of the treatment, the total effective rates of treatment group and control group were 83.3%and 70%, respectively, their total effective rates of gastric mucosa were 73.3%and 60%, respectively. Treatment group was better than control group in the total score of symptoms and the TCM syndrome score (P<0.05). Treatment group can significantly improve gastric mucosal histopathology and microscopic signs under gastroscope, with a better effect in resisting helicobacter pylori (P<0.05). Conclusion: Yiqi Huayu Jiedu decoction combined with endoscopic microcosmic syndrome differentiation has a definite efficacy in treating chronic atrophic gastritis, and so is worth promoting in clinic.