张支全

【摘要】目的 探究香砂平胃散聯合半夏泻心汤治疗HP相关性慢性胃炎的临床疗效观察。方法 选取我院2016年9月～2018年4月收治的HP检测为阳性的慢性胃炎患者80例，依据随机数字表法随机分为对照组和治疗组，各40例。对照组予以西医常规药物治疗，治疗组在对照组基础上予以香砂平胃散联合半夏泻心汤进行治疗，两组患者均治疗6周。比较两组患者临床疗效、HP转阴率、中医证候积分改善情况。结果 经治疗，治疗组患者临床总有效率为97.5%，对照组患者临床总有效率为87.5%，差异有统计学意义（P<0.05）；治疗后，治疗组患者HP转阴率为95.00%，对照组患者HP转阴率为87.50%，与对照组同期相比，治疗组患者HP转阴率更高，差异有统计学意义（P<0.05）；经治疗，与对照组相比，治疗组患者中医证候积分改善更为显著；差异有统计学意义（P<0.05）。结论 香砂平胃散联合半夏泻心汤可起到健脾燥湿、消痞散结、寒热平调之功效，针对HP相关性慢性胃炎患者胃脘灼热、心下痞满、腹胀肠鸣、口苦等临床表现疗效明显，同时中药制剂具有药效持久、肝肾功能损害轻、毒副作用小等特点，值得临床推广应用。

【关键词】香砂平胃散；半夏泻心汤；HP；慢性胃炎；临床疗效

【中图分类号】R259 【文献标识码】A 【文章编号】ISSN.2095.6681.2018.32..02

【Abstract】Objective To investigate the clinical observation of Xiangsha Pingwei San combined with Banxia Xiexin decoction in the treatment of HP-related chronic gastritis.Methods From September 2016 to April 2018，80 patients with HP positive chronic gastritis in our hospital were randomly divided into control group and treatment group according to random number table method， 40 cases in each group. The control group was treated with routine western medicine， the treatment group was treated with Xiangsha Pingwei San combined with Banxia Xiexin decoction on the basis of the control group.Both groups were treated for 6 weeks.The clinical efficacy，HP negative conversion rate and TCM syndrome integral improvement were compared between the two groups.Results After treatment， the total effective rate of the treatment group and the control group were 97.5 % and 87.5 %，respectively.The difference was statistically significant （P<0.05）.After treatment，the HP negative conversion rate of the treatment group and the control group were 95.00 % and 87.50 %，respectively.The HP negative conversion rate in the treatment group was higher than that in the control group during the same period， the difference was statistically significant （P<0.05）.After treatment， compared with the control group， the improvement of TCM syndrome score in the treatment group was more significant （P<0.05）.Conclusion Xiangsha Pingwei San combined with Banxia Xiexin decoction has the effects of invigorating spleen and eliminating dampness， eliminating mass and resolving stagnation， and regulating cold and heat. The treatment method has obvious curative effect on clinical manifestations of HP-related chronic gastritis patients， such as heartburn of stomach， fullness under the heart， abdominal distension， borborygmus and bitter taste. Meanwhile，the TCM preparation has the characteristics of lasting drug effect， light damage to liver and kidney functions， small toxic and side effects and so on， and is worthy of clinical popularization and application.

【Key words】Xiangsha Pingwei San，Banxia Xiexin Decoction，HP，Chronic gastritis，Clinical efficacy

慢性胃炎系指不同致病因素所导致的胃枯膜的慢性炎症或萎缩性病变的一类慢性消化系统疾病，是临床诊治过程中的常见病，依据其临床表现及检查结果可划分为慢性浅表性胃炎、慢性萎缩性胃炎及特殊类型胃炎三类[1]。其病因诸多，，现代医学研究发现，绝大多数慢性胃炎患者病变部位检查均提示存在不同数量的幽门螺旋杆菌（HP）[2]。现代医学针对本病主要采取临床常规治疗方案三联疗法、四联疗法等，但因HP所处部位及自身特性，只能在一定程度上缓解其所导致的临床症状及体征，且长期服药亦会加重胃部病变程度[3]。中医学将本病归属于内学科中“胃痛”、“胃痞”等疾病范畴，可因外邪侵袭、饮食失调、情志内伤、不良嗜好等诱发，病性多属本虚标实，病位责之脾胃，日久迁延肝、肠腑等，基本病机为脾胃气机升降失常，继而产生气滞、瘀血、痰湿、毒结等病理产物，临床出现胃脘部胀满不舒、痞满嗳气等一系列病理表现[4]。……