清胃降逆方治疗幽门螺杆菌相关性胃炎临床观察

[目的]观察自拟清胃降逆方治疗幽门螺杆菌(Hp)相关性胃炎湿热蕴胃兼胃阴不足型的临床疗效.[方法]将84例Hp阳性的胃炎患者随机分为2组,治疗组42例以自拟清胃降逆方(主要由黄连、吴茱萸、栀子、蒲公英、太子参等组成)为基本方随症加减,对照组42例口服胶体次枸橼酸铋、阿莫西林、克拉霉素,疗程结束后进行统计分析,并对部分病...     

清热理气方对螺杆菌感染性胃炎的作用

为检验清热理气方（蒲公英６０ｇ,黄连１０ｇ,黄芩１０ｇ,枳壳１０ｇ,佛手１２ｇ,炙甘草６ｇ）对实验性猫胃螺杆菌胃炎的治疗作用。采用复制Ｂａｌｂ／ｃ猫有螺杆菌胃炎模型,以清热理气方大,中,小剂量９分别为２６．６ｇ／ｋｇ,１３．３ｇ／ｋｇ,６．６５ｇ／ｋｇ）给药,以三联疗法（灭滴灵２．６ｍｇ,四环素１．３ｍｇ,丽珠得乐１．３ｍｇ）为阳笥对照组,以生理气方作用不如三联疗法,给药４周,末次给药４周后观察结     

Prevalence of Upper Gastrointestinal Lesions and Helicobacter pylori Infection in Crohn's Disease

Crohn's disease can affect the upper gut withreported variable frequency, although concurrentHelicobacter pylori infection has been reported to below. We prospectively investigated the prevalence of esophageal, gastric, and duodenal lesions andHelicobacter pylori infection in 67 Crohn's disease, 41ulcerative colitis patients, and 43 controls. Symptoms,esophagogastroduodenoscopy, and multiple biopsies were performed on all patients consecutively.Endoscopic lesions were found in 63% of Crohn's diseasepatients, with a Helicobacter pylori prevalence of 28%. Granulomas were found in three patients. Twenty-two percent of the ulcerative colitis patients hadlesions, with a 29% prevalence of Helicobacter pyloriinfection. Half of the controls had pathologicalendoscopy, and Helicobacter pylori was positive in 40% of the cases. Subjective symptoms did notpredict the presence of endoscopic lesions orHelicobacter pylori infection in inflammatory boweldisease patients. Chronic gastritis and duodenitis arecommon in Crohn's disease patients, and the majorityare not associated with Helicobacter pyloriinfection.     

建立慢性浅表性胃炎脾胃湿热证诊断标准的探讨

[目的]采用病证结合和现代流行病学的方法初步建立慢性浅表性胃炎脾胃湿热证的诊断标准。[方法]通过文献整理和专家调查建立脾胃湿热证的临床调查表;观察慢性浅表性胃炎病人146例,其中脾胃湿热证81例,非脾胃湿热证65例．经过问卷调查和判别分析法统计后,根据判别函数和频数分析,初步建立慢性浅表性胃炎脾胃湿热证诊断标准和简化标准。[结果]慢性浅表性胃炎脾胃湿热证的初步诊断标准为：以舌苔黄腻、胃脘痞满或胀或痛、大便溏、纳呆为主要症状;口苦而粘、胸闷、口渴少饮、肢体困重、恶心为次要症状;只要具备舌苔黄腻,再同时具备其余两个主症,或具备其余1个主症和2个次症,或具备3个以上次症,即可诊断。简化诊断标准为：同时具备舌苔黄腻和胃脘痞满或胀或痛,即可诊断。[结论]初步建立的慢性浅表性胃炎脾胃湿热证诊断标准具有一定的科学性、客观性、可行性。     

Pre- and Postoperative Esophageal and Gastric pH Levels in Morbidly Obese Patients Undergoing Vertical Gastroplasty

