清胃顺气汤治疗反流性食管炎临床疗效观察

发布时间：2019-02-17 09:32

【摘要】：目的：观察清胃顺气汤联合西药治疗肝胃郁热型反流性食管炎的临床有效性及安全性,并应用于临床。方法：严格按照纳入标准、排除标准、诊断标准,选择2014年10月-2015年12月,到三亚市中医院门诊部就诊的反流性食管炎肝胃郁热型患者60例,按照随机对照原则,分成对照组30例,治疗组30例。两组患者在年龄、性别、临床主要症状、体征、病程长短、胃镜结果、Hp感染上无明显差异。对照组给予口服兰索拉唑片30mg qd、枸橼酸莫沙比利分散片5mg tid治疗；治疗组在对照组基础上联合口服清胃顺气汤每口1剂,分早晚两次服。治疗组胃痛较甚者,加延胡索、白芍；嗳气、呃逆频繁,加沉香、旋复花；反酸明显,加煅牡蛎、煅瓦楞子；嘈杂吐酸,口干口苦,加栀子、蒲公英。两组疗程均为4周。停药后对所有患者进行随访,分别对两组患者经治疗后的临床总体疗效、中医证候疗效进行评价,对治疗后复发情况进行分析,做出疗效评估及安全性评价。结果：(1)治疗后总体疗效比较：治疗组30例,其中有1例治愈,11例明显好转,症状改善14例,无效4例,总有效率86.7%；对照组30例,治愈例数为0,症状明显好转8例,症状有所改善13例,无效9例,总有效率70.0%；治疗组的疗效显著,与对照组相比有明显优势(P0.05)。(2)治疗前后两组中医症状总积分比较：治疗组治疗前20.83±4.07,治疗后9.17±5.50；对照组治疗前21.13±3.60,治疗后13.3±5.64；治疗组治疗前后的中医症状总积分,明显低于对照组的总积分(P0.05)。结论：导师验方清胃顺气汤对治疗肝胃郁热型反流性食管炎,具有良好的临床疗效,可以帮助改善患者不同的临床症状,治疗后不容易复发,且尚未出现毒副反应,安全性较高,值得在临床安全使用。
[Abstract]:Objective: to observe the clinical efficacy and safety of Qingwei Shunqi decoction combined with western medicine in the treatment of reflux esophagitis of liver and stomach stagnation heat type. Methods: according to the inclusion criteria, exclusion criteria and diagnostic criteria, 60 patients with reflux esophagitis with liver and stomach stagnation heat were selected from October 2014 to December 2015. The patients were divided into control group (n = 30) and treatment group (n = 30). There were no significant differences in age, sex, clinical symptoms, signs, duration of disease, gastroscopy and Hp infection between the two groups. The control group was treated with oral lansoprazole tablet 30mg qd, moxapride dispersible tablet 5mg tid, the treatment group was treated with oral Qingwei Shunqi decoction on the basis of the control group, which was taken twice in the morning and evening. Treatment group stomach pain more serious, plus Yanhusuo, white peony, eructation, hiccup frequent, add incense, rotation flowers; regurgitate obvious, plus calcined oyster, calcined corrugated; noisy vomit acid, dry mouth bitter, plus gardenia, dandelion. The course of treatment was 4 weeks in both groups. All the patients were followed-up after drug withdrawal, the overall clinical efficacy and TCM syndromes of the two groups after treatment were evaluated, and the relapse after treatment was analyzed, and the evaluation of curative effect and safety were made. Results: (1) comparison of the overall curative effect after treatment: in the treatment group, 1 case was cured, 11 cases were obviously improved, 14 cases were improved, 4 cases were ineffective, the total effective rate was 86.7%; In the control group, 30 cases were cured, 8 cases were obviously improved, 13 cases were improved, 9 cases were ineffective, the total effective rate was 70.0%. The therapeutic effect of the treatment group was significant, compared with the control group, there were obvious advantages (P0.05). (2) before and after the treatment of the two groups compared with the total score of TCM symptoms: the treatment group before treatment 20.83 卤4.07, after treatment 9.17 卤5.50; The control group before treatment 21.13 卤3.60, after treatment 13.3 卤5.64; the treatment group before and after treatment of traditional Chinese medicine symptoms total score, significantly lower than the control group total score (P0.05). Conclusion: Qingwei Shunqi decoction has a good clinical effect on the treatment of reflux esophagitis of the type of liver and stomach stagnation heat, it can help to improve the different clinical symptoms of the patients, it is not easy to relapse after treatment, and no toxic side effects have appeared. The safety is high, and it is worth using safely in clinic.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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