温胆汤加味治疗气郁痰阻型非糜烂性反流病的临床研究

发布时间：2019-02-12 09:06

【摘要】：1目的本研究在于观察温胆汤加味治疗气郁痰阻型非糜烂性反流病(NERD)的临床疗效,及其对患者生活质量的影响,并通过随访来评估温胆汤加味治疗本病的远期疗效。2方法将具备纳入条件的60例患者随机分为两组,治疗组和对照组各30例。治疗组予温胆汤加味口服,对照组予雷贝拉唑联合莫沙必利口服,疗程共8周。采用问卷调查的方式,记录并分析治疗各期患者的临床症状、中医证候及生活质量积分,以进行疗效评定;疗程结束3月后进行随访,记录症状积分以观察远期疗效。3结果3.1反流症状问卷(RDQ)评价3.1.1组内各项症状积分比较治疗第4周末、第8周末及随访期,两组的各项症状积分较治疗前降低,差异有统计学意义(P0.01或P0.05)。3.1.2治疗组与对照组症状积分比较治疗第4周末,治疗组的烧心、反酸、反食积分低于对照组,有统计学差异(P0.05),胸痛积分比较,无统计学差别(P0.05);第8周末,治疗组各项症状积分均低于对照组(P0.01或P0.05)。3.1.3两组症状总积分、有效率及复发率比较治疗第4周末、第8周末及随访期,治疗组症状总积分均低于对照组,差异有统计学意义(P0.01);治疗后治疗组总显效率(90%)高于对照组总显效率(66.67%)(P0.05)。随访期,治疗组复发率(6.7%)低于对照组复发率(26.27%)(P0.05)。3.2中医证候评价3.2.1组内各项症候积分比较治疗第4周末,治疗组各项症候积分明显低于治疗前(P0.01);对照组的反流、半夜呛咳、急躁易怒、便溏、纳呆、嗳气积分低于治疗前(P0.01或P0.05),余症候积分比较无差异(P0.05);第8周末,两组患者各项积分均显著低于治疗前(P0.01)。3.2.2治疗组与对照组症候积分比较治疗第4周末,治疗组咽喉不利、反流、半夜呛咳、急躁易怒积分低于对照组(P0.01或P0.05),余症候积分比较无统计学差异(P0.05);治疗8周末,治疗组咽喉不利、反流、半夜呛咳、嗳气、急躁易怒积分低于对照组(P0.01或P0.05),余症候积分比较,无明显差异(P0.05)。3.2.3两组症候总积分、有效率比较治疗第4周末、第8周末及随访期,治疗组症状总积分均低于对照组(P0.01或P0.05);治疗后治疗组显效率(93.3%)高于对照组(66.67%)(P0.05)。3.3 SF-36量表评价治疗第8周末,治疗组生理职能(RP)、情感职能(RE)、社会功能(SF)、等维度积分高于对照组(P0.01或P0.05),精神健康(MH)、生理机能(PF)积分比较,差异无统计学意义(P0.05)。随访期,治疗组躯体疼痛(BP)、一般健康(GH)、精力(VT)等维度积分高于对照组(P0.01或P0.05),生理机能、生理职能积分无统计学差异(P0.05)。4研究结论温胆汤加味可明显缓解非糜烂性反流病患者的不适症状,并在改善患者生活质量方面具有显著的优势,且复发率低,具有较为理想的远期疗效。
[Abstract]:Objective to observe the clinical effect of Wendan decoction on non-erosive reflux disease (NERD) caused by Qi stagnation and phlegm obstruction and its effect on the quality of life of the patients. Methods 60 patients with Wentan decoction were randomly divided into two groups: treatment group (n = 30) and control group (n = 30). The treatment group was treated with Wendan decoction and the control group with rabeprazole and mosapride for 8 weeks. Questionnaire survey was used to record and analyze the clinical symptoms, TCM syndromes and quality of life scores of patients in each stage to evaluate the curative effect. Three months after the course of treatment were followed up, symptom scores were recorded to observe the long-term curative effect. 3 results 3.1Reflux symptom questionnaire (RDQ) was used to evaluate the comparison of symptom scores in group 3.1.1 at the end of the 4th week, the 8th week and the follow-up period. The scores of symptoms in the two groups were significantly lower than those before treatment (P0.01 or P0.05). 3.1.2 the symptom scores of the treatment group were compared with those of the control group at the end of the 4th week of treatment, the heart burning and regurgitation of the treatment group, and the difference between the two groups were significant (P0.01 or P0.05). The score of backeating was lower than that of the control group (P0.05), but the score of chest pain had no statistical difference (P0.05). At the end of the 8th week, the symptom scores in the treatment group were lower than those in the control group (P0.01 or P0.05). 3.1.3 the total symptom score, the effective rate and the recurrence rate of the two groups were compared at the end of the 4th week, the 8th weekend and the follow-up period. The total symptom score in the treatment group was lower than that in the control group (P0.01). The total effective rate of the treatment group (90%) was higher than that of the control group (66.67%) (P0.05). During the follow-up period, the recurrence rate in the treatment group (6.7%) was lower than that in the control group (26.27%) (P0.05). The scores of symptoms in the treatment group were significantly lower than those before treatment (P0.01). In the control group, the score of regurgitation, cough, irritability, loose stools, belching and belching was lower than that before treatment (P0.01 or P0.05), but there was no difference in the scores of other symptoms (P0.05). At the end of the 8th week, the scores of the two groups were significantly lower than those before the treatment (P0.01). 3.2.2 the symptom score of the treatment group and the control group were compared at the end of the 4th week of treatment, the treatment group had adverse throat, reflux, and cough in the middle of the night. The score of irritability and irritability was lower than that of the control group (P0.01 or P0.05), but there was no statistical difference in the score of other symptoms (P0.05). At the end of 8 weeks, the scores of pharynx, reflux, cough, belching, irritability and irritability in the treatment group were lower than those in the control group (P0.01 or P0.05). There was no significant difference between the two groups (P0.05). 3.2.3 the total score of symptoms in the treatment group was lower than that in the control group (P0.01 or P0.05) at the end of the 4th weekend, the 8th weekend and the follow-up period. The effective rate in the treatment group (93.3%) was higher than that in the control group (66.67%) (P0.05). 3.3 SF-36 scale was used to evaluate the end of the 8th week of treatment. The physiological function, (RP), emotional function, (RE), social function (SF), in the treatment group were evaluated. The equal dimension score was higher than the control group (P0.01 or P0.05), the mental health (MH), physiological function (PF) score comparison, the difference was not statistically significant (P0.05). During the follow-up period, the scores of (BP), (GH), energy, (VT) and so on in the treatment group were higher than those in the control group (P0.01 or P0.05). There was no significant difference in physiological function score (P0.05). 4 conclusion Wendan decoction can significantly relieve the discomfort of patients with non-erosive reflux disease, and has significant advantages in improving the quality of life of patients, and the recurrence rate is low. It has ideal long-term effect.
【学位授予单位】：安徽中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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