Background: The aim of this study was to determine whether the anatomicofunctional changes induced by vertical gastroplasty lead to pH alterations in the esophagus and body and antrum of the stomach. Materials and Methods: 23 non-smoking volunteers (3 men, 20 women) mean age 35.29 ± SD 6.85 years, mean weight 163.17 ± 52.11 kg and mean BMI 56.06 ± 14.01 kg/m2 were studied. The pH of the esophagus, body and antrum of the stomach were measured preoperatively and 18 months postoperatively (after excess weight loss). Data was analyzed statistically using paired student t-test. Results: The pH values before (pH₁) and after (pH₂) the operation were: for the esophagus pH_1e ± SD = 6.12 ± 0.31 and pH_2e ± SD = 5.92 ± 0.37 (P =0.38), for the body of the stomach pH_1b ± SD = 2.2 ± 0.30 and pH_2b ± SD = 2.56 ± 0.34 (P =0.30), and for the antrum pH_1a ± SD = 1.78 ± 0.28, and pH_2a ± SD = 1.65 ± 0.36 (P =0.011). Conclusions: Vertical gastroplasty does not affect the pH levels in the esophagus and in the body of the stomach. However, there is acidification in the antrum, which could lead to pH-related diseases.     

酒精所致胃炎并发大出血的外科处理

目的为探讨酒精所致胃炎大出血的外科处理。方法对１９９０年１月～１９９５年１２月因酒精所致胃炎并发大出因１１例手术治疗的临床资料进行分析。结果行包括十二指肠在内的胃体窦部切除,保留胃底或部分胃底的手术者１０例痊愈,１例仅行胃切开探查者于术后６０小时因再出血死亡。结论对于非手术疗法不能控制酒精性胃炎出血,包括十二指肠在内的胃体窦部切除术,在紧急情况下是达到止血目的的一个较好的办法。     

从水通道蛋白4的表达探讨脾胃湿热证的机理

【目的】 从水液代谢角度探讨脾胃湿热证的机理。【方法】 慢性浅表性胃炎患者57例,其中脾胃湿热证35例,脾气虚证22例;另设10例正常人为对照。胃镜下取胃体上部粘膜,分别用免疫组化法、荧光定量PCR法检测粘膜组织中的水通道蛋白4(AQP4)的蛋白表达和信使核糖核酸(mRNA)表达。【结果】 脾胃湿热证组AQP4蛋白表达量高于脾气虚证组(P<0.01)和正常组(P<0.05),AQP4 mRNA表达量亦高于脾气虚证组(P<0.01)和正常组(P>0.05);而脾气虚证组的AQP4基因表达量和蛋白表达量均低于正常组,其中两组的AQP4基因表达量有显著性差异(P<0.05),但两组的蛋白表达量差异则无显著性(P>0.05)。【结论】 与水液代谢密切相关的AQP4异常表达可能是脾胃湿热证的发生机制之一。     

慢性浅表性胃炎脾胃湿热证量化标准的初步建立

【目的】探讨建立慢性浅表性胃炎脾胃湿热证量化诊断标准。【方法】在流行病学调查的基础上,根据相关因素在脾胃湿热证和非脾胃湿热证出现状况的差异对相关因素进行赋分,并以此为基础建立量化诊断标准;然后对量化诊断标准进行检验;最后建立程度分级标准。【结果】慢性浅表性胃炎脾胃湿热证量化诊断标准为49分;量化诊断标准的回顾性检验,其敏感度、特异度、准确度、阳性似然比分别为:90.91%、90.57%、90.72%、9.64。程度分级标准:轻度49~57分,中度58~65分,重度≥65分。【结论】慢性浅表性胃炎脾胃湿热证量化标准统计严谨,相关因素赋分合理,值得进一步深入研究。     

消胀冲剂治疗大鼠慢性萎缩性胃炎实验研究

为探讨由中药党参、甘松、砂仁等组成，具有健脾、养胃、清热、行气功效的消胀冲剂对慢性萎缩性胃炎的作用机理，将主动免疫结合胆汁及热水灌胃方法制成的大鼠慢性萎缩性胃炎模型随机分为维霉素对照组、生理盐水组、消胀冲剂大、小剂量组各２０只，并设正常组２０只，检测胃粘膜ｐＨ值、胃粘膜壁细胞体密度。结果：消胀冲剂大、小剂量组与生理盐水组、维酶素组比较，ｐＨ值明显降低（Ｐ＜０．０５或Ｐ＜０．００１），壁细胞体密度明显增大（Ｐ＜０．０５或Ｐ＜０．００１）。提示消胀冲剂使胃粘膜细胞数目增多，促进壁细胞泌酸功能恢复，这可能是消胀冲剂对慢性萎缩性胃炎的作用机理之一