和胃降逆汤加减治疗胃食管反流病64例  

Addition and Subtraction Treatment of Hewei Jiangni Decoction in Treating Gastro-esophageal Reflux Disease(Stagnancy Heat of the Liver and Stomach) with 64 Cases

作　　者：周海新[1] 

机构地区：[1]海南省中医院,海口570203

出　　处：《中国实验方剂学杂志》2014年第18期204-207,共4页Chinese Journal of Experimental Traditional Medical Formulae

摘　　要：目的:观察和胃降逆汤加减治疗胃食管反流病(GERD)(肝胃郁热证)的近期和远期疗效及对生活质量的影响。方法:随机按数字表法将128例GERD患者分为西药组和观察组各64例。西药组服用奥美拉唑镁肠溶片,20 mg/次,早、晚各1次;枸橼酸莫沙必利片,5 mg/次,3次/d。观察组服用奥美拉唑镁肠溶片同西药组,并采用和胃降逆汤加减治疗,1剂/d。两组疗程均为8周。进行治疗前后肝胃郁热证评分、食管黏膜内镜和反流性疾病问卷(RDQ)量表及生活质量评价;对痊愈患者进行6个月的随访观察,计算复发率及复发时食管黏膜内镜评分。结果:观察组中医证候疗效总有效率为93.75%,优于西药组的81.25%(P<0.05);观察组胃镜下炎症疗效总有效率为90.62%,优于西药组的75.0%(P<0.05);观察组治疗后肝胃郁热证评分、食管黏膜内镜评分和RDQ量表评分均低于西药组(P<0.01);治疗后观察组SF-36健康量表除身体疼痛维度外其他维度评分均高于西药组(P<0.01);随访6个月,观察组复发率为23.5%低于西药组的64%,观察组复发时食管黏膜内镜评分也低于西药组(P<0.01)。结论:在质子泵抑制剂治疗的基础,和胃降逆汤加减能减轻GERD(肝胃郁热证)近期症状,提高治愈率,提高患者生活质量,并能降低远期复发率。Objective：Short-term and long-term effects of modified Hewei Jiangni decoction in treating Gastro-esophageal reflux disease （GERD） （stagnancy heat of the liver and stomach type） and to quality of lives were investigated.Method：One hundred and twenty-eight patients with GERD were randomly divided into western medicine groupand observation group （64 cases,respectively）.Patients in western medicine group received Omeprazole Magnesium enteric-coated tablets,20 mg each time,taken at the morning and evening.Mosapride citrate tablets,5 mg each time,three times per day.Patients in observation group received Omeprazole Magnesium enteric-coated tablets and the dose was same as which in western medicine group,and also received treatment of modified Hewei Jiangni decoction,1 dose per day.Course of treatment in both groups was 8 weeks.Scores of symptoms of stagnancy heat of the liver and stomach,endoscopic of esophageal mucosa,reflux diagnostic questionnaire （RDQ） and life quality were evaluated before and after treatment.Recovered patients received a 6-moth follow-up,recurrence rates and scores of endoscopic of esophageal mucosa were graded.Result：The total effective rate of improvement of traditional Chinese medicine syndrome in observation group was 93.75％,whic h issuperior to that in western medicine group （81.25％） （P ＜ 0.05）.The total effective rate of elimination of inflammation in observation group was 90.62％,which is superior to that in western medicine group （75％）（P ＜ 0.05）.Scores symptoms of stagnancy heat of the liver and stomach,endoscopic of esophageal mucosa and RDQ in observation group were all lower than those in western medicine group （P ＜ 0.01）.Except for score of physical pain,the SF36 scores of health scale in observation group were higher than those in western medicine group （P ＜ 0.01）.During the 6-mouth follow-up,recurrence rate in observation group was 23.5％,which is lower than that in western medicine group （64％）,and when it relapse,

关 键 词：胃食管反流病 和胃降逆汤 肝胃郁热证 复发率 生活质量 

分 类 号：R287[医药卫生—中药学]