CAJ | 학술논문

目的：课题以研究胃溃疡活动期的中医“毒热”病因理论为突破口，以建立中医病因学研究方法为途径，以阐明中医药治疗胃癌前状态性疾病的疗效机制为特色，丰富和发展中医病因学理论和实践。方法：通过中医胃脘病“毒热”病因理论研究、中医“毒热”实验病因学研究、“毒热”病因要素的临床流行病学调查、“毒热”病因的中药干预验证性临床试验，进行系统研究。结果：通过病例对照设计，581例胃溃疡活动期83.3％为毒热证；266例浅表性胃炎13.3％为毒热证，从而确证胃溃疡活动期“毒热”为多发、常见病因，通过多因素Logistic回归分析，辨证求因要点包括幽门螺杆菌（ Hp）感染、胆汁反流、炎症因子增高、胃肠激素分泌异常等。经300例随机双盲双模拟多中心对照临床试验，试验组证候积分愈显率86.62％，胃镜愈显率80.29％。改良胃溃疡活动期胃毒热证的实验动物模型及其评价方法，验证清热解毒、消痈生肌治法中药复方疗效确切，并阐明其生物学机制。结论：“毒热”为胃溃疡活动期的主要病因，“以痈论治”胃溃疡活动期的新治法为清热解毒、消痈生肌，疗效显著。
목적：과제이연구위궤양활동기적중의“독열”병인이론위돌파구，이건립중의병인학연구방법위도경，이천명중의약치료위암전상태성질병적료효궤제위특색，봉부화발전중의병인학이론화실천。방법：통과중의위완병“독열”병인이론연구、중의“독열”실험병인학연구、“독열”병인요소적림상류행병학조사、“독열”병인적중약간예험증성림상시험，진행계통연구。결과：통과병례대조설계，581례위궤양활동기83.3％위독열증；266례천표성위염13.3％위독열증，종이학증위궤양활동기“독열”위다발、상견병인，통과다인소Logistic회귀분석，변증구인요점포괄유문라간균（ Hp）감염、담즙반류、염증인자증고、위장격소분비이상등。경300례수궤쌍맹쌍모의다중심대조림상시험，시험조증후적분유현솔86.62％，위경유현솔80.29％。개량위궤양활동기위독열증적실험동물모형급기평개방법，험증청열해독、소옹생기치법중약복방료효학절，병천명기생물학궤제。결론：“독열”위위궤양활동기적주요병인，“이옹론치”위궤양활동기적신치법위청열해독、소옹생기，료효현저。
Objective:To enrich and develop the theory and practice of TCM etiology , taking “toxin-heat” etiological study of gastric ulcer in active state ( GUIAS) as a breakthrough , to establish the research methods of TCM etiology and elucidated the therapeutic mech -anism of GUIAS TCM therapy .Methods:By theoretical analyses , experiments , clinical epidemiological investigations , clinical trials of Chinese medicine , we systematically analyzed the role of “toxin-heat” etiological factor in gastric ulcer in active state .Results:Case-control studies revealed that 83.3%out of 581 patients with GUIAS presented a “toxin-heat” syndrome which was only diagnosed in 13. 3%of 266 patients with superficial gastritis .Multiple logistic regression analysis further confirmed that “toxin-heat” could lead to heli-cobacter pylori infection , bile reflux, increase of inflammatory factors and abnormal secretion of gastrointestinal hormone , etc.In a 300-patient-involved clinical trial , syndrome analyses and gastroscopy showed that the effective rate of the treatments was as high as 86.62%and 80.29%, respectively.Besides, this project modified the animal model and its evaluation method , and verified the efficacy of TCM extract and elucidated the underlying biological mechanism .Conclusion: “Toxin-heat” is a common and frequent cause of GUIAS . Treating GUIAS as carbuncle is a new and effective way for GUIAS therapy , which is capable of clearing heat , detoxifying , and elimina-ting carbuncle while growing muscle .