左金丸加味辨证治疗反流性食管炎的临床研究  

Clinical Study of Differential Treatment with Modified Zuojin Pills for Reflux Esophagitis

作　　者：李力强[1,2] 张贵锋[1,2] 曾艺文 王芳[1,2] 宾建平 温鸿源[2] 谢君 

机构地区：[1]肇庆医学高等专科学校,广东肇庆526020 [2]肇庆医学高等专科学校附属医院,广东肇庆526020 [3]肇庆市中医院,广东肇庆526020

出　　处：《中药新药与临床药理》2016年第2期286-290,共5页Traditional Chinese Drug Research and Clinical Pharmacology

基　　金：肇庆市科技创新项目(2015040304-9)

摘　　要：目的观察左金丸加味辨证治疗反流性食管炎的临床疗效。方法 120例反流性食管炎患者随机分为观察组与对照组,每组60例;观察组采用左金丸加味辨证治疗,对照组采用奥美拉唑联合麦滋林治疗;3个疗程后评价两组患者的近期疗效、远期疗效和不良反应。结果 (1)观察组与对照组临床观察总有效率分别为98.33%和93.33%,胃镜观察总有效率分别为90.00%和86.67%,组间比较均无统计学意义(P>0.05)。(2)治疗后,两组患者主要症状积分较治疗前均显著下降(P<0.05,P<0.01);观察组患者烧心、反酸、恶心呕吐症状积分比对照组下降显著(P<0.01)。(3)观察组肝胃不和证治愈率高于肝胃郁热、脾胃虚弱证(P<0.01);对照组3种证型总有效率和治愈率差异均无统计学意义(P>0.05)。(4)观察组复发率显著低于对照组(P=0.0072),对照组患者部分出现腹胀、轻微头痛、胃中嘈杂等不良反应。结论左金丸加味与奥美拉唑联合麦滋林均能有效治疗反流性食管炎,前者治愈率较高、复发率较低、不良反应少,对肝胃不和型证疗效比较好。Objective To investigate the clinical efficacy of differential treatment with modified Zuojin Pills（ZP） for reflux esophagitis. Methods A total of 120 cases of reflux esophagitis were randomly divided into observation group and control group,60 cases in each group. Observation group was given differential treatment with modified ZP,and the control group was given Omeprazole and Marzulene treatment orally. After 3 treatment courses,the therapeutic effect,long- term efficacy and adverse reaction of the two groups were evaluated. Results（1）The total clinical observation efficiency of the observation group and the control group was 98.33 % and 93.33 %, and the total efficiency of endoscopic observation was 90.00 % and 86.67 %,respectively. There were no significant differences between the two groups（P〉0.05）.（2）After treatment, the major symptom scores of both groups were significantly lower than those before treatment（P〈0.05,P〈0.01）. The scores of heartburn,acid reflux,nausea and vomiting in observation group were decreased significantly（P〈0.05） compared with the control group.（3）In the observation group, patients with liver- stomach disharmony syndrome had higher cure rate than the syndromes of liver- stomach stagnated heat and spleen- stomach deficiency（P〈0.05）. The differences of the total effective rate and cure rate were insignificant among the three syndromes of the control group（P〉0.05）.（4）Observation group had lower recurrence rate than the control group（P=0.0072）. Some patients in the control group had the adverse reaction of abdominal distention,mild headache,and gastric discomfort. Conclusion Differential treatment with modified ZP is as effective as Omeprazole and Marzulene for the treatments of reflux esophagitis,and differential treatment with mmodified ZP has the advantages of higher cure rate, low recurrence rate and less adverse reactions, and is the best option for the treatment of liver- stomach disharmony type reflux esophagitis.

关 键 词：左金丸 辨证论治 反流性食管炎 临床研究 

分 类 号：R285.6[医药卫生—中药学]