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目的:探讨浅表性胃炎与功能性消化不良的关系。方法:在丽水市6所市、县级医院消化科胃病就诊者1002例中,选择经胃镜、活检病理及尿素酶检查幽门螺杆菌(Hp)均阴性的门诊或住院病人360例成年人,随机分成两组。采用随机、交叉、对照的方法,给予(1)甲方案(甲→乙):雷尼替丁150mg,早晚各1次,施维舒50mg,每日3次。2月复查记录症状、胃镜及病理。停药待复发记录临床症状,予乙方案交叉治疗2月复查。(2)乙方案(乙→甲):西沙比利10mg,每日3次,多虑平25mg,每晚1次,多酶片3片,每日3次。2月复查记录症状、胃镜及病理。停药待复发予甲方案交叉治疗,2月复查记录症状、胃镜及病理。结果:(1)甲、乙方案治疗前后症状明显改善。P<0.05。(2)乙、甲方案疗效对比有明显差异:乙总有效率90％,甲总有效率74。6％,x~2=4.25,P<0.05。甲→乙130例,总有效率(交叉后)86.1％;乙→甲40例,总有效率60％。总有效率对比具有明显差异,x~2=0.035,P<0.05。(3)甲→乙总有效率提高11.5％,乙→甲总有效率下降30％。结论:(1)甲、乙方案均有效。(2)乙方案明显优于甲方案。(3)说明临床上诊断为浅表性胃炎的疾病可能部分是功能性消化不良。
Objective: To explore the relationship between superficial gastritis and functional dyspepsia. Methods: A total of 360 outpatients or inpatients with negative H. pylori (H. pylori) by gastroscope, biopsy pathology and urease were selected from 1002 patients with gastroenterology in 6 hospitals in county-level hospitals of Lishui City. Divided into two groups. A randomized, crossover, control method (1) A program (A → B): ranitidine 150mg, morning and evening 1 times, Schwechsel 50mg, 3 times a day. February review records the symptoms, gastroscopy and pathology. Drugs to be discontinued to record the clinical symptoms of treatment, to cross-treatment program B review in February. (2) B program (B → A): Cisapride 10mg, 3 times daily, doxepin 25mg, 1 night, multi-enzyme tablets 3 times a day. February review records the symptoms, gastroscopy and pathology. Stop treatment to be recurred to a cross-treatment program, review records in February symptoms, endoscopy and pathology. Results: (1) A, B program before and after treatment symptoms were significantly improved. P <0.05. (2) There is obvious difference in the efficacy of B and A: the total effective rate of B is 90%, the total effective rate of A is 74.6%, x ~ 2 = 4.25, P <0.05. A → B in 130 cases, the total effective rate (after the cross) 86.1%; B → A 40 cases, the total efficiency of 60%. The total effective contrast has obvious difference, x ~ 2 = 0.035, P <0.05. (3) A → B total effective rate increased by 11.5%, B → A total effective rate decreased by 30%. Conclusion: (1) A, B programs are valid. (2) Project B is obviously superior to Project A. (3) The disease that is clinically diagnosed as superficial gastritis may be partially functional dyspepsia.