疏肝和胃方治疗58例胃食管反流病相关性胸痛临床观察  

Clinical Observation of 58 Cases of Chest Pain Associated with Gastroesophageal Reflux Disease

作　　者：李黎[1,2] 朱生樑[1,2] 

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437 [2]上海中医药大学脾胃病研究所,上海201203

出　　处：《辽宁中医杂志》2009年第2期220-222,共3页Liaoning Journal of Traditional Chinese Medicine

基　　金：上海市教委重点学科资助(J50305)

摘　　要：目的:观察胃食管反流病相关性胸痛的中医证型分布特点及疏肝和胃方治疗本病的临床疗效。方法:对58例胃食管反流病相关性胸痛患者进行中医辨证分型与胃镜下分级,分析两者的关系。以中药疏肝和胃方随证加减治疗8周后,观察胸痛症状积分与其他临床症状积分的改善情况。结果:①属肝胃郁热证39例(67.24%),胆热犯胃证4例(6.90%),气郁痰阻证9例(15.52%),中虚气逆证6例(10.34%)。胃镜下分级在中医证型分布中无显著性差异(P>0.05)。②治疗前后胸痛症状积分及其他临床症状积分均有显著性差异(P<0.01)。③胸痛症状改善显效率是96.55%,临床症状改善显效率是87.93%。结论:胃食管反流病相关性胸痛以肝胃郁热证多见,其次为气郁痰阻证;其中医证型分布与胃镜下分级无明显关系;疏肝和胃方能有效改善本病的胸痛症状及其他临床症状。Objective：To observe the TCM Syndromes characteristics of Chest Pain Associated with GERD and the clinical effect of recipe of soothing the liver and regulating the stomach in treating the disease. Methods ： To carry out syndrome differentiation and endoscopic examination over the 58 cases, and analyze the relationship between types of TCM differentiation and level under the endoscope. All the cases were treated with recipe of soothing the liver and regulating the stomach for eight weeks. The chest pain and the other clinical symptomatic scores were observed. Results ： （ 1 ） 39 cases belong to stagnant heat of liver and stomach（67.24% ） ,4 cases belong to the heat of gallbladder attacking into stomach（6. 90% ） ,9 cases belong to qi depression and phlegm obstruction（ 15.52% ） ,6 cases belong to the instffficiency of spleen inducing adverse flowing of qi（ 10. 34% ）. There was no significant difference between level partition under endoscope and the TCM syndrome differentiation （ P 〉 0. 05 ）. （ 2 ） Chest pain and the other clinical symptomatic scores were significantly different（ P 〈 0. 01 ）. （3）The effective rate for chest pain symptom was 96. 55% while the other clinical symptoms was 87.93%. Conclusion ：The most common pattern among TCM syndromes of chest Pain Associated with GERD is the pattern of stagnant heat of liver and stomach, and secondly is the pattern of qi depression and phlegm obstruction. There is no significant difference between TCM Syndromes and level partition under endoscope. Recipe of soothing the liver and regulating the stomach can effectively improve chest pain symptom and the other Clinical symptoms of the disease.

关 键 词：胃食管反流病 非心源性胸痛 中医证型 中医药疗法 疏肝和胃方 

分 类 号：R571[医药卫生—消化系统]