四磨汤口服液联合PPI治疗胃食管反流病的临床疗效观察

发布时间：2018-03-08 11:05

本文选题：四磨汤口服液　切入点：质子泵抑制剂　出处：《湖北中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的本研究通过采取随机对照法,观察四磨汤口服液联合质子泵抑制剂(PPI)治疗肝胃不和型胃食管反流病的临床症状疗效、胃镜疗效及生活质量改善情况,为胃食管反流病的临床治疗提供一种新选择。方法将本课题中入选的59例患者随机为A1组30例、A2组29例,A1组患者予以泮托拉唑40mg口服2/日、四磨汤口服液20ml口服2/日,连续服用2周,2周后继续予以泮托拉唑40mg口服1/日、四磨汤口服液10ml口服2/日,连续服用2周;A2组予以泮托拉唑40mg口服2/日,连续服用2周,2周后继续予以泮托拉唑40mg口服1/日,连续服用2周,即两组疗程均为4周。在治疗前、治疗2周、治疗4周时记录两组患者临床症状积分、生活质量评分,以观察不同治疗阶段临床症状疗效的差异及生活质量改善情况;在治疗前两组患者均行胃镜检查,治疗4周后经胃镜检查诊断为反流性食管炎的患者需复查胃镜,以便观察两组患者胃镜疗效的差异;在治疗前及4周疗程结束后两组患者均行血常规、尿常规、大便常规、肝功能、肾功能、心电图检查,记录上述检查结果及疗程期间内不良反应发生情况,以了解药物安全性的情况。结果(1)临床症状积分比较:治疗后A1组反酸、烧心、胸痛、嗳气、纳差、心烦易怒、胃脘嘈杂、痞闷症状积分及总积分较治疗前均有所下降(p0.05),其中反酸、烧心、嗳气、胃脘嘈杂症状积分及总积分下降显著(p0.01);治疗后A2组反酸、烧心、胸痛、嗳气、胃脘嘈杂症状积分及总积分较治疗前均有所下降(p0.05),其中反酸症状积分及总积分下降显著(p0.01);治疗后A1组反酸、烧心、嗳气症状积分及总积分均较A2组低(p0.05),其中反酸、嗳气症状积分的差异显著(p0.01)。(2)临床症状疗效比较:治疗2周及治疗4周后A1组痊愈率及总有效率均高于A2组,但治疗2周后痊愈率及总有效率的差异均无统计学意义(p0.05);治疗4周后,痊愈率的差异有统计学意义(p0.05),总有效率的差异无统计学意义(p0.05)。(3)胃镜疗效比较:4周疗程结束后A1组痊愈率及总有效率均高于A2组,但痊愈率的差异无统计学意义(p0.05),总有效率的差异有统计学意义(p0.05)。(4)生活质量评分比较:与治疗前相比,两组患者治疗2周后生活质量评分均下降显著(p0.01);与治疗2周后相比,两组患者治疗4周后生活质量评分均下降显著(p0.01);治疗2周后A1组生活质量评分较A2组低,但差异无统计学意义(p0.05);治疗4周后A1组生活质量评分较A2组低,且差异有统计学意义(p0.05)。结论与单纯抑酸疗法相比,四磨汤口服液联合PPI治疗肝胃不和型胃食管反流病在改善患者反酸、烧心、嗳气症状方面更强,同时还能弥补单纯抑酸疗法无法缓解患者纳差、心烦易怒、痞闷症状的不足;治疗4周后,在提高患者临床症状的痊愈率及胃镜疗效的总有效率方面更佳,在改善患者生活质量方面更优。
[Abstract]:Objective to observe the clinical effect of Simo Tang oral liquid combined with proton pump inhibitor PPI in the treatment of gastroesophageal reflux disease (GERD) by using a randomized controlled method, and to observe the effect of gastroscopy and the improvement of quality of life (QOL) in the treatment of gastroesophageal reflux disease (GERD). Methods A total of 59 patients with gastroesophageal reflux disease were randomly divided into A 1 group (n = 30), A _ 2 group (n = 29) and A _ 1 group (n = 29) received pam Tora zol 40 mg orally for 2 days, and Simo decoction 20 ml orally for 2 days. After 2 weeks of continuous administration, 40 mg of pam Tora zole was given orally for 1 day, 10 ml of Simo decoction was given orally for 2 days, and 2 days of treatment with 40 mg of pam Tora azole was given to group A 2 for 2 weeks. After 2 weeks of continuous administration of pam Tora, 40 mg of pam Tora was given orally once a day for 2 weeks, and the course of treatment for both groups was 4 weeks. Before treatment, 2 weeks after treatment, the clinical symptom scores and quality of life scores were recorded at 4 weeks after treatment. In order to observe the difference of clinical symptoms and the improvement of quality of life in different stages of treatment, two groups of patients were examined with gastroscopy before treatment, and the patients diagnosed as reflux esophagitis after 4 weeks of treatment should be reexamined. In order to observe the difference of gastroscopy effect between the two groups, blood routine, urine routine, stool routine, liver function, renal function, electrocardiogram were performed before and after 4 weeks of treatment. The results of the above examination and the adverse reactions during the course of treatment were recorded in order to understand the situation of drug safety. Results: after