旋覆代赭汤加味对胃食管反流病患者食管动力的影响及其机制探讨  

Study on Effect and Mechanism of Modified Xuanfu Daizhe Decoction on Esophageal Motility in Patients with Gastroesophageal Reflux Disease

作　　者：曹利红[1] 刘学飞[1] 杜昕[1] CAO Lihong;LIU Xuefei;DU Xin(Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang 050011,Hebei,China)

机构地区：[1]河北省中医院,河北石家庄050011

出　　处：《辽宁中医杂志》2019年第4期735-738,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：河北省自然科学基金项目(H2015423064)

摘　　要：目的:探讨旋覆代赭汤加味对胃食管反流病患者食管动力的影响及其机制探讨。方法:2017年2月7日—2018年4月3日选择本院胃食管反流病患者86例,随机分为对照组和治疗组,分别为43例,对照组采用奥美拉唑(20mg,2次/d)和伊托必利(50mg,3次/d)治疗;在此基础上,治疗组采用旋覆代赭汤加味治疗,2次分服,1剂/d,持续治疗8周。比较两组间临床疗效、食管下括约肌(lower esophageal sphincter,LES)静息压、蠕动传导速度、湿咽成功率、食管上括约肌(upper esophageal sphincter,UES)静息压及反酸、烧心、胸膈痞满、嗳气中医积分,记录不良反应状况。结果:对照组有效率为81. 39%,治疗组有效率为95. 35%,两组间有效率比较,差异有统计学意义(P <0. 05)。治疗后对照组和治疗组LES静息压分别为(22. 39±5. 12) mm Hg、(27. 61±5. 49) mm Hg,蠕动传导速度分别为(3. 64±0. 65) cm/s、(3. 75±0. 62) cm/s,湿咽成功率分别为(50. 35±8. 47)%、(58. 81±8. 76)%,UES静息压分别为(59. 10±7. 21) mm Hg、(65. 01±7. 34) mm Hg,反酸积分分别为(1. 59±1. 03)(0. 81±0. 42),烧心积分分别为(1. 35±0. 86)、(0. 72±0. 51),胸膈痞满分别为(1. 49±1. 13)(0. 61±0. 53),嗳气分别为(1. 07±0. 74)(0. 51±0. 39),对照组和治疗组上述指标比较,差异有统计学意义(P <0. 05)。治疗期间各项生化检查及心电图均未发现任何明显异常。结论:采用旋覆代赭汤加味治疗胃食管反流病患者的疗效显著,有效改善中医证候,与改善患者食管动力相关,且患者可以耐受,值得广泛推广。Objective: To explore the effect and mechanism of Modified Xuanfu Daizhe Decoction on esophageal motility in patients with gastroesophageal reflux disease. Methods: Eighty-six patients with gastroesophageal reflux disease from February 72017 to April 3 2018 were selected and divided into the control group and the treatment group. The control group received 20 mg omeprazole bid,Itopride 50 mg tid,and the treatment group additionally received Modified Xuanfu Daizhe Decoction,and two groups were treated for 8 weeks. The clinical efficacy,the resting pressure of the lower esophageal sphincter( LES),the peristaltic conduction velocity,the success rate of wet pharynx,the resting pressure of the upper esophageal sphincter( UES),anti acid,heart burning,chest diaphragmatic fullness and belching traditional Chinese medicine were compared,and the adverse reactions in two groups were recorded. Results: The effective rate of the control group( 81. 39%) was lower than the treatment group’s( 95. 35%)and the difference between the two groups was statistically significant( P < 0. 05). After treatment,the resting pressure of LES in the control group and the treatment group were( 22. 39 ± 5. 12) mm Hg and( 27. 61 ± 5. 49) mm Hg,respectively. The peristaltic conduction velocities were( 3. 64 ± 0. 65) cm/s and( 3. 75 ± 0. 62) cm/s,respectively and the success rates of wet throat were( 50. 35 ± 8. 47)% and( 58. 81 ± 8. 76)%,respectively. And the resting pressures of UES were( 59. 10 ± 27. 61) mm Hg and( 65. 01 ± 7. 34) mm Hg,respectively and the anti acid scores was 1. 59 ± 1. 03 and 0. 81 ± 0. 42,respectively. The scores of heartburn were 1. 35 ± 0. 86 and 0. 72 ± 0. 51 and scores of chest diaphragm were 1. 49 ± 1. 13 and 0. 61 ± 0. 53 and belching scores were 1. 07 ± 0. 81 and 0. 51 ± 0. 39. All indexes had differences( P < 0. 05). No obvious abnormalities were found in all biochemical examinations and electrocardiograms during treatment. Conclusion: It is effective to treat patients with gastroesophageal reflux di

关 键 词：旋覆代赭汤加味 胃食管反流病 食管动力 

分 类 号：R571[医药卫生—消化系统]