柴胡疏肝散联合质子泵抑制剂治疗胃食管反流病临床研究  

Clinical Effect of Chaihu Shugan Powder Combined with Proton Pump Inhibitor in Treatment of Gastroesophageal Reflux Disease

作　　者：陈昶洲[1] 张雯[1] 李熠萌[1] 凌江红 CHEN Chang-zhou;ZHANG Wen;LI Yi-meng;LING Jiang-hong(Department of Gastroenterology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200021, China)

机构地区：[1]上海中医药大学附属曙光医院消化科,上海200021

出　　处：《安徽中医药大学学报》2020年第2期42-45,共4页Journal of Anhui University of Chinese Medicine

基　　金：曙光医院中医经典病房建设试点项目[ZY(2018-2020)-FWTX-6002]。

摘　　要：目的观察柴胡疏肝散联合质子泵抑制剂(proton pump inhibitors,PPIs)治疗胃食管反流病的临床疗效。方法纳入212例胃食管反流病患者,分为糜烂性食管炎(erosive esophagitis,EE)和非糜烂性反流病(non-erosive reflux disease,NERD)两组,每组106例,所收集患者均符合中医肝胃郁热证诊断。EE组和NERD组再各自随机分为治疗组和对照组,每组53例。治疗组给予柴胡疏肝散加PPIs,对照组给予PPIs,疗程均为8周。治疗后通过反流诊断问卷(reflux diagnostic questionnaire,RDQ)了解患者症状及发作频率的改善情况,并在治疗结束4周后随访复发情况。结果共198例(占93.4%)患者按方案完成治疗。治疗8周末,4组患者RDQ评分均较治疗前降低(P<0.05)。停药4周末,4组患者RDQ评分均较治疗8周末上升,但均低于治疗前(P<0.05)。在EE患者和NERD患者中,治疗组患者治疗8周末和停药4周末的RDQ评分均低于对照组(P<0.05)。结论柴胡疏肝散联合PPIs能显著改善肝胃郁热型胃食管反流病患者的症状,疗效明显优于单用PPIs,且能减少停药后的复发。Objective To investigate the clinical effect of Chaihu Shugan Powder combined with proton pump inhibitors(PPIs)in the treatment of gastroesophageal reflux disease(GERD).Methods A total of 212 patients with GERD were enrolled and divided into erosive esophagitis(EE)group and non-erosive reflux disease(NERD)group,with 106 patients in each group,and all patients met the diagnostic criteria for liver-stomach heat accumulation in traditional Chinese medicine.Both groups were further randomly divided into treatment group and control group,with 53 patients in each group.The patients in the two treatment groups were given Chaihu Shugan Powder combined with PPIs,and those in the two control groups were given PPIs alone.The course of treatment was 8 weeks for all groups.The reflux diagnostic questionnaire(RDQ)was used after treatment to evaluate the improvements in symptoms and attack frequency,and the patients were followed up at 4 weeks after treatment to observe recurrence.Results Of all patients,198(93.4%)completed the study.All groups had a significant reduction in RDQ score after the 8-week treatment(P<0.05),followed by an increase in RDQ score after 4 weeks of drug withdrawal(P<0.05),which remained lower than the score before treatment(P<0.05).For the patients with EE or NERD,the treatment group had a significantly lower RDQ score than the control group after the 8-week treatment and after 4 weeks of drug withdrawal(P<0.05).Conclusion Chaihu Shugan Powder combined with PPIs can improve the symptoms of patients with GERD with liver-stomach heat accumulation and has a better clinical effect than PPIs alone,and it can also reduce recurrence after drug withdrawal.

关 键 词：胃食管反流病 肝胃郁热 柴胡疏肝散 质子泵抑制剂 

分 类 号：R571[医药卫生—消化系统]