疏肝和胃方联合雷贝拉唑治疗肝胃不和型难治性反流性食管炎的临床疗效观察

发布时间：2019-06-11 02:23

【摘要】：目的:旨在观察疏肝和胃方联合雷贝拉唑治疗肝胃不和型难治性反流性食管炎(refractory reflux esophagitis,RRE)的临床疗效及安全性。方法:采用随机、对照、双盲、双模拟的方法将72例肝胃不和型RRE患者分为两组,对照组与治疗组各36例,分别予雷贝拉唑+疏肝和胃方模拟剂与疏肝和胃方+雷贝拉唑治疗,疗程为8周。最终完成病例64例,其中对照组34例,治疗组30例;基于患者治疗前后中医证候积分、胃镜下食管黏膜积分、生活质量积分、焦虑和抑郁自评量表积分的比较分析,研究疏肝和胃方联合雷贝拉唑治疗肝胃不和型难治性反流性食管炎的有效性;同时观察治疗前后三大常规、肝肾功能和心电图的变化情况,对其进行安全性评价。结果:(1)治疗组中医证候痊愈率为16.67%,显效率为36.67%,有效率为26.67%,总有效率为80.00%,无效率为20.00%;对照组中医证候痊愈率为5.88%,显效率为20.59%,有效率为41.18%,总有效率为67.65%,无效率为32.35%;治疗组中医证候总体疗效显著优于对照组(P0.05)。在改善烧心、嗳气、情绪不畅、打呃方面疗效优于对照组(P0.05);(2)治疗组能够改善肝胃不和型RRE患者食管黏膜炎症,但其作用低于对照组(P0.05);(3)治疗组能够有效改善患者生存质量,可明显改善SF-36量表中总体健康、心理健康、生命活力、生理功能、生理职能、情感职能等6个维度积分(P0.05),且在生理功能、生理职能、心理健康3个维度方面疗效优于对照组(P0.05);(4)治疗组能够有效改善患者焦虑抑郁的情绪,且疗效优于对照组(P0.05);(5)治疗前后两组患者的安全性指标无统计学意义。结论:疏肝和胃方联合雷贝拉唑疗效确切,安全性好,并且优化了治疗RRE的方案,值得应用推广。
[Abstract]:Objective: to observe the clinical efficacy and safety of Shugan Hewei recipe combined with rabeprazole in the treatment of refractory reflux esophagitis of hepatogastric disharmony type (refractory reflux esophagitis,RRE). Methods: 72 patients with hepatogastric disharmony type RRE were randomly divided into control group (n = 36) and treatment group (n = 36). The patients in the control group and the treatment group were treated with rabeprazole Shugan and Weifang simulator and rabeprazole respectively. The course of treatment was 8 weeks. 64 cases were finally completed, including 34 cases in the control group and 30 cases in the treatment group. Based on the comparative analysis of TCM syndrome score, gastroscopic esophageal mucous membrane score, quality of life score, anxiety and depression scale score before and after treatment, To study the efficacy of Shugan Hewei recipe combined with rabeprazole in the treatment of refractory reflux esophagitis of hepatogastric disharmony. At the same time, the changes of three routine, liver and kidney function and electrocardiogram were observed before and after treatment, and the safety of them was evaluated. Results: (1) in the treatment group, the cure rate of TCM syndrome was 16.67%, the effective rate was 36.67%, the effective rate was 26.67%, the total effective rate was 80.00%, and the ineffective rate was 20.00%. In the control group, the cure rate of TCM syndrome was 5.88%, the effective rate was 20.59%, the effective rate was 41.18%, the total effective rate was 67.65%, and the ineffective rate was 32.35%. The overall curative effect of TCM syndrome in the treatment group was significantly better than that in the control group (P 0.05). In improving heartburn, belching, poor mood, er, the curative effect of the treatment group was better than that of the control group (P 0.05); (2), but the effect of the treatment group was lower than that of the control group (P 0.05), but the effect of the treatment group was lower than that of the control group (P 0.05). (3) the treatment group can effectively improve the quality of life of the patients, and can significantly improve the overall health, mental health, vitality, physiological function, emotional function and other six dimensions of the SF- 36 scale (P 0.05). The curative effect was better than that of the control group in three dimensions: physiological function, physiological function and mental health (P 0.05). (4) the treatment group could effectively improve the anxiety and depression mood of the patients, and the curative effect was better than that of the control group (P 0.05); (5). There was no significant difference in the safety index between the two groups before and after treatment. Conclusion: Shugan Hewei recipe combined with rabeprazole is effective and safe, and optimizes the treatment of RRE, which is worth popularizing.
【作者单位】：上海中医药大学附属市中医医院脾胃病科;
【基金】：国家自然科学基金项目(81573775) 上海市“新百人”人才计划项目(XBR2013120) 上海市科委重大支撑项目(13401902802)
【分类号】：R571

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