金柴清肝汤联合西药治疗肝胃郁热型反流性食管炎的临床疗效研究  

Clinical effect of Jinchai Qinggan decoction combined with western medicine on reflux esophagitis of depression-heat in liver and stomach type

作　　者：黄秋思 郭丹丹[2] 姚丹[1] 王楠楠[1] 张金良[1] Huang Qiusi;Guo Dandan;Yao Dan;Wang Nannan;Zhang Jinliang(Liver Spleen Stomach Ward,the Second Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150010,China;the First Cardiac Ward,the Second Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150010,China)

机构地区：[1]黑龙江中医药大学附属第二医院肝脾胃病房,哈尔滨150010 [2]黑龙江中医药大学附属第二医院心病一病房,哈尔滨150010

出　　处：《中国医药》2021年第3期389-392,共4页China Medicine

基　　金：国家中医药管理局第六批全国老中医药专家学术经验继承项目(国中医药办人教函[2017]125号);孙申田青年人才基金(SC-201801)。

摘　　要：目的探讨金柴清肝汤联合西药治疗肝胃郁热型反流性食管炎(RE)的临床疗效。方法回顾性分析2018年8月至2019年7月黑龙江中医药大学附属第二医院收治的60例肝胃郁热型RE患者的临床资料,根据不同治疗方案将其分为对照组和观察组,各30例。对照组予马来酸曲美布汀片、雷贝拉唑钠肠溶片治疗,观察组在对照组基础上予金柴清肝汤治疗,2组均连续治疗4周。比较2组治疗前后反流性疾病问卷(RDQ)、内镜检查评分。观察2组临床疗效、内镜检查疗效,记录随访期间患者胃肠道症状及RE复发情况。结果治疗后,2组RDQ及内镜检查评分均低于治疗前,且观察组均低于对照组[(13.8±2.5)分比(21.2±4.9)分、(0.51±0.12)分比(1.43±0.41)分],差异均有统计学意义(均P<0.05)。观察组临床总有效率、内镜检查总有效率均高于对照组[93.3%(28/30)比80.0%(24/30)、86.7%(26/30)比70.0%(21/30)](均P<0.05)。随访期间,2组患者胃肠道症状发生率比较,差异无统计学意义(P>0.05),观察组复发率低于对照组,差异有统计学意义(P<0.05)。结论金柴清肝汤联合西药治疗肝胃郁热型RE效果显著,可有效改善患者临床症状,降低复发率。Objective To investigate the clinical effect of Jinchai Qinggan decoction combined with western medicine on reflux esophagitis(RE)of depression-heat in liver and stomach type.Methods From August 2018 to July 2019,clinical data of 60 patients with RE of depression-heat in liver and stomach type admitted to the Second Affiliated Hospital of Heilongjiang University of Chinese Medicine were retrospectively analyzed.According to different treatment regimens,they were divided into the control group and the observation group,with 30 cases in each group.The control group was treated with trimebutine maleate tablets and sodium rabeprazole enteric-coated tablets,and the observation group was treated with Jingchai Qinggan decoction on the basis of the control group.Both groups were treated for 4 weeks.The reflux diagnostic questionnaire(RDQ)score and endoscopic score were compared between the two groups before and after treatment.The clinical curative effect and endoscopic curative effect in two groups were observed,and the incidence of gastrointestinal symptoms and recurrence of RE during follow-up period were recorded.Results After treatment,RDQ score and endoscopic score of the two groups were lower than those before treatment,and those of the observation group were lower than those of the control group[(13.8±2.5)vs(21.2±4.9),(0.51±0.12)vs(1.43±0.41)](all P<0.05).The total clinical effective rate and total endoscopic effective rate of the observation group were higher than those of the control group[93.3%(28/30)vs 80.0%(24/30),86.7%(26/30)vs 70.0%(21/30)](both P<0.05).During follow-up period,there was no significant difference in the incidence of gastrointestinal symptoms between the two groups(P>0.05),and the recurrence rate of the observation group was lower than that of the control group(P<0.05).Conclusions Jinchai Qinggan decoction combined with western medicine is effective in treating RE of depression-heat in liver and stomach type.It can effectively improve clinical symptoms and reduce the recurrence rate.

关 键 词：反流性食管炎 金柴清肝汤 肝胃郁热 

分 类 号：R571[医药卫生—消化系统]