【摘要】 88例慢性萎缩性胃炎均经胃镜和活组织检查确诊,按中医辨证分四型,脾胃虚寒型治以黄芪建中汤合良附丸加减,肝胃不和型治以柴胡疏肝散合黄鹤丹加减,胃阴不足型用沙参麦冬汤加减,脾胃湿热型用三仁汤合藿朴夏苓汤加减。临床总有效率为97.7%,胃镜总有效率为47.7%,病理总有效率为61.4%。伴发肠上皮化生42例中消失11例,减轻14例,总有效率为59.9%,伴不典型增生27例中消失17例,减轻1例,总有效率66.7%,提示肠化和不典型增生仍可逆转。认为中医疗效比较满意。更多还原

【Abstract】 This paper reports an observation on TCM treatment of 88 chronic atrophic gastritis(CAG)cases with satisfactory results.According to the principle of"treat the patient according to syndrome differentiation", 88 cases are grouped into Pi Wei Xu Han(脾胃虚寒,deficiency and cold of spleen and stomach),Gan Wei- Bu He(肝胃不和,disharmony of liver and stomach),Wei Yin 8u Zu(胃阴不足,deficiency of stomach Yin) and Pi Wei Shi Re(脾胃湿热,dampness and heat accumulated in stomach and spleen).All the patients were hospitalized for three months and treated with different decoctions,By means of fibro-gastroscopy and pathological biopsy,a definite diagnosis was made.Meanwhile,some tests including analysis of gastric juice with pentapeptide gastrin,as well as parietal cell antibody determination,rosette test and immunoglobulin determination were also done.All the above-mentioned examinations were checked after treatment. Results showed that the clinical effective rate was 97.7%,the biopsy improvement was 61.4%,and 47.7% improved gastroscopically.It seems that for CAG,"treat the patient according to syndrome differentiation" has satisfactory efficacy with negligible side-effects.It exerts beneficial action on the recovery of the lesions provided a large doses of drugs for"promoting the blood circulation and relieving the stasis"and "reinforcing the vital energy"were added to a given decoction.42 cases out of the present series were associated with intestinal metaplasia,which disappeared or reduced after treatment in 25 cases,the total effective rate was 59.5%.The atypical hyperplasia vanished or alleviated after medication in 18 cases,their total effective rate was 66.7%.The results showed that the reversibility of intestinal metaplasia and atypical hyperplasia was possible,It also confirmed that TCM treatment plays a certain role in restoring gastric acidity,and that the drugs for warming and invigorating the spleen have an obvious effect in increasing the cell-mediated immunity.We consider that TCM-WM treatment of CAG will become one of the methods with better immediate efficacy and brilliant prospect.更多还原