清郁和降汤联合奥美拉唑治疗肝胃郁热型非糜烂性反流病的临床观察
发布时间：2018-12-10 07:32
【摘要】：目的:观察清郁和降汤联合奥美拉唑治疗肝胃郁热型非糜烂性反流病伴焦虑状态的临床疗效及复发率,并进行客观评价。方法:通过胃食管反流病问卷(GerdQ)、胃镜、PPI诊断试验、肝胃郁热型非糜烂性反流病临床症状分级量化评分表对患者进行中西医诊断,对符合诊断标准者予填写焦虑自评量表(SAS),筛选SAS评分大于50的患者,最终共纳入62例,采用完全随机、复合处理对照原则将其分为治疗组和对照组各31例,因剔除治疗组1例,故实际纳入61例,治疗组30例,对照组31例。对照组口服奥美拉唑肠溶胶囊,治疗组在西药基础上予以清郁和降汤治疗,疗程均为8周,分别在治疗结束时、停药4周后对患者症状进行评分,通过前后积分对照了解患者病情变化,比较并评价治疗效果以及观察停药后病情复发情况。结果:1.两组治疗后西医症状总疗效比较,治疗组和对照组均有疗效,治疗组总有效率90.0%,对照组总有效率87.1%,两组疗效无显著统计学差异(P=0.722 P0.05)。胃食管反流病问卷(GerdQ)各症状治疗后比较,治疗组与对照组在改善反流、烧心等典型症状上无明显差别,而治疗组在改善因典型症状引起的睡眠障碍方面优于对照组;各症状自身前后比较有显著统计学差异(P0.05),表明治疗组与对照组对改善各症状均有疗效。2.两组治疗后中医症状总疗效比较,治疗组总有效率93.3%,对照组总有效率74.2%,两组疗效有极显著统计学差异(P=0.044P0.05),表明治疗组对改善肝胃郁热型非糜烂性反流病(NERD)的疗效优于对照组。3.在患者肝胃郁热证型的症状比较中,两组自身前后比较有统计学差异(P0.05),表明治疗组与对照组对症状改善均有疗效;两组治疗后比较,对于两胁胀满或隐痛、暖气反流、大便干燥、食欲减退症状的改善具有显著统计学差异(P0.05),其中在改善嗳气反流、大便干燥、食欲减退症状有极显著统计学差异(P0.01),其他症状无显著性差异(P0.05),表明治疗组在改善全身症状方面优于对照组。4.两组治疗后SAS评分比较,治疗组有极显著统计学差异(P=0.000,P0.01),对照组无显著统计学差异(P=0.083,P0.05),说明治疗组在改善患者焦虑状态方面明显优于对照组。5.两组停药4周后复发情况的比较,治疗组与对照组的复发率分别为3.3%和26.0%,具有显著性统计学差异(P=0.013,P0.05),表明治疗组比对照组复发率低。结论:清郁和降汤联合奥美拉唑治疗肝胃郁热型非糜烂性反流病疗效明确,临床具有较低的复发率,未见明显不良反应。清郁和降汤能有效改善患者全身症状及焦虑状态、提高患者的生活质量。
[Abstract]:Objective: to observe the clinical effect and recurrence rate of Qingyu and Jiangtang combined with omeprazole in the treatment of non-erosive reflux of liver and stomach. Methods: the gastroesophageal reflux disease (GERD) was diagnosed by (GerdQ), gastroscope, PPI diagnostic test, and clinical symptom scale of non-erosive reflux of liver and stomach. 62 patients with SAS scores greater than 50 were selected by filling out the anxiety Self-Rating scale (SAS),) to meet the diagnostic criteria. The patients were randomly divided into treatment group (31 cases) and control group (31 cases). There were 61 cases in the treatment group, 30 cases in the treatment group and 31 cases in the control group. The control group was treated with omeprazole enteric-coated capsule, the treatment group was treated with Qingyu and Jiangtang on the basis of western medicine, the course of treatment was 8 weeks. The changes of patients' condition were compared and evaluated, and the relapse after withdrawal was observed. Results: 1. The total effective rate of the treatment group was 90.0%, the total effective rate of the control group was 87.1%, there was no significant difference between the two groups (P0.722 P0.05). There was no significant difference between the treatment group and the control group in improving reflux, heartburn and other typical symptoms, but the treatment group was superior to the control group in improving the sleep disorder caused by typical symptoms. There was a significant difference between the symptoms before and after (P0.05), indicating that the treatment group and the control group were effective in improving each symptom. 2. The total effective rate of the treatment group and the control group were 93.3and 74.2 respectively. There was a significant difference between the two groups (P=0.044P0.05). The results showed that the curative effect of the treatment group was better than that of the control group in improving the (NERD) of the non erosive reflux disease of the type of liver and stomach stagnation heat. In the syndrome of stagnation of the liver and stomach, there was statistical difference between the two groups before and after the comparison (P0.05), indicating that the treatment group and the control group were effective in improving the symptoms. After treatment, there were significant differences between the two groups in the improvement of symptoms of fullness or pain, warm air reflux, dry stool and anorexia (P0.05), among which belching and stool dryness were improved. There was significant difference in appetite loss (P0.01), but no significant difference in other symptoms (P0.05), which indicated that the treatment group was better than the control group in improving systemic symptoms. 4. There was significant difference in SAS score between the two groups after treatment (P0. 000 P 0. 01), while in the control group there was no significant difference (P 0. 083 P 0. 05). It shows that the treatment group is obviously superior to the control group in improving the anxiety state of the patients. 5. 5. The recurrence rate of the treatment group and the control group were 3.3% and 26.0 respectively (P < 0.05), which indicated that the recurrence rate of the treatment group was lower than that of the control group. Conclusion: Qingyu and Jiangtang combined with omeprazole are effective in the treatment of non-erosive reflux disease with stagnation of liver and stomach. Qingyu and Jiangtang can effectively improve patients' systemic symptoms and anxiety, and improve their quality of life.
