小柴胡降逆汤联合天突穴针刺对胃食管反流病相关性支气管哮喘患者胃肠激素、食管动力学和生活质量的影响  

Effect of Xiaochaihu Jiangni Decoction combined with acupuncture at Tiantu point on gastrointestinal hormones,esophageal motility and quality of life in patients with gastroesophageal reflux disease-related asthma

作　　者：穆恒 于勇 MU Heng;YU Yong(The Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine, Xianyang 712000, Shaanxi, China;Xi’an Hospital of Traditional Chinese Medicine, Xi’an 710021, Shaanxi, China)

机构地区：[1]陕西中医药大学附属医院,陕西咸阳712000 [2]西安市中医医院,陕西西安710021

出　　处：《现代中西医结合杂志》2021年第8期843-847,888,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的探讨小柴胡降逆汤联合天突穴针刺对胃食管反流病相关性支气管哮喘患者胃肠激素、食管动力学和生活质量的影响。方法将2018年12月—2019年12月陕西中医药大学附属医院诊治的90例胃食管反流病相关性支气管哮喘患者随机分为对照组和治疗组,每组45例。对照组给予多潘立酮片、奥美拉唑胶囊口服及吸入异丙托溴铵气雾剂治疗,治疗组在对照组治疗基础上给予小柴胡降逆汤联合天突穴针刺治疗,2组患者均连续治疗4周。观察2组治疗后食管动力学指标(食管括约肌压力、立位反流时间百分比、卧位反流时间百分比和总反流时间百分比)、血清胃肠激素指标[胃动素(MTL)、胃泌素(GAS)、胆囊收缩素(CCK)]、肺功能指标[第1秒用力呼气容积占预计值百分比(FEV1%)、最大呼气流速占预计值百分比(PEF%)]、SF-36生活质量各项评分变化情况,统计2组治疗效果。结果治疗后2组食管括约肌压力及血清MTL、GAS水平和FEF1%、PEF%均显著高于治疗前(P均<0.05),立位反流时间百分比、卧位反流时间百分比、总反流时间百分比及CCK水平均显著低于治疗前(P均<0.05),且治疗组治疗后上述各指标较对照组改善更明显(P均<0.05);2组SF-36生活质量各项评分均显著高于治疗前(P均<0.05),且治疗组各项评分均显著高于对照组(P均<0.05)。治疗组临床总有效率为91.1%(41/45),对照组为75.6%(34/45),治疗组显著高于对照组(P<0.05)。结论小柴胡降逆汤联合天突穴针刺治疗胃食管反流病相关性支气管哮喘患者效果理想,可有效改善临床症状,调节胃肠激素水平,改善食管动力和生活质量。Objective It is to explore the effect of Xiaochaihu Jiangni Decoction combined with acupuncture at Tiantu point on gastrointestinal hormones,esophageal dynamics and quality of life in patients with gastroesophageal reflux disease-related asthma.Methods Ninety patients with gastroesophageal reflux disease-related asthma treated in the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from December 2018 to December 2019 were randomly divided into control group and treatment group,45 cases in each group.The control group was treated with domperidone tablet,omeprazole capsule and ipratropium bromide aerosol;the treatment group was treated with Xiaochaihu Jiangni Decoction and acupuncture at Tiantu point on the basis of the treatment in the control group.Both groups were treated for 4 weeks.The changes in esophageal dynamics indicators(esophageal sphincter pressure,percentage of standing reflux time,percentage of supine reflux time and percentage of total reflux time),serum gastrointestinal hormones[motilin(MTL),gastrin(GAS),cholecystokinin(CCK)],pulmonary function indexes(FEV1%,PEF%)and the scores of each item of SF-36 were observed before and after the treatment,at the end of the treatment,the clinical effect was evaluated.Results The esophageal sphincter pressure and levels of serum MTL and GAS,FEV1%,PEF%after treatment were significantly higher than those before treatment(P<0.05),the percentage of standing reflux time,percentage of supine reflux time,percentage of total reflux time and level of CCK was significantly lower than that before treatment in the two groups(P<0.05),and the improvements of these indexes of the treatment group were significantly better than those of the control group(P<0.05);the scores of eight dimensions of quality of life(GH,RP,PF,SF,RE,BP,MH,VT)in the two groups were significantly higher than those before treatment(P<0.05),and the above eight dimensions of the treatment group were significant higher than those before treatment(P<0.05).The total clinical effective

关 键 词：小柴胡降逆汤 针刺 胃食管反流病相关性支气管哮喘 胃肠激素 食管动力学 生活质量 

分 类 号：R562.25[医药卫生—呼吸系统]