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調(diào)胃沖劑治療功能性消化不良765例臨床療效觀察 內(nèi)容預(yù)覽:
觀察以健脾疏肝法組成的調(diào)胃沖劑結(jié)合辨病論治,治療功能性消化不良(FD)臨床療效,探討其臨床治療規(guī)律。方法:采用大樣本臨床觀察方法。結(jié)果:共治療765例,顯效568例(74.25%)、有效156例(20.39%)、無(wú)效41例(5.36%)、總有效率為94.64.。結(jié)論:通過大樣本臨床觀察,本病基本病機(jī)變化是脾虛肝郁,胃氣不和,以健脾化濕,疏肝和胃法為主結(jié)合辨病論治符合其病機(jī)演變規(guī)律。
Abstract:Objective:to observe the chinical curative effect of treating FD with stomach-adjusting preparation made by the method of invigorating the spleen and relkeving depression of the liver-qi as well as treatment with disease differentiation,and make research in its clinical treatment law.Method:clinical observation with major samples was adopted.Result:Among the 765 cases,568 cases had marked effect(74.25%),156cases had effect(20.39%),and 41 cases had no effect(5.36%).The whole effective rate reached 94.64%.Conclusion:according to the clinical observation of mjajor samples,the basic pathological change of FD is the insufficiency of the spleen and the stagnation of the liver-qi as the disorder of the stomach-qi,therefore,the method of invigorating the spleen and removing dampness,relieving the depression of the liver-qi and adjusting stomach,and treatment with disease differentation was the right choice.
Key words:functional dyspepsia;TCM treatment;method of invigorating the spleen & relieving the stagnation of the liver-qi;treatment with disease differentiation
根據(jù)對(duì)FD脾虛肝郁病機(jī)關(guān)鍵的認(rèn)識(shí),以健脾化濕,疏肝和胃為法組成調(diào)胃沖劑。從1997年1月~1999年12月應(yīng)用調(diào)胃沖劑結(jié)合辨病論治治療FD765例,取得了較好的臨床療效,現(xiàn)將結(jié)果報(bào)告如下。
西醫(yī)診斷標(biāo)準(zhǔn) 主要臨床癥狀:上腹飽脹,餐后加重,早飽,上腹痛痛,噯氣、惡心嘔吐,燒心反酸,癥狀持續(xù)4周以上;內(nèi)鏡檢查正常或排除潰瘍、腫瘤等病變;實(shí)驗(yàn)室、B超及X線檢查排除了肝膽、胰腺的器質(zhì)性病變。病情診斷:根據(jù)癥狀的輕重程度分為3級(jí)。癥狀輕,經(jīng)提示病人能意識(shí)到癥狀的存在為Ⅰ級(jí);病人意識(shí)到癥狀存在,就診時(shí)作為主訴敘述,但正?;顒?dòng)未受到限制為Ⅱ級(jí);病人僅意識(shí)到癥狀存在,且正?;顒?dòng)受到限制為Ⅲ級(jí)。
中醫(yī)辨證標(biāo)準(zhǔn) 脾虛肝郁:納少,腹脹、痞滿、食后尤甚,胃脘隱痛、時(shí)輕時(shí)重,便溏,肢體倦怠,面色少華,舌質(zhì)淡,苔薄白,脈細(xì)無(wú)力。肝胃不和:脘脅脹滿疼痛,噯氣,惡心嘔吐,燒心反酸,舌質(zhì)淡紅舌或尖紅,苔薄白,脈弦。脾胃陰虛:胃脘痞脹隱疼,饑不欲食,少食則飽,干嘔,燒心,口燥咽干,或大便干結(jié),或形體消瘦,舌質(zhì)紅少苔,脈細(xì)數(shù)。兼證診斷要點(diǎn):兼濕熱者癥見口干苦、粘膩,小便短赤,大便粘膩不爽,舌紅、苔黃厚膩,脈滑或滑數(shù)。兼血瘀者癥見胃脘刺痛、入夜尤甚、疼痛拒按,舌質(zhì)暗或有瘀點(diǎn)、瘀斑,脈細(xì)澀。
凡符合FD診斷標(biāo)準(zhǔn)者,根據(jù)患者意愿皆可作為本研究觀察對(duì)象。伴有嚴(yán)重心、腎疾患、孕婦以及不能按規(guī)定用藥而無(wú)法判斷療效者除外。一般資料 共觀察765例,其中男362例,女403例;年齡:18~70歲,平均年齡32.6歲;病程:1個(gè)月~12年,平均2.3年;病情:Ⅰ級(jí)412例,Ⅱ級(jí)273例,Ⅲ級(jí)80例;中醫(yī)辨證:脾虛肝郁472例,肝胃不和216例,脾胃陰虛77例;兼證:濕熱106例,血瘀92例。
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