| Research backgroundChronic atrophic gastritis is a common clinical chronic gastric disease,which is a precancerous disease of gastric cancer.Pathological tissue biopsy is the gold standard for the diagnosis of CAG.And there is currently no specific therapeutic drug.Clinical studies have found that a large number of patients with CAG have varying degrees of anxiety and depression.On the one hand,long-term anxiety and depression can be an important cause of the onset of CAG.On the other hand,the physiological and psychological changes in patients with CAG also can cause or aggravate anxiety and depression.The two are mutually causal,making the disease lingering and difficult to heal.Therefore,CAG with anxiety and depression should also belong to the category of digestive psychosomatic medicine.At present,the western medical treatment of CAG with anxiety and depression is mainly combined anti-anxiety and anti-depressive drugs with basic treatment of CAG at home and abroad.However,the western medical treatment has definite disadvantages,include general long-term effect,easy relapse after withdrawal,drug resistance,and certain side effects.Traditional Chinese medicine has unique characteristics and advantages in the treatment of this disease.According to clinical observations,Chinese medicine treatment of this disease can not only fundamentally relieve the patient’s digestive symptoms,but also significantly relieve the patient’s anxiety and depression,thereby greatly improving the patient Quality of life.At present,there are many researches on western medicine intervention for this disease,but relatively few observations on the efficacy of traditional Chinese medicine in the treatment of this disease.Research purposesThis study is based on the years of clinical experience of Professor Zhou Bin.We aim to evaluate the effect of improvement in the symptoms,mood and quality of life of patients with this disease by the tutor’s experience prescription which is named "Guben Tongluo Decoction",according to the subjective judgement of patients.research contentThis research is divided into two parts:literature research and clinical research.Part one:the literature reviewI reviewed and summarized the modern research progress of CAG,expounded the causal relationship and mechanism of CAG with anxiety and depression,as well as the progress of TCM treatment.According to the common symptoms of CAG,its TCM name belongs to the categories of"stomach pain","sufficiency",and "suffocation syndrome",while anxiety and depression belong to the categories of "stagnation syndrome" and "dryness".Since ancient times,there are a large number of ancient books explaining that emotions can affect the functions of the spleen,stomach,liver and other organs,leading to "stomach pain" and "fullness".Modern studies have found that long-term abnormal emotions can cause gastrointestinal dysfunction and damage the gastric mucosa.Long-term abnormal emotions is an important risk factor for the occurrence of CAG.Animal experiments have also proved that long-term anxiety and depression can lead to the occurrence and development of CAG.While,CAG patients often lead to aggravation of anxiety and depression due to gastrointestinal discomfort symptoms and cancer fear.At present,Western medicine treatment of CAG with anxiety and depression has limitations.While,TCM treatment can not only relieve gastrointestinal symptoms quickly,but also improve patients’ anxiety and depression,and significantly improve the quality of life.Regarding the assessment of the quality of life,the PRO scale for spleen and stomach diseases closely combines the quality of life with the characteristics of traditional Chinese medicine,and is currently the most common assessment scale for the quality of life of the spleen and stomach diseases in TCM.Part Two:Clinical Observationresearch methodI collect 45 cases of patients with CAG,who are diagnosed with spleen and stomach weakness syndrome.They all are first diagnosed in Professor Zhou Bin’s outpatient clinic and met HAMA total score≥14 points and/or HAMD total score>20 points.After treatment for 12 weeks,they will fill in questionnaires include the TCM Symptom Score Scale,Hamilton Anxiety/Depression Scale(HAMA/HAMD),and PRO Scale for Spleen and Stomach Diseases at before treatment,4th,8th,and 12 weeks.Then I observe the changes in the scores of each scale before and after treatment,so as to evaluate the efficacy of "Gu Ben Tong Luo Decoction".SPSS20.0 will be used to analyze all the data in this study.Research resultOf the 45 cases included,17 were males(38%),28 were females(62%),and the ratio of female to male was approximately 1.64:1.The average age of men is 46.41±10.69 years old,of which 36-45 years old is the most common;the average age of women is 55.5±6.98 years old,of which 56-65 years old is the most common.Among the subjects.26 were mildly anxious,accounting for 57.78%of the total,12 were obviously anxious,accounting for 26.67%of the total,and 7 were severely anxious.Among male subjects,mild anxiety accounted for 70.59%of the total number of men,obvious anxiety accounted for 23.53%,and severe anxiety accounted for only 5.88%;among female subjects,mild anxiety accounted for 50.00%of the total number of women.Obviously anxious people accounted for 28.57%;severely anxious people accounted for 21.43%."Gu Ben Tong Luo Decoction" has a significant effect in treating CAG with anxiety and depression.Compared with TCM syndromes before treatment,the total effective rate in 4th weeks is 44.44%,and it is 68.89%in 8th weeks.After treatment for 12 weeks,the total effective rate is 80.00%.Besides,the symptoms of "stomach/flank fullness","dummy pain","warming and pressing","fatigue","suffocation after eating",and "diminished diet" were significantly reduced compared with before treatment(P<0.001).The symptoms of "shortness of breath","lazy speech","noisy stomach",and "vomiting and clear water" were alleviated compared with before treatment(P<0.05).However,there is no cured cases.In terms of anxiety and depression,the total scores of HAMA and HAMD scales at the 4th,8th,and 12th weeks after taking the medicine decreased compared with those before the treatment,and the difference is statistically significant(P<0.001).Before treatment,all subjects has different degrees of anxiety.After treatment,the subjects’ anxiety improved significantly.Those with no or possible anxiety accounted for 51.11%,68.89%,and 82.22%in the 4th,8th,and 12th weeks,respectively.In terms of quality of life,the total score of the PRO scale for spleen and stomach diseases and the self-score of the subjects’ quality of life after treatment are significantly higher than those before treatment(P<0.001).Statistics show that the scores of subjects in the"physiological field" and "psychological field" are significantly higher than before treatment(P<0.001),and the scores of "independence field" are also higher than before treatment(P<0.05).The scores of the subjects in the modules of "pain and discomfort","digestive function" and"psychological aspects" increased significantly(P<0.001),and the scores of the modules of "energy and form" and "independence" increased(P<0.05).Research conclusion:First of all,the majority of subjects with CAG accompanied by anxiety and depression are women,and women are prone to suffer from severe anxiety.So we should pay special attention to the evaluation and treatment of anxiety and depression in female patients when we conduct clinical practice.Secondly,CAG with anxiety and depression is a chronic.And the treatment cycle is long.So the patient must takes a long time to take the medicine continuously.At last,Taking"Gu Ben Tong Luo Decoction" for 12 weeks to treat CAG with anxiety and depression can significantly improve the patient’s digestion-related symptoms and alleviate the patient’s anxiety and depression.At the same time it can significantly improve the patient’s quality of life. |
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