通降舒膈汤治疗胃食管反流病肝胃不和证疗效观察  

Clinical therapeutic effect of TongJiang Shugetang Decoction on Patients with Gastroesophageal Reflux Disease ( GERD) of Incoordination Between the Liver and Stomach type

作　　者：诸葛丽[1] 周斌[1] 

机构地区：[1]中国中医科学院广安门医院,北京100029

出　　处：《中医学报》2010年第6期1170-1172,共3页Acta Chinese Medicine

摘　　要：目的:观察临床经验方通降舒膈汤治疗胃食管反流病中医肝胃不和证型的临床疗效。方法:将60例符合诊断的病人采取简单随机法分为治疗组30例和对照组30例。治疗组予以通降舒膈汤治疗,对照组予以通降舒膈汤联合雷贝拉唑钠肠溶片及莫沙必利片治疗。1个疗程为28d。分别进行治疗14d、28d后两组中医证候疗效、单项主症疗效比较,及停药后复发情况的比较。结果:治疗28d时,治疗组痊愈率0.0%,显效率16.7%,有效率80.0%,无效率3.3%;对照组痊愈率0.0%,显效率26.7%,有效率70.0%,无效率3.3%,两组治疗疗效相似,无统计学差异(P=1.000,P>0.05)。在单项主症的疗效比较中,治疗14d时,治疗组与对照组治疗反流的痊愈率分别为14.3%/52.6%,对照组治疗反流的痊愈率高于中药组(P=0.033,P<0.05)。治疗组与对照组组治疗反酸的显效率分别为20.7%/50.0%,中西药组治疗反酸的显效率高于中药组(P=0.027,P<0.05)。在单项主症的疗效比较中,治疗28d时,治疗组与对照组治疗无统计学差别。停药14d时,中药组与中西药组的复发率分别为16.7%/43.3%,中西药组复发率明显高于中药组(P=0.047,P<0.05);停药28d时,中药组与中西药组复发率分别为19.2%/51.9%,中西药组复发率明显高于中药组(P=0.021,P<0.05)。结论:通降舒膈汤治疗胃食管反流病具有良好的临床疗效。配合西药治疗,早期可在短时间内(14d左右)在一定程度上控制胃食管反流病反流、反酸症状,但长时间应用(28d左右)对反流及反酸症状疗效无进一步提高,且停药后部分患者症状反复,复发率较高。中药组早期(14d左右)针对反流、反酸起效稍慢,但长时间应用时(28d左右),疗效逐渐增加,且疗效稳定,停药后复发率较低。中药组与中西药组在控制烧心及非心源性胸痛症状方面疗效相同。Objective：To monitor the clinical therapeutic effect of TongJiang Shuge tang decoction （treatment group ）on patients with Gastroesophageal Reflux Disease （GERD） of ineoordination between the liver and stomach type and compare it. Methods： 60 eases who consistent with diagnostic code were divided into two group according to random digits table, 30 cases in treatment group,30 eases in control group. Treatment group used TongJiang Shugetang decoction. Control group received TongJiang ShuGetang decoction and Rabeprazole Sodium Enteric - coated Capsules and mosapride Capsules （ Collaborative group）. 28 d as a course. The evaluation of the curative effect is conducted at three levels： main symptoms, minor symptoms and the recurrent rate. Results： Both treatment group and Collaborative group are proved to be effective on the treatment of GERD. After one course of treatment, the curative of TCM group is 0.0%, excellent rate is 16.7%, effective rate is 80% , inefficiency is 3.3% ; the the curative of Collaborative group is 0.0%, excellent rate is 26.7%, effective rate is 70% , inefficiency is 3.3%. The treatment group and the Collaborative group have similar thera- peutic effect （P = 1. 0000, P 〉0.05）. After 14 d treatment, the Collaborative group has a higher curative rate （52.6%） on the reflux side than the treatment group （ 14.3 % ） （P = 0.033, P 〈 0.05 ）. The Collaborative group also has a higher excellent rate （50.0%） on the acid reflux side than the treatment group （20.7%） （P =0.027 ,P 〈0.05）. The relapse rate of Collaborative group after suspension of treatment for 14 d is 43.3%, which is higher than TCM group （ 16.7% ） （ P = 0. 047 ,P 〈 0.05 ）. And the relapse rate of Collaborative group after suspension of treatment for 28 d is 51.9% , whichis still higher than TCM group （ 19.2% ） （P =0.021 ,P 〈0.05）. Conclusion ： TongJiang Shugetang is quite effective in treating GERD. The Collaborative group has the higher therapeutic effect of reflux a

关 键 词：胃食管反流病 肝胃不和证型 通降舒膈汤 

分 类 号：R259.71[医药卫生—中西医结合]