疏降和胃Ⅰ号方治疗肝胃不和型非糜烂性反流病的临床研究

发布时间：2018-05-12 02:16

本文选题：疏降和胃Ⅰ号方 + 肝胃不和　；参考：《福建中医药大学》2017年硕士论文

【摘要】：目的:观察疏降和胃I号方(小柴胡汤合四逆散化裁)加减治疗肝胃不和型非糜烂性反流病的临床疗效,以期为临床提供客观有效的治疗方案,同时,初步探讨肝胃不和型非糜烂性反流病与焦虑抑郁状态的相关性。方法:选择2016年02月-2017年02月福建中医药大学附属第二人民医院脾胃病科门诊及病房中诊断为肝胃不和型非糜烂性反流病的患者60例,随机分为实验组和对照组各30例。实验组予疏降和胃I号方加减治疗,对照组予兰索拉唑+莫沙必利治疗,疗程4周。治疗结束后,比较治疗前后GerdQ量表、胃食管反流病肝胃不和症状量表、焦虑自评量表(SAS)、抑郁自评量表(SDS)积分、食道测压、24小时PH/阻抗监测的结果,最后以SPSS 20.0软件进行统计分析,P0.05,表示差异具有统计学意义。结果:1.反流症状比较:两组治疗后GerdQ量表积分均较治疗前显著降低(P0.05),提示两种方案均有疗效,组间比较:两组治疗后差异不显著(P0.05),提示两组方案疗效相当。2.中医证候比较:两组治疗后肝胃不和症状量表积分均较治疗前显著降低(P0.05),提示两种方案均有疗效。组间比较:两组治疗后差异显著,实验组优于对照组。同时,对两组治疗后中医证候疗效等级进行比较,结果亦显示两组差异显著(P＜0.05),提示实验组方案改善作用更明显。3.食道测压指标比较:两组治疗后食管下括约肌静息压力(LESP)及远端收缩积分(DCI)平均值均较治疗前显著升高(P＜0.05),提示两组方案均能改善食管下括约肌功能及食管体部收缩能力,组间比较:两组治疗后差异均不显著(P0.05),提示两组方案疗效相当。4.24小时PH/阻抗数据比较:两组治疗后DeMeester评分及总反流次数均较治疗前显著降低(P＜0.05),提示两组方案均能改善反流情况;组间比较:两组治疗后差异均不显著(P0.05),提示两组方案疗效相当。5.焦虑抑郁情绪比较:两组治疗后SAS、SDS积分均较治疗前显著降低(P＜0.05),提示两组方案均可改善焦虑抑郁情绪;组间比较:两组治疗后差异显著(P0.05),提示实验组方案改善作用更明显。6.肝胃不和型非糜烂性反流病中医证候总积分与SAS积分的相关系数为0.402,与SDS积分的相关系数为0.321。结论:1.疏降和胃Ⅰ号方对肝胃不和型非糜烂性反流病患者的反流症状、中医证候、食管下括约肌功能、食道体部收缩能力、反流情况及焦虑抑郁情绪均具有改善作用。2.肝胃不和型非糜烂性反流病与焦虑抑郁状态具有相关性,相关系数分别为:0.402;0.321。
[Abstract]:Objective: to observe the clinical effect of Shujianghe Wei I recipe (Xiaochaihu decoction combined with Sini Powder) in the treatment of non-erosive reflux disease of liver and stomach disharmony type, in order to provide an objective and effective treatment scheme for clinic, at the same time, To explore the relationship between non erosive reflux disease of disharmony between liver and stomach and anxiety and depression. Methods: from February 2016 to February 2017, 60 patients with non-erosive reflux disease of hepatogastric disharmony type were selected and randomly divided into two groups: the experimental group (n = 30) and the control group (n = 30). The experimental group was treated with Shujiang and Wei I recipe and the control group was treated with lansoprazole mosapride for 4 weeks. After treatment, the scores of GerdQ scale, gastroesophageal reflux disease hepatogastric disharmony scale, self-rating anxiety scale and self-rating depression scale were compared before and after treatment, and the results of 24 hours PH/ impedance monitoring of esophageal manometry were compared. Finally, the statistical analysis was carried out with SPSS 20.0 software (P0.05), which indicated that the difference was statistically significant. The result is 1: 1. Comparison of reflux symptoms: the scores of GerdQ scale after treatment in both groups were significantly lower than those before treatment, indicating that the two schemes were effective, and the comparison between the two groups: there was no significant difference between the two groups after treatment, indicating that the curative effect of the two groups was equal to that of the two groups. Comparison of TCM syndromes: after treatment, the scores of liver and stomach disharmony symptom scale in both groups were significantly lower than those before treatment, indicating that the two schemes were effective. Comparison between the two groups: there was a significant difference between the two groups after treatment, the experimental group was superior to the control group. At the same time, the curative effect grades of TCM syndrome were compared between the two groups after treatment. The results also showed that the difference between the two groups was significant (P < 0.05), indicating that the improvement effect of the experimental group was more obvious than that of the control group (P < 0.05). Comparison of esophageal manometry: the mean values of lower esophageal sphincter resting pressure (LESPP) and distal contractile integral (DCI) were significantly higher than those before treatment (P < 0.05), suggesting that both groups could improve the function of lower esophageal sphincter and the contractility of esophageal body. Comparison between the two groups: there was no significant difference after treatment between the two groups (P < 0.05), suggesting that the two groups had the same curative effect and 4.24 hour PH/ impedance data comparison: the DeMeester score and the total reflux times of the two groups were significantly lower than those before treatment (P < 0.05), suggesting that both groups could improve the reflux. Comparison between the two groups: there was no significant difference between the two groups after treatment, indicating that the therapeutic effect of the two groups was equal to .5. Comparison of anxiety and depression: after treatment, the scores of SDS in both groups were significantly lower than those before treatment (P < 0.05), indicating that the two groups could improve anxiety and depression, and the difference between the two groups was significant (P 0.05), indicating that the improvement of the treatment group was more obvious than that of the control group (P < 0.05). The correlation coefficient between the total syndromes of TCM syndromes and SAS integral of non-erosive reflux disease was 0.402, and the correlation coefficient with SDS integral was 0.321. Conclusion 1. Shujiaowi recipe can improve reflux symptoms, syndromes of TCM, lower esophageal sphincter function, esophagus contraction ability, reflux condition and anxiety and depression in patients with non-erosive reflux disease of liver and stomach disharmony type. The relationship between non-erosive reflux of liver and stomach was correlated with anxiety and depression, and the correlation coefficients were 0.402 and 0.321, respectively.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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