| Non-atrophic gastritis, as a type of chronic gastritis, is a common disease of the digestive system. With the accelerated pace of life, improvement of living standards, the incidence of gastritis rises year by year. However, most patients deal with this disease with ignorance and long delay in treatment due to the often mild symptoms, resulting in the extension course of the disease, persistent refractory, high recurrence rates and bad influence to life quality. Modern medical treatment of non-atrophic gastritis is mainly symptomatic treatment, which includes eradicating Helicobacter pylori, protecting gastric mucosa, decreasing the damaging effect of attack factors, suppressing or neutralizing stomach acid, neutralizing bile, promoting gastrointestinal motility and else. And yet, above treatments are all non-specific. The clinical use of western medicine alone can help relieve some of the symptoms, but clinical outcome in longer term is poor and the recurrence rates are high. Therefore, some scholars have paid more attention to the Chinese and western medicine combined treatment of chronic gastritis. As a result, there are more and more research cases on the approach of Chinese medicine treatment related to chronic non-atrophic gastritis. Chronic gastritis is a term of modern medicine, and according to the clinical manifestations of this disease, it falls into categories such as "epigastralgia","gastralgia","gastric distention and fullness","epigastric oppression" and "gastric upset" in TCM (Traditional Chinese Medicine). Since ancient times, Chinese physicians in the past dynasties have addressed the etiology and pathogenesis of this disease. Based on syndrome differentiation and with holism in mind, the TCM treatment turns out having better clinical outcome, fewer side effects and long-term efficacy, which is worthy of further study and extensive application. On the basis of literature research, this paper analyzes and evaluates the curative effect of Xinkai Kuxiang method in treating the cold-heat complex type of non-atrophic gastritis and compares with the clinical efficacy of western medicine in treating this disease.This paper is divided into two parts:literature review and clinical research.PART I:LITERATURE REVIEW1.Introducing the research development of western medicine in treating non-atrophic gastritis from etiology, pathogenesis, diagnostic criteria, treatment and other perspectives.2.Introducing the current understanding and research in TCM from several perspectives of medical terms, etiology and pathogenesis, syndrome differentiation and treatment of non-atrophic gastritis.PART II:CLINICAL RESEARCHObjective:To explore the clinical efficacy of Xinkai Kuxiang Method in treating cold-heat mixed type of non-atrophic gastritis and to compare with the western medicine treatment of this disease.Method:All80cases are from patients receiving treatments in the outpatient service and inpatient of spleen and stomach department of China Academy of Traditional Chinese Medicine Wangjing Hospital during June,2013and March,2014. All cases were confirmed as chronic non-atrophic gastritis by digestive endoscopy and histopathology, and cold-heat mixed type by TCM diagnosis.80patients were divided into control group and treatment group at random,40cases in each group. The treatment group received treatment with the Pinelliae Tuber Decoction, which is the basic formula that could be altered in accordance with symptom differentiation, for four weeks; the control group was given Colloidal Bismuth Pectin Capsules100mg po tid+A/B/C/D (A. Patients suffering from upper abdominal pain, heartburn and acid reflux:Omeprazole Sodium Enteric-coated Tablets20mg po qd; B. Patients suffering from abdominal distention and belch:Trimebutine Maleate Tablets0.2g po tid; C. Patients with bile regurgitation and bitter taste:Hydrotalcite chewable Tablets1g po tid; D. HP Postive:eradicating Helicobacter pylori with quadri-combination therapy.) for four weeks. Both groups filled in the clinical symptom tables (Schedule1) at four different points of time:before treatment,4weeks after treatment,1month after finishing treatment,3months after finishing treatment. Researcher scored each of these patients according to the severity of symptoms showed on CRF table and recorded the degree of symptom reduction. The CRF table was designed by TCM symptom integral standard, patients’ clinical efficacy was evaluated in integrals based on the degree of symptoms reduction. The variations of symptom integrals before and after treatment were compared by data analysis and statistical methods. The total effective rates were evaluated by efficacy index (Efficacy index-(integral before treatment-integral after treatment)/integral before treatment*100%). Comparing and analyzing the difference of clinical efficacy and variation of symptom integrals of each group before and after treatment, according to the data obtained from efficacy results, the researcher evaluated the statistical significance of effective rate by X2examination, statistically counts and analyzes the symptom integrals before and after treatment by SPSS18.0, and also recorded the adverse incidents during the course of treatment so that the safety could be guaranteed.Results:1.After4-week TCM oral solution treatment, the main symptom integral, the minor symptom integral and the total integral of the treatment group is different comparing to the baseline before treatment, there was statistical significance (P<0.5).2.After4-week western medicine treatment,, the main symptom integral, the minor symptom integral and the total integral of the treatment group is different comparing to the baseline before treatment, there was statistical significance (P<0.5).3.The difference of total effective rate between the treatment group and control group after treatment suggests obvious statistically significance (P<0.5), the treatment group was significantly better than the control group.4.During the course of treatment, no significant abnormalities was found in both groups in metrical safety indexes (blood pressure, pulse rate, respiration, body temperature, liver function (ALT, AST), kidney function (BUN, CRE), ECG, routine blood/urine testing). No obvious side effect was found. The whole treatment is effective and safe.Conclusion:1.The TCM treatment with Xinkai Kuxiang Method is effective in improving clinical symptoms of patients who suffer from cold-heat mixed type of non-atrophic gastritis.2.The western medicine treatment can improve clinical symptoms of cold-heat mixed type of non-atrophic gastritis.3.The total effective rate of Xinkai Kuxiang Method on treatment of cold-heat mixed type of non-atrophic gastritis is better than that of western medicine.4.The treatment of cold-heat mixed type of non-atrophic gastritis with Xinkai Kuxiang Method is effective and safe. |
PDF Full Text Request