清热和胃法治疗非糜烂性胃食管反流病的临床观察

发布时间：2018-03-29 22:12

本文选题：非糜烂性胃食管反流病　切入点：清热和胃法　出处：《南京中医药大学》2016年硕士论文

【摘要】：研究目的运用清热和胃法治疗非糜烂性胃食管反流病(NERD),并与西药奥美拉唑随机对照,观察其对NERD患者的临床症状的改善情况,以客观评价清热和胃法的疗效,为临床应用提供有力的依据。研究方法选择40例符合纳入标准的NERD患者,随机分为治疗组20例和对照组20例,疗程8周,治疗组采用中药协定方清热和胃治疗,对照组采用奥美拉唑20mg bid治疗。分别计算治疗前后受试者临床症状积分、耐信量表积分,观察不良反应,客观评估清热和胃法治疗非糜烂性胃食管反流病的临床疗效。研究结果1.中医证候疗效：治疗组20例：治愈5例,显效12例,有效1例,无效2例,总有效率90%,愈显率60%；对照组20例：治愈0例,显效4例,有效8例,无效8例,总有效率60%,愈显率20%。两组总体中医证候疗效的比较,治疗组优于对照组(P0.05)；两组愈显率的比较,治疗组显著优于对照组(P0.01)。2.临床症状治疗前后积分变化：治疗组各临床症状积分治疗后比治疗前均有降低(P0.1、P0.05)；对照组治疗后反酸、烧心、嗳气、口苦口干、咽部异物感等症状积分较治疗前均有下降(P0.01、P0.05),而胃脘闷胀、两胁胀满、胸闷胸痛及心烦易怒等临床症状积分改善不明显(P0.05)。两组治疗后的各个临床症状积分比较,在反流、烧心,胃脘闷胀等方面,治疗组优于对照组(P0.01、P0.05)；在嗳气、两胁胀满、口苦口干、胸闷胸痛、咽部异物感、心烦易怒等方面,治疗组与对照组比较无显著性差异(P0.05)。3.临床症状总积分比较：两组临床症状总积分治疗后较治疗前均有明显下降(P0.01)。两组之间比较,治疗组疗效显著优于对照组(P0.01)。4.耐信量表(RDQ)积分变化：治疗组治疗前后比较,其临床症状频率及程度较治疗前均能明显改善(P0.01)：对照组治疗前后比较,其症状频率及程度较治疗前均能改善(P0.01、P0.05)。治疗后两组比较,在反酸频率及程度、反流频率及程度、烧心程度上,治疗组疗效优于对照组(P0.05)；在烧心频率、非心源性心痛频率及程度上,治疗组与对照组比较无显著性差异(P0.05)。5.不良反应：治疗组和对照组在治疗过程中未出现不良反应。研究结论清热和胃法治疗非糜烂性胃食管反流病能改善患者的临床症状,治疗过程中未出现不良反应。说明清热和胃法治疗NERD安全有效。
[Abstract]:Objective to study the treatment of non erosive gastroesophageal reflux disease using qingrehewei method (NERD), and omeprazole were observed the clinical symptoms of NERD patients, to objectively evaluate the efficacy qingrehewei method, provide the basis for the clinical application. Methods 40 cases included in the study standard NERD patients were randomly divided into treatment group 20 cases and control group 20 cases, treatment for 8 weeks, treatment group were treated with traditional Chinese medicine qingrehewei treatment, the control group were treated with omeprazole 20mg bid treatment before and after treatment. The subjects of clinical symptom score were calculated, Nexium scale scores, observation of adverse reaction, clinical efficacy erosive gastroesophageal reflux disease objective assessment qingrehewei method. Results 1. TCM syndrome curative effect: the treatment group of 20 cases: 5 cases were cured, 12 cases markedly effective, 1 cases effective, 2 cases ineffective, the total efficiency of 90%, the effective rate was 60%; control Group of 20 cases: 0 cases were cured, 4 cases were cured, 8 cases effective, 8 cases ineffective, the total efficiency of 60%, compared to two overall rate of 20%. group of TCM syndrome curative effect, the treatment group than the control group (P0.05); the two group rate comparison, the treatment group was significantly better than the control group (P0.01.2.) changes of clinical symptoms score before and after treatment: the treatment group clinical symptom scores were lower after treatment than before treatment (P0.1, P0.05); the control group after treatment with acid reflux, heartburn, belching, mouth pain, dry mouth, pharyngeal foreign body sensation and symptom score were decreased compared with before treatment (P0.01, P0.05), and epigastric fullness. Two threatened fullness, chest pain and irritability and other clinical symptoms improved obviously (P0.05). Compare the clinical symptom scores of two groups after treatment, the reflux, heartburn, epigastric fullness and so on, the treatment group than the control group (P0.01, P0.05); in two threatened fullness, belching, bitter taste and dry mouth chest tightness, chest pain, pharyngeal foreign body A sense of irritability and other aspects, there is no significant difference between the treatment group and the control group (P0.05.3.) the total score of clinical symptoms: two groups of clinical symptoms total score after treatment than before treatment were significantly decreased (P0.01). A comparison between the two groups, the curative effect of treatment group was significantly better than the control group (P0.01).4. Nexium scale (RDQ) integral change: To compare the treatment group before and after treatment, the clinical symptoms of frequency and extent than before treatment can significantly improve (P0.01): the treatment group before and after treatment, the frequency and severity of symptoms before treatment were improved (P0.01, P0.05). After treatment between the two groups in the frequency and severity of regurgitation the frequency and extent of reflux, heartburn, degree, the treatment group than the control group (P0.05); the frequency of heartburn, non cardiogenic pain frequency and extent, there is no significant difference between the treatment group and the control group (P0.05).5. adverse reactions: treatment group and control group in the treatment of No adverse reactions were observed in the course. Conclusion the treatment of clearing away heat and stomach in treating non erosive gastroesophageal reflux disease can improve the clinical symptoms and no adverse reactions during treatment. It shows that clearing heat and stomach therapy for NERD is safe and effective.

【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】：2016
【分类号】：R259

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