降逆汤治疗复发反流性食管炎的临床疗效  

Efficacy of Jiangni Decoction in treatment of recurrent reflux esophagitis

作　　者：陈昱倩[1] 杨璐[1] 王光铭[1] 刘万里[1] 

机构地区：[1]南京市中西医结合医院消化内科,江苏省南京市210014

出　　处：《世界华人消化杂志》2013年第21期2076-2080,共5页World Chinese Journal of Digestology

摘　　要：目的:运用降逆汤治疗复发反流性食管炎(reflux esophagitis,RE),评价其临床疗效及远期疗效.方法:将90例治疗后复发的RE患者随机分为3组,A组给予降逆汤治疗,B组给予降逆汤联合奥美拉唑治疗,对照组给予奥美拉唑治疗.观察3组治疗8wk后综合疗效、内镜疗效以及停药6mo后复发情况.结果:(1)综合疗效:A组、B组、对照组总有效率分别为86.7%、96.7%、90.0%,A组、对照组差异无统计学意义(P>0.05),B组与A组、对照组差异有统计学意义(P<0.05);(2)内镜疗效:A组治愈8例,显效5例,有效12例,无效5例,总有效率为83.3%;B组治愈12例,显效10例,有效5例,无效3例,总有效率为90.0%;对照组治愈10例,显效9例,有效7例,无效4例,总有效率为86.7%,3组比较无显著差异(P>0.05)(3)远期疗效:停药6mo后,A组有效病例中有4例复发,B组有效病例中有4例复发,对照组有效病例中有12例复发,3组的复发率分别为15.4%、13.8%、44.4%,与对照组比较,A组与对照组有显著差异(P<0.05),B组与对照组有显著差异(P<0.05),A、B组两组间差异性比较无统计学意义(P>0.05).结论:降逆汤治疗复发反流性食管炎与奥美拉唑治疗具有相似的好转率,并具有更低的半年复发率.降逆汤联合奥美拉唑治疗不仅能够提高复发反流性食管炎的临床疗效,还能降低复发反流性食管炎患者的再次复发率.AIM： To evaluate the clinical efficacy of Jiangni Decoction in treatment of recurrent reflux esoph- agitis （RE）. METHODS： Ninety patients with recurrent RE were randomly divided into three groups： a Ji- angni Decoction group, an omeprazole group, and a Jiangni Decoction plus omeprazole group. Overall response and endoscopic response were observed 8 wk after treatment, and relapse at 6 mo after drug withdrawal was also recorded.RESULTS： （1） Overall response： Overall re- sponse was significantly higher in the Jiangni Decoction plus omeprazole group than in theomeprazole group and Jiangni Decoction group （96.7% vs 90.0%, 86.7%, both P 〈 0.05）, but showed no significant difference between the omeprazole group and Jiangni Decoction group （P 〉 0.05）; （2） Endoscopic response： In the Jiang- ni Decoction group, 8 patients were cured, 12 patients showed significant response, 5 patients showed no response, and the total response rate was 83.3%. In the Jiangni Decoction plus omeprazole group, 12 patients were cured, 10 patients showed significant response, 3 patients showed no response, and the total response rate was 90.0%. In the omeprazole group, 10 pa- tients were cured, 9 patients showed significant response, 4 patients showed no response, and the total response rate was 86.7%. There was no significant difference in the total endoscopic re- sponse rate among the three groups （P 〉 0.05）; （3） Relapse： The number of patients developing re- lapse at 6 mo after drug withdrawal was 4 （15.4%） in the Jiangni Decoction group, 4 （13.8%） in the Jiangni Decoction plus omeprazole group, and 12 （44.4%） in the omeprazole group. The relapse rate was significantly higher in the omepra- zole group than in the Jiangni Decoction plus omeprazole group and Jiangni Decoction group （P 〈 0.05）, but showed no significant difference between the latter two groups （P 〉 0.05）. CONCLUSION： Jiangni Decoction has similar effect to omeprazole in the treatment of RE in terms of

关 键 词：反流性食管炎 降逆汤 临床疗效 复发率 

分 类 号：R259[医药卫生—中西医结合]