抑酸和降方联合奥美拉唑治疗反流性食管炎的临床疗效观察

发布时间：2018-12-14 03:59

【摘要】：目的：观察具有疏肝清热,和胃降逆作用的抑酸和降方联合奥美拉唑对反流性食管炎的疗效,探索中西医结合治疗该病的方法,以期进一步提高临床疗效,降低复发率。方法：选择符合反流性食管炎纳入标准的患者60例,随机分为治疗组和对照组。对照组口服奥美拉唑,治疗组在对照组基础上加服抑酸和降方加减,服用疗程同对照组,均为8周。疗程结束后进行临床症状改善情况的比较,并比较内镜效果。疗程结束后16周进行随访,观察复发情况。结果：治疗组中医证候疗效总有效率(93.3%)明显优于对照组(83.3%),具有统计学意义(P0.05)。两组RDQ量表评分治疗前后比较,具有统计学意义(P0.05),组间比较,在改善烧心、反酸、反食方面,治疗组要优于对照组(P0.05),在改善非心源性胸痛方面,两组疗效相当,差异无显著性(P0.05)。对治疗后复查胃镜的患者进行组内比较,两组胃镜分级治疗前后比较有统计学意义(P0.05),组间比较,治疗组胃镜下食管黏膜改善情况优于对照组(P0.01)。疗程结束后16周随访,两组复发率比较具有统计学意义(P0.05)。患者治疗期间均未发生明显不良反应。结论：抑酸和降方是治疗反流性食管炎的有效方剂,能够改善反流性食管炎患者的临床症状,改善内镜下食管黏膜情况,治疗效果持久,预防复发作用明显,且无明显不良反应,值得进一步研究和推广。
[Abstract]:Objective: to observe the curative effect of anti-acid and omeprazole combined with omeprazole on reflux esophagitis, and to explore the method of integrated traditional Chinese and western medicine for the treatment of reflux esophagitis, in order to further improve the clinical efficacy and reduce the recurrence rate. Methods: 60 patients with reflux esophagitis were randomly divided into treatment group and control group. Omeprazole was taken orally in the control group, and the treatment group was treated for 8 weeks with the same course of treatment as that in the control group. After the course of treatment, the improvement of clinical symptoms was compared, and the effect of endoscopy was compared. The patients were followed up 16 weeks after the course of treatment and the recurrence was observed. Results: the total effective rate of TCM syndrome in the treatment group (93.3%) was significantly better than that in the control group (83.3%), with statistical significance (P0.05). Before and after treatment, the scores of RDQ scale in the two groups were statistically significant (P0.05). Compared between the two groups, the treatment group was superior to the control group in improving heartburn, acid regurgitation and food reflux (P0.05), and in improving non-cardiogenic chest pain, the treatment group was better than the control group (P0.05). There was no significant difference between the two groups (P0.05). After the treatment of patients with gastroscopy to carry out intra-group comparison, the two groups before and after gastroscope grading treatment compared with statistical significance (P0.05), the treatment group under gastroscope esophageal mucosal improvement was better than the control group (P0.01). 16 weeks after the end of the course of follow-up, the recurrence rate of the two groups was statistically significant (P0.05). No significant adverse reactions occurred during treatment. Conclusion: Yiyaohe Jiangfang is an effective prescription for the treatment of reflux esophagitis. It can improve the clinical symptoms of patients with reflux esophagitis, improve the condition of esophageal mucosa under endoscope, have a lasting effect and prevent recurrence obviously. And there is no obvious adverse reaction, which is worthy of further study and promotion.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R571

【参考文献】