treatment, the scores of clinical symptoms in group A1 were as follows: regurgitation, heartburn, chest pain, belching, anorexia, irritability, stomachache, stomachache, anorexia, anorexia, irritability and stomachache. The integral and total score of the symptoms of ruffiness were lower than that of before treatment. The scores of regurgitation, heartburn, belching, gastralgia and total score were significantly decreased in group A2 after treatment, the scores of regurgitation, heartburn, chest pain, belching, and belching were significantly decreased after treatment. The score and total integral of stomach-noisy symptoms were lower than those before treatment, among which the integral and total integral of regurgitation symptoms decreased significantly (p 0.01), and the scores of regurgitation, heartburn, belching and total score in group A1 were lower than those in group A _ 2 (P 0.05), among which, acid regurgitation was found in group A, and the total score in group A was lower than that in group A (P < 0.05). Comparison of clinical symptom efficacy: the recovery rate and total effective rate of A1 group were higher than that of A2 group after 2 weeks and 4 weeks of treatment. However, there was no significant difference in the recovery rate and the total effective rate after 2 weeks of treatment (P 0.05), but after 4 weeks of treatment, there was no significant difference in the recovery rate and the total effective rate. The difference of cure rate was statistically significant (p 0.05). There was no significant difference in total effective rate (P 0.05) and the total effective rate in group A 1 was higher than that in group A 2 after 4 weeks of treatment. However, there was no significant difference in recovery rate (P 0.05), but the difference in total effective rate was statistically significant (P < 0.05). Compared with before treatment, the scores of quality of life (QOL) of the two groups were significantly decreased after 2 weeks of treatment, and those of the two groups were significantly lower than those of the patients after 2 weeks of treatment, and those of the two groups were significantly lower than those of the patients after 2 weeks of treatment. After 4 weeks of treatment, the scores of quality of life in group A 1 were significantly lower than those in group A 2, but there was no significant difference between group A 2 and group A 2, the scores of quality of life in group A1 were lower than those in group A 2 after 4 weeks of treatment. Conclusion the combination of Simo Tang oral liquid and PPI in the treatment of gastroesophageal reflux disease with disharmony of liver and stomach is more effective in improving the symptoms of regurgitation, heartburn and belching in patients with gastroesophageal reflux. At the same time, it can also make up for the deficiency of anorexia, irritability and suffocating symptoms, which can not be alleviated by acid suppressive therapy alone. After 4 weeks of treatment, it is better to improve the recovery rate of clinical symptoms and the total effective rate of gastroscopy. Better in improving the quality of life of patients.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R571

【参考文献】