| This thesis includes two parts:the part of summary and inheritance on academic thought and clinical experience of Wang-changqi old famous expert of traditional Chinese medicine and the part of relevant clinical research.The first part:the summary and inheritance on academic thought and clinical experience.Wang-changqi old famous doctor of traditional Chinese medicine, is the famous doctor of qinghai province. He has been engaged in clinical practice for fifty two years and is good at treating spleen and stomach diseases, and accumulated rich clinical experience. Teacher Wang is especially good at treatment of chronic atrophic gastritis. The specific rules and clinical experiences of Wang Changqi old doctor of traditional Chinese medicine in treatment of chronic atrophic gastritis are as follows:Treating this disease must regulate qi activity, use ascending and descending simultaneously and ascend lucidity and descend turbidity; Treatment of this disease must treat both manifestation and root cause of disease, combine reinforcement with purgation, and also mainly apply on reinforcing insufficiency and strengthening resistance; Treatment of this disease should invigorate spleen for eliminating dampness, activate spleen with aromatics and regulate stomach and eliminate turbid; Treatment of chronic atrophic gastritis need regulate qi and activate blood circulation, treat both of qi stagnation and blood stasis, furthermore this treatment focus on removing blood stasis; Treatment of chronic atrophic gastritis suggest that the treatment should combine cooling with warming, disperse by pungent drugs and descend by bitter drugs; The treatment of chronic atrophic gastritis is mainly in clearing heat-toxin.If toxic heat is cleared, the root of diseases can be removed; The treatment of chronic atrophic gastritis is appropriate for mildness and moistness, and it aim at the balance, the combination of moistness and dryness and the harmony of cooling and warming, namely, this treatment should not be too moist or dry. In addition, teacher Wang is good at treatment of chronic diarrhea and have outstanding curative effect. He thinks that the treatment of chronic diarrhea should pay attention on the dampness and stress removing dampness and eliminating dampness, activating spleen and replenishing qi. If spleen could activate and dampness could be removed, chronic diarrhea can be stop; Treatment of chronic diarrhea should not blindly warmly invigorating and astringing, while should respectively assist with regulating qi activity, resolving food-stagnation, removing dampness for relieving diarrhea, clearing heat and promoting diuresis and ascending lucidity and descending turbidity,etc on the basis of different intermingled syndromes. Besides the above diseases said, teacher Wang also is good at the treatment of other spleen-stomach diseases, such as the keynote of the treatment of reflux esophagitis is dispering stagnated liver-qi and regulating qi, coordinating liver and stomach, opening diaphragm and removing phlegm, promoting blood circulation for removing blood stasis, clearing heat and lowering adverse qi, assisting with nourishing yin for promoting production of fluid. The treatment of the disease must regulate qi, remove phlegm, eliminate blood stasis, clear heat, open diaphragm, lower adverse qi. The treatment of bile reflux gastritis must disperse stagnated liver-qi for promoting bile flow, regulate stomach for lowering adverse qi, clear bile heat, dissipate phlegm and resolve masses. The principle of treatment of the peptic ulcer are that stress on invigorating deficiency and searching for the primary cause of disease in treatment; Emphasis on promoting blood circulation and accelerating healer; Combination of the discrimination of the disease and flexible treatment; regulating liver and invigorating spleen and treatment from liver.The second part:relevant clinical study.Objective:(1)Systematically observe and study the clinical curative effect on reflux esophagitis and the effect of prevention about the recurrence of the disease by using the experience recipe of Wang-changqi old doctor of traditional Chinese medicine in the treatment of reflux esophagitis.(2) Observe and study the relationship between the spirit-social-psychological factors and the attack of reflux esophagitis.(3) Observe the clinical curative effect on reflux esophagitis with the depression and anxiety by using the experience recipe of Wang-changqi old doctor of traditional Chinese medicine in the treatment of reflux esophagitis.Method:(1) According to the random and control principle, selected patients randomly were divided into two groups:the Chinese medicine treatment group by using the experience recipe of Wang-changqi old doctor of traditional Chinese medicine to treat and the western medicine control group by using routine western medicine to treat. Two groups will all collect 50 cases. The two group cases will be treated as following therapy:the Chinese medicine treatment group:treated by taking the capsule filled by the ground medicine powder of the experience recipe of Wang-changqi old doctor of traditional Chinese medicine in the treatment of reflux esophagitis,0.4g per capsule,3 capsule,3 times a day, after meals. The medicine control group:treated with taking 40mg omeprazole enteric capsules,1 time a day, and Mosa Billy dispersible tablets 5mg,3 times a day. The period of treatment are all 1 month. After treatment the patients of two groups will all accept gastroscopy check, then will respectively calculate the clinical cure rate, significant efficient rate, efficient rate and total efficient rate of two groups. A follow-up study will be performed for two group cases 1 month,3 months and 6 months after treatment by using GerdQ scale.6 months after treatment the two groups are again checked by gastroscopy. The recurrence rate of two groups of 1 month,3 months and 6 months after treatment will all be calculated.