半夏泻心汤对反流性食管炎患者临床疗效及焦虑、睡眠质量的影响  

Clinical Efficacy of Banxia Xiexin Decoction and Its Effects on Anxiety and Sleep Quality of Patients with Reflux Esophagitis

作　　者：曹翠纳 张北平[2] 赵喜颖[2] CAO Cui-Na;ZHANG Bei-Ping;ZHAO Xi-Ying(Postgraduates of Grade 2013 of Guangzhou University of Chinese Medicine,Guangzhou 510006 Guangdong,China;Dept.of Spleen-stomach Disease,Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou 510120 Guangdong,China)

机构地区：[1]广州中医药大学 [2]广东省中医院总院脾胃病科,广东广州510120

出　　处：《广州中医药大学学报》2018年第5期779-784,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医院院内中医临床评价专项课题(编号:2014KT1064)

摘　　要：【目的】探讨半夏泻心汤联合雷贝拉唑治疗寒热错杂型反流性食管炎(RE)的临床疗效及其对患者焦虑、睡眠质量的影响。【方法】将72例寒热错杂型RE患者随机分为中药组、西药组和联合组,每组各24例。中药组单纯给予半夏泻心汤加减方治疗,西药组单纯给予西药雷贝拉唑钠肠溶片治疗,联合组给予半夏泻心汤加减方联合雷贝拉唑钠肠溶片治疗,疗程8周。观察3组患者治疗前后症状评分、胃镜下黏膜炎症评分以评价其症状综合疗效和胃镜疗效,并采用焦虑自评量表(SAS)、匹兹堡睡眠质量指数量表(PSQI)以评价患者心理状态、睡眠质量的变化情况。【结果】(1)治疗后,联合组综合疗效的总有效率为100.00%,中药组为87.50%,西药组为79.17%,联合组的综合疗效优于中药组和西药组(P<0.05)。(2)治疗后,联合组胃镜疗效的总有效率为100.00%,中药组为75.00%,西药组为79.17%,联合组的胃镜疗效优于中药组和西药组(P<0.05)。(3)治疗后,3组患者的主症积分均较治疗前降低(P<0.05);经校正α'=0.05/3后,联合组在降低主症总积分方面明显优于中药组和西药组(P<α')。(4)治疗后,3组患者的SAS、PSQI积分均较治疗前降低(P<0.05);经校正α'=0.05/3后,联合组和中药组在降低SAS、PSQI积分方面明显优于西药组(P<α')。【结论】半夏泻心汤加减方与雷贝拉唑钠肠溶片均能有效改善患者的反流症状,促进食管黏膜愈合,改善患者焦虑状态及睡眠质量,中西药联合及单纯中药治疗疗效相当且均优于单纯西药治疗。Objective To investigate the clinical effect of Banxia Xiexin Decoction（a recipe mainly composed of Rhizoma Pinelliae with the actions of purging stomach-fire）combined with Rabeprazole Sodium Enteric-coated Tablets for the treatment of reflux esophagitis（RE）with the syndrome of concurrence of cold and heat,and to observe the effect on axiety and sleep quality of RE patients. Methods Seventy-two qualified RE patients were randomized into Chinese medicine group, western medicine group and combination group, 24 cases in each group. Patients in Chinese medicine group were treated with modified Banxia Xiexin Decoction,patients in western medicine group were given Rabeprazole Sodium Enteric-coated Tablets, and the combination group was given Banxia Xiexin Decoction combined with Rabeprazole Sodium Enteric-coated Tablets. The treatment for the 3 groups lasted 8 weeks. The scores of clinical symptoms and mucosal inflammation under the gastroscope were observed before and after treatment for the evaluation of comprehensive therapeutic effect and therapeutic effect under the gastroscope,respectively. Meanwhile,the psychological state and sleep quality were monitored with the scores of Self-Rating Anxiety Scale（SAS）,Pittsburgh Sleep Quality Index（PSQI）respectively. Results（1）After treatment,the comprehensive therapeutic effective rate of the combination group was 100.00%,and was superior to that of Chinese medicine group（87.50%）and western medicine group（79.17%）,the difference being significant（P〈0.05）.（2）After treatment,the therapeutic effective rate showed by gastroscopy in the combination group was 100.00%,and was superior to that in Chinese medicine group（75.00%）and western medicine group（79.17%）,the difference being significant（P〈0.05）.（3）After treatment,the scores of primary symptoms of the 3 groups were decreased（P〈0.05 compared with those before treatment）;under the condition of corrected α＇=0.05/3,the decrease of scores of primary symptoms in the comb

关 键 词：反流性食管炎 寒热错杂型 半夏泻心汤加减 寒热平调 雷贝拉唑 

分 类 号：R259.71[医药卫生—中西医结合]