基于气机论治四君子汤加减对非糜烂性胃食管反流中抗Hp的影响  

Analysis of Therapeutic Effects of Modified Sijunzi Decoction on Anti Helicobacter Pylori in Non-erosive Gastroesophageal Reflux Disease based on Qi Movement Theory

作　　者：石亮[1] 杨健[1] 徐丹[1] Shi Liang;Yang Jian;Xu Dan(Department of Gastroenterology,Wuhan Integrated Chinese and Western Medicine Hospital,Wuhan 430000,China)

机构地区：[1]武汉市中西医结合医院消化内科,武汉430000

出　　处：《世界中医药》2018年第12期2999-3002,共4页World Chinese Medicine

基　　金：湖北省武汉市卫计委(WZ15C02)

摘　　要：观察在基于气机论治运用四君子汤加减对脾胃虚弱型非糜烂性胃食管反流病及抗Hp的疗效。方法:选取2015年7月至2017年2月武汉市中西医结合医院消化科门诊和住院部诊治的脾胃虚弱型非糜烂性胃食管反流病(Non-erosive Reflux Disease,NERD) Hp阳性患者90例,按随机数字表法将患者分为观察组与对照组,每组45例。对照组采用抗Hp三联疗法加胃动力药治疗,观察组在此基础上加以中药四君子汤加减口服,分别在治疗前及6周后对2组的症状积分改善程度,临床疗效及Hp转阴率进行统计分析,同时观察电镜下食管黏膜细胞的变化。结果:在6周后,观察组总有效率(95. 55%)优于对照组(84. 44%)(P <0. 05); 2组的临床症状积分Sc值均明显降低(P <0. 05),且观察组明显优于对照组(P <0. 05)。观察组转阴41例(91. 11%,对照组37例(82. 22%),观察组的转阴率明显优于对照组(P <0. 05),2组细胞间隙宽度变小,细胞间隙内单位面积桥粒数目增多(P <0. 05),且观察组明显优于对照组(P <0. 05)。结论:在脾胃虚弱型非糜烂性胃食管反流病抗Hp治疗时,结合使用中药四君子汤加减可明显提高疗效,提高Hp转阴率。Objective:To observe the effects of modified Sijunzi Decoction on anti helicobacter pylori(HP)in the treatment of non-erosive reflux disease(NERD)in patients with spleen and stomach weakness.Methods:A total of 90 cases with NERD with spleen and stomach weakness and HP positive who were admitted and treated in our hospital from July 2015 to February 2017 were randomly selected and divided into treatment group and control group according to random number table,with 45 cases in each group.The control group was treated with HP triple therapy plus gastric motility drug.The treatment group was added with oral administration of Sijunzi decoction.The improvement of symptom integral,clinical efficacy and the negative rate of HP were analyzed before treatment and 6 weeks after treatment.And the changes of esophageal mucosa cells under electron microscope were observed.Results:After 6 weeks,the total effective rate of treatment group(95.55%)was better than the control group(84.44%)(P<0.05);Symptom integral Sc value of two groups were significantly decreased(P<0.05),and the treatment group was significantly better than the control group(P<0.05).A total of 41 cases in the treatment group were negative,with negative rate of 91.11%,37 cases in the control group with 82.22%of negative rate.The negative rate of treatment group was significantly better than the control group(P<0.05).The electron microscope observation results showed that the cell gap width decreased,and intercellular space per unit area increased(P<0.05).The treatment group was significantly better than the control group.Conclusion:In the treatment of NERD with spleen and stomach weakness for anti HP,Sijunzi decoction can significantly improve the curative effect,improve the HP negative rate,which is worthy of clinical application.

关 键 词：气机论治 四君子汤 消化道疾病 胃食管反流病 非糜烂性 脾胃虚弱型 幽门螺杆菌 临床有效性 

分 类 号：R289.5[医药卫生—方剂学] R573[医药卫生—中药学]