【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
本文编号：2370204
[Abstract]:Objective: to observe the clinical effect and recurrence rate of Qingyu and Jiangtang combined with omeprazole in the treatment of non-erosive reflux of liver and stomach. Methods: the gastroesophageal reflux disease (GERD) was diagnosed by (GerdQ), gastroscope, PPI diagnostic test, and clinical symptom scale of non-erosive reflux of liver and stomach. 62 patients with SAS scores greater than 50 were selected by filling out the anxiety Self-Rating scale (SAS),) to meet the diagnostic criteria. The patients were randomly divided into treatment group (31 cases) and control group (31 cases). There were 61 cases in the treatment group, 30 cases in the treatment group and 31 cases in the control group. The control group was treated with omeprazole enteric-coated capsule, the treatment group was treated with Qingyu and Jiangtang on the basis of western medicine, the course of treatment was 8 weeks. The changes of patients' condition were compared and evaluated, and the relapse after withdrawal was observed. Results: 1. The total effective rate of the treatment group was 90.0%, the total effective rate of the control group was 87.1%, there was no significant difference between the two groups (P0.722 P0.05). There was no significant difference between the treatment group and the control group in improving reflux, heartburn and other typical symptoms, but the treatment group was superior to the control group in improving the sleep disorder caused by typical symptoms. There was a significant difference between the symptoms before and after (P0.05), indicating that the treatment group and the control group were effective in improving each symptom. 2. The total effective rate of the treatment group and the control group were 93.3and 74.2 respectively. There was a significant difference between the two groups (P=0.044P0.05). The results showed that the curative effect of the treatment group was better than that of the control group in improving the (NERD) of the non erosive reflux disease of the type of liver and stomach stagnation heat. In the syndrome of stagnation of the liver and stomach, there was statistical difference between the two groups before and after the comparison (P0.05), indicating that the treatment group and the control group were effective in improving the symptoms. After treatment, there were significant differences between the two groups in the improvement of symptoms of fullness or pain, warm air reflux, dry stool and anorexia (P0.05), among which belching and stool dryness were improved. There was significant difference in appetite loss (P0.01), but no significant difference in other symptoms (P0.05), which indicated that the treatment group was better than the control group in improving systemic symptoms. 4. There was significant difference in SAS score between the two groups after treatment (P0. 000 P 0. 01), while in the control group there was no significant difference (P 0. 083 P 0. 05). It shows that the treatment group is obviously superior to the control group in improving the anxiety state of the patients. 5. 5. The recurrence rate of the treatment group and the control group were 3.3% and 26.0 respectively (P < 0.05), which indicated that the recurrence rate of the treatment group was lower than that of the control group. Conclusion: Qingyu and Jiangtang combined with omeprazole are effective in the treatment of non-erosive reflux disease with stagnation of liver and stomach. Qingyu and Jiangtang can effectively improve patients' systemic symptoms and anxiety, and improve their quality of life.
【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
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