清热降逆通腑法治疗GERD与IBS-C重叠症胃热气逆肠结证的临床观察

发布时间：2018-07-14 18:48

【摘要】：目的:观察清热降逆通腑法治疗GERD与IBS-C重叠症胃热气逆肠结证的临床疗效。方法:将符合纳入标准的64例GERD与IBS-C重叠症胃热气逆肠结证患者随机分为两组:治疗组32例,对照组32例,治疗组给予自拟清热降逆通腑中药口服,对照组给予雷贝拉唑胶囊联合双歧杆菌三联活菌胶囊,疗程共8周,观察并记录治疗前、治疗后、停药4周,两组患者主要单项症状积分、症状总积分变化及中医证候积分变化。全部数据以SPSS 20统计软件进行统计学分析。结果:1.治疗组和对照组主要单项症状积分疗效比较中,组内比较,两组治疗后主要单项症状积分均较治疗前下降(P0.05),组间比较,对腹痛腹胀、大便秘结症状缓解情况,治疗组优于对照组(P0.05),对烧心、反酸症状缓解情况,两组没有统计学差异(P0.05)。2.治疗组和对照组中医症状总积分比较:组内比较,两组治疗后中医症状总积分均较治疗前下降(P0.05)。组间比较,治疗组中医症状总积分降低程度较对照组显著(P0.05)。3.治疗组和对照组中医症候疗效评价比较:治疗组治愈1例,显效6例,有效23例,无效2例,总有效率93.3%,对照组治愈0例,显效1例,有效24例,无效7例,总有效率78.1%,对比两组疗效,经统计学检验P0.05,治疗组症候有效率优于对照组。4.远期疗效评价:两组停药后与治疗后症状总积分之差具有统计学差异(P0.05),治疗组停药后症状积分增加的程度小于对照组,治疗组远期疗效优于对照组。结论:清热降逆通腑法治疗GERD与IBS-C重叠症胃热气逆肠结证,能够很好的改善相关症状,具有较高的有效率,远期疗效良好。值得进一步研究推广。
[Abstract]:Objective: to observe the clinical effect of clearing away heat and lowering the inverses of entrails in the treatment of GERD and IBS-C overlapping syndrome of stomach heat, qi and intestine. Methods: 64 patients with GERD and IBS-C overlap syndrome were randomly divided into two groups: treatment group (n = 32) and control group (n = 32). The control group was treated with Rabeprazole capsule combined with Bifidobacterium triple live bacilli capsule for 8 weeks. The main symptom scores were observed and recorded before treatment, 4 weeks after treatment and 4 weeks after treatment. Symptom total integral change and TCM syndrome integral change. All the data were analyzed by SPSS 20 statistical software. The result is 1: 1. In the treatment group and the control group main single symptom integral comparison, the two groups after treatment main single symptom integral is all lower than before treatment (P0.05), the inter-group comparison, to abdominal pain abdominal distension, the big constipation knot symptom relief situation, The treatment group was better than the control group (P0.05), for heartburn, acid regurgitation symptom relief, there was no statistical difference between the two groups (P0.05). 2. Comparison of the total scores of TCM symptoms in the treatment group and the control group: compared with the control group, the total score of TCM symptoms in the two groups decreased after treatment (P0.05). The total score of TCM symptom in the treatment group was significantly lower than that in the control group (P0.05). Comparison of curative effects of TCM symptoms between the treatment group and the control group: 1 case was cured, 6 cases were markedly effective, 23 cases were effective, 2 cases were ineffective, the total effective rate was 93.33.0 cases were cured in the control group, 1 case was markedly effective, 24 cases were effective, 7 cases were ineffective. The total effective rate was 78.1%, compared with the two groups, the treatment group was superior to the control group in symptom response rate by statistical test (P0.05). Long-term curative effect evaluation: the difference between the two groups after withdrawal and after treatment symptom total score has statistical difference (P0.05), the treatment group after withdrawal symptom score increase degree is smaller than the control group, the treatment group long-term curative effect is superior to the control group. Conclusion: the treatment of GERD and IBS-C overlap syndrome of stomach heat qi and intestinal knot with the method of clearing away heat and lowering the inverses and unblocking the Fu organs can improve the symptoms well and has a high effective rate and good long-term curative effect. It is worth studying and popularizing further.
【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】：2017
【分类号】：R259

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