Clinical observation of therapeutic effect of Zhitong paste on epigastric pain(chronic gastritis) of spleen-stomach deficiency-cold type
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摘要: 观察止痛膏治疗脾胃虚寒型胃脘痛(慢性胃炎)的临床疗效。选取2021年1月-2022年4月在上海中医药大学附属龙华医院脾胃病科治疗符合胃脘痛(慢性胃炎)诊断且中医证型为脾胃虚寒型的70例患者为研究对象，采用随机数字表法按照入组顺序分为治疗组和对照组，每组各35例。在进行健康宣教基础上，治疗组用止痛膏外敷联合温胃舒胶囊口服，对照组用安慰剂外敷联合温胃舒胶囊口服，两组疗程均为2周。观察比较两组胃脘痛疼痛缓解程度、中医证候改善及不良反应发生情况。治疗组在缓解中度脾胃虚寒型胃脘痛(慢性胃炎)疼痛程度上总有效率达89.7%，优于对照组的83.3%(P< 0.05)。两组在缓解胃脘痛疼痛程度上均有效(P< 0.001)，并且治疗时间越长效果越明显(P< 0.001)；治疗7 d后，两组疗效相当(P=0.119)，但治疗14 d后治疗组的疗效优于对照组(P=0.006)。两组均对胃痛、大便稀溏等中医证候有效(P< 0.05)，治疗组在缓解胃痛证候方面优于对照组(P< 0.05)。止痛膏联合温胃舒胶囊可有效缓解中度脾胃虚寒型胃脘痛疼痛程度、改善部分中医证候，且无明显不良反应，值得临床推广普及。Abstract: A total of 70 patients who were diagnosed with epigastric pain(chronic gastritis) and whose Traditional Chinese Medicine(TCM) syndrome was spleen-stomach deficiency cold type, they were selected from January 2021 to April 2022. The subjects were divided into a treatment group(n=35) and a control group(n=35) by random number table method according to the order of enrollment. On the basis of health education in the two groups, the treatment group was given external application of Zhitong paste combined with oral administration of Wenweishu capsules, while the control group was given external application of placebo combined with oral administration of Wenweishu capsules. The course of treatment in both groups was 2 weeks. The pain relief, TCM syndromes and adverse reactions were observed and compared between the two groups.The total effective rate of the treatment group(Zhitong paste combined with Wenweishu capsules) in relieving moderate epigastric pain(chronic gastritis) of spleen and stomach deficiency type was 89.7%, which was better than that of the control group(placebo combined with Wenweishu capsules) 83.3%(P< 0.05). Both groups were effective in relieving epigastric pain(P< 0.001), and the longer the treatment time, the more obvious the effect will be(P< 0.001), after 7 days of treatment, the curative effects of the two groups were comparable(P=0.119), but the curative effect of the treatment group was better than that of the control group after 14 days of treatment(P=0.006). In addition, both groups were effective for TCM syndromes such as stomachache and loose stool(P< 0.05), and the treatment group was better than the control group in relieving stomachache syndrome(P< 0.05). Zhitong paste combined with Wenweishu capsules can effectively relieve the moderate pain degree of patients with epigastric pain of spleen-stomach deficiency cold type, improve some TCM syndromes, and has no obvious adverse reactions, which is worthy of clinical promotion.
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表 1 两组患者临床资料比较
例，X±S 组别 例数 胃脘痛程度 性别 年龄/岁 轻度 中度 重度 男 女 治疗组 35 5 29 1 16 19 36.09±4.32 对照组 35 5 30 0 20 15 38.00±5.01 
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表 2 两组胃脘痛临床疗效比较
例 组别 例数 痊愈 显效 有效 无效 总有效率/% 治疗组 总例数 35 11 1 19 4 88.6 中度 29 7 0 19 3 89.7 对照组 总例数 35 2 0 25 8 77.1 中度 30 0 0 25 5 83.3
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表 3 两组VAS评分比较
分，X±S 组别 例数 治疗前 治疗7 d 治疗14 d 治疗组 35 4.86±1.06 3.11±0.90 1.60±1.26 对照组 35 4.69±1.02 3.46±0.92 2.37±1.00 P >0.05 0.119 0.006
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表 4 两组治疗前后中医证候积分比较
分，X±S 组别 例数 时间 胃痛 泛吐清水 四肢倦怠 大便稀溏 治疗组 35 治疗前 5.66±1.21 0.29±0.46 0.20±0.47 0.46±0.70 治疗14 d后 2.31±1.791)2) 0.26±0.44 0.17±0.38 0.23±0.431) 对照组 35 治疗前 5.57±1.07 0.20±0.41 0.23±0.43 0.37±0.65 治疗14 d后 3.26±1.341) 0.14±0.36 0.17±0.38 0.26±0.441) 与治疗前比较，1)P < 0.05；与对照组治疗14 d后比较，2)P < 0.05。
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