调胃冲剂治疗功能性消化不良765例临床疗效观察 内容预览：

    观察以健脾疏肝法组成的调胃冲剂结合辨病论治，治疗功能性消化不良(FD)临床疗效，探讨其临床治疗规律。方法：采用大样本临床观察方法。结果：共治疗765例，显效568例(74.25%)、有效156例(20.39%)、无效41例(5.36%)、总有效率为94.64.。结论：通过大样本临床观察，本病基本病机变化是脾虚肝郁，胃气不和，以健脾化湿，疏肝和胃法为主结合辨病论治符合其病机演变规律。

    Abstract：Objective：to observe the chinical curative effect of treating FD with stomach-adjusting preparation made by the method of invigorating the spleen and relkeving depression of the liver-qi as well as treatment with disease differentiation，and make research in its clinical treatment law.Method:clinical observation with major samples was adopted.Result:Among the 765 cases,568 cases had marked effect(74.25%),156cases had effect(20.39%),and 41 cases had no effect(5.36%).The whole effective rate reached 94.64%.Conclusion:according to the clinical observation of mjajor samples,the basic pathological change of FD is the insufficiency of the spleen and the stagnation of the liver-qi as the disorder of the stomach-qi,therefore,the method of invigorating the spleen and removing dampness,relieving the depression of the liver-qi and adjusting stomach,and treatment with disease differentation was the right choice.

   Key words:functional dyspepsia;TCM treatment;method of invigorating the spleen & relieving the stagnation of the liver-qi;treatment with disease differentiation

    根据对FD脾虚肝郁病机关键的认识，以健脾化湿，疏肝和胃为法组成调胃冲剂。从1997年1月～1999年12月应用调胃冲剂结合辨病论治治疗FD765例，取得了较好的临床疗效，现将结果报告如下。

    西医诊断标准　主要临床症状：上腹饱胀，餐后加重，早饱，上腹痛痛，嗳气、恶心呕吐，烧心反酸，症状持续4周以上；内镜检查正常或排除溃疡、肿瘤等病变；实验室、B超及X线检查排除了肝胆、胰腺的器质性病变。病情诊断：根据症状的轻重程度分为3级。症状轻，经提示病人能意识到症状的存在为Ⅰ级；病人意识到症状存在，就诊时作为主诉叙述，但正常活动未受到限制为Ⅱ级；病人仅意识到症状存在，且正常活动受到限制为Ⅲ级。

    中医辨证标准　脾虚肝郁：纳少，腹胀、痞满、食后尤甚，胃脘隐痛、时轻时重，便溏，肢体倦怠，面色少华，舌质淡，苔薄白，脉细无力。肝胃不和：脘胁胀满疼痛，嗳气，恶心呕吐，烧心反酸，舌质淡红舌或尖红，苔薄白，脉弦。脾胃阴虚：胃脘痞胀隐疼，饥不欲食，少食则饱，干呕，烧心，口燥咽干，或大便干结，或形体消瘦，舌质红少苔，脉细数。兼证诊断要点：兼湿热者症见口干苦、粘腻，小便短赤，大便粘腻不爽，舌红、苔黄厚腻，脉滑或滑数。兼血瘀者症见胃脘刺痛、入夜尤甚、疼痛拒按，舌质暗或有瘀点、瘀斑，脉细涩。

    凡符合FD诊断标准者，根据患者意愿皆可作为本研究观察对象。伴有严重心、肾疾患、孕妇以及不能按规定用药而无法判断疗效者除外。一般资料　共观察765例，其中男362例，女403例；年龄：18～70岁，平均年龄32.6岁；病程：1个月～12年，平均2.3年；病情：Ⅰ级412例，Ⅱ级273例，Ⅲ级80例；中医辨证：脾虚肝郁472例，肝胃不和216例，脾胃阴虚77例；兼证：湿热106例，血瘀92例。

调胃冲剂治疗功能性消化不良765例临床疗效观察 ***下载