健脾活萎方治疗脾虚胃热型慢性萎缩性胃炎60例

目的:观察健脾活萎方对慢性萎缩性胃炎脾虚胃热证的临床疗效。方法:将60例脾虚胃热型慢性萎缩性胃炎随机分为治疗组和对照组,每组30例。其中治疗组口服健脾活萎方,每日1剂,早晚餐后半小时温服;对照组口服胃复春片,每次4片,每日3次,餐后半小时服用,3个月为1疗程。采用中医症状积分和SF-36生活质量量表分别对治疗前后患者脾胃症状及生活质量情况进行评估;观察随访患者胃镜及病理检查以观察胃组织的变化。结果:(1)治疗后患者胃症状积分及SF-36生活质量各维度均较治疗前有明显改善,其中在改善胃脘灼热症状方面,健脾活萎方组较胃复春组疗效更显著,比较有统计学意义(P<0.05);(2)在生理功能(PF)、躯体角色(RP)、躯体疼痛(BP)、总体健康(GH)、生命活力(VT)、社会功能(SF)、情感角色(RE)、心理健康(MH)、生理健康总评(PCS)、心理健康总评(MCS)十个维度改善方面,健脾活萎方组较胃复春组疗效更显著,比较有统计学意义(P<0.05);(3)胃黏膜病理随访显示:健脾活萎方可有效逆转慢性萎缩性胃炎的发展及转归,与治疗前比较有统计学意义(P<0.05),与胃复春对照组比较有统计学差异(P<0.05)。结论:(1)健脾活萎方可明显改善脾虚胃热型慢性萎缩性胃炎脾胃相关症状,其中在改善患者胃脘灼热症状方面,较胃复春更加显著;(2)SF-36生活量表各维度变化情况表明健脾活萎方可显著提高患者生理及心理健康水平。

Clinical Research of Jianpi Huowei Decoction in Treatment of Chronic Atrophic Gastritis of Spleen insufficiency and Stomach Heat Syndrome

Objective: To observe the clinical efficacy of Jianpi Huowei decoction on the chronic atrophic gastritis of spleen insufficiency and stomach heat syndrome. Methods: Sixty patients of chronic atrophic gastritis of spleen insufficiency and stomach heat syndrome were randomly divided into control group and treatment group. Each group contained 30 cases. The treatment group administered Jianpi Huowei decoction orally every day half an hour after breakfast and supper. The control group administered Weifuchun Tablets orally four pills for each time half an hour after dinner for three times a day. Each Group took three months for a course. We evaluated the spleen- stomach symptoms and life quality pre and post treatment by TCM symptoms integral and SF- 36 short form health survey questionnaire. We also observed the stomach tissues changes by gastroscopy and pathological examination. Results:( 1) After treatment,the stomach symptoms integral and each dimension of SF- 36 short form health survey questionnaire had significant improvement. Among this,the treatment group had a statistical significance in improving gastric cavity calor compared with the control group( P < 0. 05).( 2) In the ten dimensions including physiological functions( PF),role physical( RP),bodily pain( BP),general health( GH),vitality( VT),social functioning( SF),role emotional( RE),mental health( MH),physical component summary( PCS),mental component summary( MCS),the treatment group also had a statistically significant better efficacy than the control group( P < 0. 05.( 3) Gastric mucosa follow- ups indicated that Jianpi Huowei Decoction could effectively reverse the development and outcome of chronic atrophic gastritis. It was statistically significant compared with pre-treatment and that of the control group( P < 0. 05). Conclusion:( 1) Jianpi Huowei Decoction can significantly improve the spleen and stomach symptoms of chronic atrophic gastritis spleen insufficiency and stomach heat syndrome,particularly in improving gastric cavity calor which is more obviously than Weifuchun tablets.( 2) The changes of SF- 36 short form health survey questionnaire dimensions indicated that Jianpi Huowei Decoction can significantly improve the mental and physical health of patients.