解郁化痰消瘀方治疗肝胃不和型胃癌前病变的疗效观察

Effect of Jieyu Huatan Xiaoyu Decoction in treatment of precancerous lesions of gastric cancer with syndrome of disharmony between liver and stomach

  • 摘要:
    目的 观察解郁化痰消瘀方治疗胃癌前病变(肝胃不和型)患者的疗效, 探讨其治疗特色及优势。
    方法 将80例患者随机分为治疗组40例和对照组40例。治疗组采用解郁化痰消瘀方治疗,对照组采用摩罗丹治疗, 2组疗程均为6个月。比较2组患者治疗前和治疗6个月后中医证候积分、胃镜下黏膜病理积分、汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)评分,并综合比较2组患者的疗效。
    结果 治疗6个月后, 2组患者胃脘或胁肋胀满、嗳气反酸、胸闷、饮食减少等证候积分均下降,治疗组上述证候积分及总积分优于对照组,差异有统计学意义(P < 0.05)。治疗6个月后, 2组患者内镜下胃黏膜萎缩、肠化及异型增生积分低于治疗前,且治疗组胃黏膜萎缩、肠化积分低于对照组,差异有统计学意义(P < 0.05)。治疗6个月后,治疗组患者HAMA和HAMD评分分别为(9.33±2.08)、(8.38±2.13)分,低于治疗前的(17.58±3.36)、(13.33±3.40)分,对照组治疗后HAMA评分为(14.43±2.71)分,低于治疗前的(17.03±4.05)分,差异有统计学意义(P < 0.05)。治疗6个月后,治疗组HAMA及HAMD评分均低于对照组,差异有统计学意义(P < 0.05)。治疗组总有效率为95.00%(38/40), 高于对照组的77.50%(31/40), 差异有统计学意义(P < 0.05)。
    结论 解郁化痰消瘀方可有效改善胃癌前病变(肝胃不和型)患者胃黏膜病理改变,同时改善患者焦虑和抑郁状态。

     

    Abstract:
    Objective To observe the effect of Jieyu Huatan Xiaoyu Decoction in precancerous lesions of gastric cancer patients with syndrome of disharmony between live and stomach, and to explore the advantages and characteristics.
    Methods A total of 80 patients were randomly divided into treatment group(n=40) and control group(n=40). Patients in the treatment group were treated with Jieyu Huatan Xiaoyu Decoction and those in the control group were treated with Moluodan. Treatment of both groups was lasted for 6 months. The syndrome scores of traditional Chinese medicine(TCM), gastroscopic mucosal pathology scores, Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) scores were compared between the two groups before and after treatment, and the efficacy of the two groups was comprehensively compared.
    Results After 6 months of treatment, the syndrome scores of epigastric or hypochondriac distension, belching and acid regurgitation, chest tightness, diet reduction, and constipation score decreased in the two groups, and the above syndrome scores and total score in the treatment group were better than those in the control group(P < 0.05). After 6 months of treatment, the scores of endoscopic gastric mucosa atrophy, intestinal metaplasia and dysplasia in the two groups were lower than those before treatment, and the scores of gastric mucosa atrophy and intestinal metaplasia in the treatment group were lower than those inthe control group (P < 0.05). After 6 months of treatment, the scores of HAMA and HAMD of patients in the treatment group scored (9.33±2.08) and (8.38±2.13), which were lower than (17.58±3.36) and (13.33±3.40) respectively before treatment. The HAMA score ofthe control group was (14.43±2.71) after 6 months of treatment, which was lower than (17.03±4.05) before treatment (P < 0.05). After 6 months of treatment, HAMA and HAMD scores of the treatment group were lower than those of the control group (P < 0.05). The total effective rate of the treatment group was 95.00%(38/40), which was higher than 77.50% (31/40) in the control group (P < 0.05).
    Conclusion Jieyu Huatan Xiaoyu Decoction can effectively improve the pathological changes of gastric mucosa and the state of anxiety and depression in patients with precancerous lesions of gastric cancer with syndrome of disharmony between liver and stomach.

     

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