四逆泻心剂对非糜烂性胃食管反流病食管敏感性影响的研究  

Clinical Study on the Effect of Sini Xiexin Decoction on Esophageal Sensitivity in Non-erosive Reflux Disease

作　　者：刘欢 白小雪 郝淑兰[1] 李聚林[1] LIU Huan;BAI Xiaoxue;HAO Shulan(Shanxi Aacdemy of Traditional Chinese Medicine,Taiyuan Shanxi 030012,China;Shanxi University of Chinese Medicine,Taiyuan Shanxi 030012,China)

机构地区：[1]山西省中医药研究院,山西太原030012 [2]山西中医药大学,山西太原030024

出　　处：《四川中医》2023年第8期120-123,共4页Journal of Sichuan of Traditional Chinese Medicine

基　　金：山西省卫生健康委科研课题(编号:2019070)。

摘　　要：目的:探索四逆泻心剂对于肝胃郁热型非糜烂性胃食管反流病食管敏感性影响,分析其可能的作用机制。方法:选取于2019年1月至2021年12月就诊于山西省中医院脾胃科门诊肝胃郁热型非糜烂性胃食管反流病116例患者。采用随机数字表法分为观察组和对照组,每组各58例,试验组予四逆泻心剂治疗,对照组给予艾司奥美拉唑肠溶胶囊、莫沙必利分散片联合治疗。治疗8周后,比较两组总体疗效、滴酸试验、球囊扩张试验、24小时pH阻抗等指标变化。结果:试验组有效率(94.34%)高于对照组有效率(71.15%)(P<0.05);试验组在延长反酸、烧心出现时间,降低疼痛程度,提高初始感觉阈值与最大耐受感觉阈值方面高于对照组(P<0.05);试验组与对照组在降低酸暴露时长,减少酸暴露次数方面无统计学差异(P>0.05);试验组在减少非酸反流次数、弱酸反流次数方面优于对照组(P<0.05)。结论:四逆泻心剂治疗肝胃郁热型非胃食管反流病疗效优于艾司奥美拉唑肠溶胶囊联合莫沙必利分散片,其作用机制可能与降低食管敏感性有关,对临床有一定指导意义。Objective To explore the effect of Sini Xiexin decoction on esophageal sensitivity of stagnation-heat in liver and stomach syndrome of non-erosive gastroesophageal reflux disease(GERD),and to analyze its possible mechanism.Methods From January 2019 to December 2021,116 patients with non-erosive gastroesophageal reflux disease of stagnation-heat in liver and stomach syndrome in the outpatient Department of Spleen and Stomach of Shanxi Provincial Hospital of Traditional Chinese Medicine were selected.They were randomly divided into experimental group and control group,with 58 cases in each group.The experimental group was treated with Sini Xiexin decoction.The control group was treated with esomeprazole enteric capsules and mosapride dispersible tablets.After 8 weeks of treatment,Bernstein test,24-hour pH impedance and other indicators were compared between the two groups.Results The effective rate of experimental group was 94.34%significantly higher than that of control group 71.15%(P<0.05).In the the Bernstein test,occurrence time of acid reflux and heartburn in the experimental group was prolonged,and the degree of pain was reduced significantly than that in the control group(P<0.05).In balloon dilatation test,IPT and MPT were significantly higher than that in the control group(P<0.05).There was no statistical difference between the experimental group and control group in reducing acid exposure length and reducing acid exposure number(P>0.05).The times of non-acid reflux and weak acid reflux in the experimental group were significantly better than those in the control group(P<0.05).Conclusion Sini Xiexin Decoction is better than esomeprazole enteric capsule combined with mosapride in the treatment of non-gastroesophageal reflux disease with stagnation-heat in liver and stomach syndrome.The mechanism of action may be related to the reduction of esophageal sensitivity,which has certain guiding significance for clinical practice.

关 键 词：四逆泻心剂 非糜烂性胃食管反流病 食管敏感性 肝胃郁热 临床研究 

分 类 号：R57[医药卫生—消化系统]