浅表性胃炎与功能性消化不良的关系研究

目的:探讨浅表性胃炎与功能性消化不良的关系。方法:在丽水市6所市、县级医院消化科胃病就诊者1002例中,选择经胃镜、活检病理及尿素酶检查幽门螺杆菌(Hp)均阴性的门诊或住院病人360例成年人,随机分成两组。采用随机、交叉、对照的方法,给予(1)甲方案(甲→乙):雷尼替丁150mg,早晚各1次,施维舒50mg,每日3次。2月复查记录症状、胃镜及病理。停药待复发记录临床症状,予乙方案交叉治疗2月复查。(2)乙方案(乙→甲):西沙比利10mg,每日3次,多虑平25mg,每晚1次,多酶片3片,每日3次。2月复查记录症状、胃镜及病理。停药待复发予甲方案交叉治疗,2月复查记录症状、胃镜及病理。结果:(1)甲、乙方案治疗前后症状明显改善。P<0.05。(2)乙、甲方案疗效对比有明显差异:乙总有效率90％,甲总有效率74。6％,x~2=4.25,P<0.05。甲→乙130例,总有效率(交叉后)86.1％;乙→甲40例,总有效率60％。总有效率对比具有明显差异,x~2=0.035,P<0.05。(3)甲→乙总有效率提高11.5％,乙→甲总有效率下降30％。结论:(1)甲、乙方案均有效。(2)乙方案明显优于甲方案。(3)说明临床上诊断为浅表性胃炎的疾病可能部分是功能性消化不良。

The Relationship Between Superficial Gastritis and Function Dyspepsia,by Observation Both of Therapeutic Effect

Prupose: To investigate the relationship between superficial gastritis and function dyspepsia.Methods: There are 1002 patients with gastric diseases in six hospital of lishui city from 2000 to 2002. Among them,360 individuals were comfirmed to be helicobacter pylori(Hp) negative by both CLO test and 14C breath history.They were randomly divided into rwo groups: (1)The first group received ranitidine 150 mg bid ,siweishu 50 mg tid ,after two months reexamined and took down symptoms and endoscope and puthology. When the patients had a relapse after stopping drugs, it received the second treatment group, reexamine after two months. (2) The second group received cisapride 10 mg tid doxal 25 mg qN, domeipian 3 # tid , after two months reex-amine and took down symptoms and endoscope and pathelogy. When the patients had a relapse after stopping drugs, it received the first treatment group, re-examined after two months. Results: (1) The symptom after therapy were significant improved in both first group and second group (P < 0.05, respective-ly). (2)The effective rate in second group(90%) was significant higer than first group (74.6%)(x2 = 4.25, P < 0.05) .There were 130 cases from first group to second group, the total effective rate after cross cas 86.1 % . There were 40 cases from second group to first group, the total effective rate after cross was 60% .The total effective rate in first and second group had significant difference, ( x2 = 4.25, P < 0.05). (3)The total effective rate increased 11.5% from first group to second group, and decreasd 30% from second group to first group. Conclusion: (1)Both methods of first and second are effective. (2) The second method is more effective than first method. (3)It indicats that some superfical gastritis diaguosed in clinic are possible function dyspepsia.