(2) Screen and diagnose the total cases of two groups on the depression and anxiety according to diagnostic criteria, combined with the self-rating depression scale (SDS) and self-rating anxiety scale(SAS) before treatment and statistice the the incidence of the reflux esophagitis with the depression and anxiety.Results:(1) In the Chinese medicine treatment group,24 cases were cured in clinic,13 cases had marked effect, the clinical curative effect of 9 cases were effective and 3 cases were ineffective. Through calculation, the clinical cure rate of this group was 48.98%, the significant efficient rate was 26.53%, the efficient rate was 18.37%, the total efficient rate was 93.88%, while in the western medicine control group,25 cases were cured in clinic,10 cases had marked effect, the clinical curative effect of 9 cases were effective and 2 cases were ineffective.Through calculation, the clinical cure rate of this group was 54.35%, the significant efficient rate was 21.74%, the efficient rate was 19.57%, the total efficient rate was 95.65%.There all were not significant distinctions between two groups in the clinical cure rate, the significant efficient rate, the efficient rate and the total efficient rate (all P>0.05).(2)The recurrence rate of 1 month,3 months and 6 months after treatment in the Chinese medicine treatment group respectively was 12.5%,19.15%,22.22%, while in the western medicine control group respectively was 32.61%,37.78%,40.91%.There all were significant distinctions between two groups in the recurrence rate of 1 month,3 months and 6 months after treatment (all P< 0.05).(3) There are 39 patients with depression (39%) and 41 patients with anxiety(41%) in 100 cases patients of two groups.(4) The clinical curative effect on reflux esophagitis with the depression was following: In the Chinese medicine treatment group,2cases were cured in clinic, lOcases had marked effect, the clinical curative effect of 7cases were effective and lcases were ineffective. Through calculation, the clinical cure rate of this group was 10%, the significant efficient rate was 50%, the efficient rate was 35%, the total efficient rate was 95%, while in the western medicine control group, lcases were cured in clinic,3cases had marked effect, the clinical curative effect of 7 cases were effective and 8 cases were ineffective.Through calculation, the clinical cure rate of this group was 5.26%, the significant efficient rate was 15.79%, the efficient rate was 36.84%, the total efficient rate was 57.89%. The clinical curative effect on reflux esophagitis with the anxiety is following:In the Chinese medicine treatment group,3cases were cured in clinic, 12cases had marked effect, the clinical curative effect of 4 cases were effective and 2 cases were ineffective. Through calculation, the clinical cure rate of this group was 14.29%, the significant efficient rate was 57.14%, the efficient rate was 19.05%, the total efficient rate was 90.48%, while in the western medicine control group, leases were cured in clinic,5 cases had marked effect, the clinical curative effect of 5cases were effective and 9cases were ineffective.Through calculation, the clinical cure rate of this group was 5%, the significant efficient rate was 25%, the efficient rate was 25%, the total efficient rate was 55%. There all were significant distinctions on reflux esophagitis with the depression between two groups in the significant efficient rate and the total efficient rate (P<0.05, P<0.01). There all were significant distinctions on reflux esophagitis with anxiety the anxiety between two groups in the significant efficient rate and the total efficient rate(P<0.05, P<0.05).Conclusion:(1)The clinical research showed that the clinical curative effect compared with the experience recipe of Wang-changqi old doctor of traditional Chinese medicine and routine western medicine about treatment of reflux esophagitis was equal, but there ws not any obvious adverse reaction in the course of treatment on reflux esophagitis by the experience recipe of Wang-changqi old doctor of traditional Chinese medicine, its treatment was safe and reliable, with good compliance and low cost, so we can consider that it have unique advantages and characteristics of its own that the treatment on reflux esophagitis by the experience recipe of Wang-changqi old doctor of traditional Chinese medicine, and this treatment is worthy of further application in clinical. Thus the results of the research can provide reliable basis for clinical application of coordinating liver and stomach, opening diaphragm and removing phlegm, regulatingon qi for lowering adverse qi on reflux esophagitis.(2)On the other hand, the results of the research also show that the experience recipe of Wang-changqi old doctor of traditional Chinese medicine has good effect on prevention of recurrence to reflux esophagitis, and the effect of prevention is obviously superior to routine western medicine treatment. Therefore this therapy is worthy of further application in clinical,and can provides effective measures on the prevention and control of the recurrence of reflux esophagitis, so that effectively reduce the recurrence rate.(3)The clinical research results show that there is the close relationship between the spirit-social-psychological factors and the attack of reflux esophagitis.(4) The experience recipe of Wang-changqi old doctor of traditional Chinese medicine has good effects on the treatment of reflux esophagitis with depression and anxiety and the effects is obviously superior to routine western medicine treatment. The research results shows that traditional Chinese medicine on the treatment of the reflux esophagitis with depression and anxiety has their own advantages and characteristics. |
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