基于24h食管阻抗-pH监测及血清学指标变化评估降逆益中汤治疗胃食管反流病的疗效  

Evaluation of the therapeutic effect of Jiangni Yizhong Decoction on GERD based on 24h esophageal impedance pH monitoring and serological changes

作　　者：王勋 孙晓娜 杨玲玲 梁志涛 WANG Xun;SUN Xiaona;YANG Lingling;LIANG Zhitao(Henan Hospital of Traditional Chinese Medicine/The Second Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450053,China)

机构地区：[1]河南省中医院/河南中医药大学第二附属医院,郑州450053

出　　处：《吉林中医药》2023年第2期182-185,共4页Jilin Journal of Chinese Medicine

基　　金：2022年度河南省中医药科学研究专项课题(2022ZY2035)。

摘　　要：目的探讨降逆益中汤在胃食管反流病(GERD)患者治疗中的应用及药理作用。方法用随机数字表法将80例于2021年1月-2021年12月在河南省中医院接受治疗的胃食管反流病患者分为A、B两组,各40例。A组给予基础治疗,同时给予奥美拉唑肠溶胶囊及枸橼酸莫沙必利片,B组在A组基础上给予降逆益中汤。2组均持续治疗4周。结果治疗4周后,B组的总有效率为97.50%,A组为80.00%,B组的中医证候疗效明显优于A组(P<0.05)。2组治疗4周后的血清高敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)水平及p H值<4时间百分比均低于治疗前,且B组比A组低;血清胃蛋白酶原Ⅰ(PGⅠ)、胃泌素-17(G-17)水平均高于治疗前,且B组比A组高;弱碱反流、弱酸反流、酸反流次数均少于对照组,且B组弱碱反流次数比A组少(P<0.05)。B组及A组治疗期间的不良反应发生率比较差异没有统计学意义(P>0.05)。结论中药降逆益中汤能够减轻胃食管反流病患者机体炎症反应,有效改善患者胃肠分泌功能,进而提高临床疗效,安全性良好。Objective To explore the application and pharmacological effects of Jiangni Yizhong Decoction in the treatment of patients with gastroesophageal reflux disease(GERD).Methods A total of 80 GERD patients who were treated in the Henan Provincial Hospital of Traditional Chinese Medicine from January 2021 to December 2021 were divided into group A and group B by random number table method,with 40 cases in each group.Group A was given a basic treatment plus omeprazole enteric-coated capsules and mosapride citrate tablets,while group B was given Jiangni Yizhong Decoction on the basis of group A.Both groups were treated continuously for 4 weeks.Results After4 weeks of treatment,the total effective rate of group B was 97.50%,while that of group A was 80.00%,and the curative effect of TCM syndrome in group B was significantly better than that in group A(P<0.05).After 4 weeks of treatment,the levels of serum high-sensitivity C-reactive protein(hs-CRP)and interleukin-6(IL-6)and the pH<4 time percentages in the two groups were lower than those before treatment,and group B was lower than group A,while the levels of serum pepsinogen Ⅰ(PGⅠ)and gastrin-17(G-17)were higher than those before treatment,and group B was higher than group A.The numbers of weak base reflux,weak acid reflux and acid reflux were less than those before treatment,and the number of weak base reflux in group B was less than that in group A(P<0.05).There was no significant difference in the incidence of adverse reactions between group B and group A during treatment(P>0.05).Conclusion Jiangni Yizhong Decoction can reduce the inflammatory reaction of patients with gastroesophageal reflux disease,effectively improve their gastrointestinal secretion function,thereby improving the clinical efficacy and safety.

关 键 词：胃食管反流病 奥美拉唑肠溶胶囊 枸橼酸莫沙必利片 降逆益中汤 

分 类 号：R573.9[医药卫生—消化系统]