176第18卷第7期2016年7月辽宁中医药大学学报JOURNALOFLIAONINGUNIVERSITYOFTCMVol.18No.7Jul.，2016结合微观辨证治疗脾胃湿热型胆汁反流性胃炎李枝锦，袁祺肇，吴平财（海口市中医医院，海南海口570216）摘要：目的：观察中医宏观辨证结合胃镜下微观辨证治疗脾胃湿热型胆汁反流性胃炎的临床疗效。方法：将120例经胃镜检查确诊并中医宏观辨证为脾胃湿热型胆汁反流性胃炎患者随机分为两组，两组均给予铝碳酸镁片、枸橼酸莫沙必利片口服，治疗组60例采用连朴饮基础方的基础上，根据胃镜下微观辨证加味用药，8周为1个疗程，1个疗程后对比治疗前后胃脘胀满、胃脘疼痛、早饱、嗳气等临床症状的变化，治疗前后临床症状总积分，治疗前后胆汁反流程度、胃黏膜组织学以及胃镜下微观征象变化。结果：疗程结束，治疗组临床疗效总有效率为88.3%、内镜总有效率为86.7%，对照组临床疗效总有效率为80%、内镜总有效率为68.3%，治疗后治疗组的症状总积分以及主要中医症状积分改善优于对照组，差异均有统计学意义（P<0.05）；治疗组能显著改善内镜下胆汁反流分级、胃黏膜组织学病变及微观征象，与对照组比较差异有统计学意义（P<0.05）。结论：结合内镜下微观辨证治疗脾胃湿热型胆汁反流性胃炎的临床疗效良好，能够明显改善患者临床症状、内镜下胆汁反流分级、胃黏膜炎性病变、胃黏膜组织学病变等，值得在临床上推广应用。关键词：微观辨证；脾胃湿热；胆汁反流性胃炎；临床疗效中图分类号：R573.3文献标志码：A文章编号：1673-842X(2016)07-0176-04收稿日期：2015-10-14作者简介：李枝锦（1985-），男，江西赣州人，主治中医师，硕士，研究方向：中医内科临床。EffectObservationonTreatingSpleen-stomachDampness-heatTypeBileRefluxGastritisinTraditionalChineseMedicineMacroscopicSyndromeDifferentiationandMicrocosmicSyndromeDifferentiationLIZhijin，YUANQizhao，WUPingcai（HaikouHospitalofTraditionalChineseMedicine，Haikou570216，Hainan，China）Abstract：Objective：Toobservetheeffectofspleen-stomachdampness-heattypebilerefluxgastritisintraditionalChinesemedicinemacroscopicsyndromedifferentiationandmicrocosmicsyndromedifferentiation.Methods：120casesofspleen-stomachdampness-heattypebilerefluxgastritispatientswererandomlyandequallydiwidedintotwogroups.ThecontrolgroupwasorallygivenhydrotalcidandCitratemoserwillbenefit，thetreatmentgrouponthebasisofthatwasorallygivenLianpuDrinkandothertraditionalChinesemedicineonthebasisoftraditionalChinesemedicinemicrocosmicsyndromedifferentiation.Bothtypesoftreatmentlast8weekstoobserveclinicalsymptoms，thedegreeofbilereflux，mucosallesionsandmicroscopicsignsundergastroscopebeforeandaftertreatment.Results：Attheendofthecourse，thetotaleffectiverateofthetreatmentgroupwas88.3%，thetotaleffectiverateofthegastricmucosaofthetreatmentgroupwas86.7%，whichweresignificantlylowerthanthoseofthecontrolgroup（80%and68.3%，P<0.05）.ThetreatmentgroupwasbetterthanthecontrolgroupinthescoreofsymptomsandTCMsyndromeeffect（P<0.05）.Thetreatmentgroupcansignificantlyrelievesthedegreeofbilereflux，mucosallesionsandmicroscopicsignsundergastroscope，thereweresignificantdifferencesbetweentwogroups（P<0.05）.Conclusion：Theeffectofthespleen-stomachdampness-heattypebilerefluxgastritisintraditionalChinesemedicinemacroscopicsyndromedifferentiationandmicrocosmicsyndromedifferentiationisfavorable.Itcansignificantlyrelievesthedegreeofbilereflux，mucosallesionsandmicroscopicsignsundergastroscope.Therefore，itisworthtobewidelyusedclinically.Keywords：microcosmicsyndromedifferentiation；spleen-stomachdampness-heat；bilerefluxgastritis；clinicalcurativeeffect胆汁反流性胃炎（Bilerefluxgastritis，BRG）为慢性胃炎的一种特殊类型，...
