调肝理脾法治疗肝胃郁热型难治性胃食管反流的临床研究  

Clinical study on the treatment of refractory gastroesophageal reflux disease of stagnation-heat in liver and stomach type with Tiao-gan Li-pi method

作　　者：李帷[1] 丁洋[1] 王志强 LI Wei;DING Yang;WANG Zhiqiang(The Center of Digestive System Diseases,Beijing Hospital of Traditional Chinese Medicine Afiliated to Capital Medical University,Bejing 100010,China;Department of Spleen and Stomach Diseases,Pinggu District Hospital of Traditional Chinese Medicine,Beijing Hospital of Traditional Chinese Medicine,Bejing 101200,China)

机构地区：[1]首都医科大学附属北京中医医院消化中心,北京100010 [2]北京中医医院平谷医院脾胃病科,北京101200

出　　处：《长春中医药大学学报》2024年第7期756-760,共5页Journal of Changchun University of Chinese Medicine

基　　金：北京市属医院科研培育计划项目(PZ2021020);首都卫生发展科研专项项目(首发2020-4-7132)。

摘　　要：目的观察调肝理脾法治疗肝胃郁热型难治性胃食管反流病的临床疗效。方法选取2022年3月-2023年9月首都医科大学附属北京中医医院收治的肝胃郁热型难治性胃食管反流病患者共60例,随机分为2组,各30例。对照组给予奥美拉唑肠溶胶囊+调肝理脾方中药颗粒模拟剂治疗,治疗组给予调肝理脾方中药颗粒+奥美拉唑肠溶胶囊。比较治疗前后食管黏膜炎症改善情况、健康状况调查简表(SF-36)和胃食管反流病量表(GERD-Q)、症状及证候的疗效评价、复发率以及不良反应发生率。结果治疗后,治疗组胃镜下食管黏膜炎症改善有效率为93.33%,高于对照组(73.33%)(P<0.05);2组治疗后的SF-36评分显著升高,GERD-Q评分在治疗后显著降低,且治疗组SF-36评分高于对照组,GERD-Q评分低于对照组(P均<0.05);治疗后,治疗组中医证候评分显著低于对照组,治疗组的中医症候治疗率为96.67%,高于对照组80.00%(P均<0.05);治疗后,治疗组临床疗效为93.33%高于对照组73.33%(P<0.05);随访6个月后,治疗组未服药人数显著多于对照组(P<0.05);2组不良反应发生率无显著差异(P>0.05)。结论调肝理脾法可显著改善肝胃郁热型难治性胃食管反流病患者食管黏膜炎症、提高生活质量,改善中医证候及临床症状、复发性低,具有较好的临床治疗效果。Objective To observe the effect of Tiao-gan Li-pi method in the treatment of refractory gastroesophageal reflux disease(RGERD)of stagnation-heat in liver and stomach type.Methods A total of 60 patients with RGERD of stagnation-heat in liver and stomach type admitted to Beijing Hospital of Traditional Chinese Medicine Afiliated to Capital Medical University from March 2022 to September 2023 were selected and randomly divided into the treatment group and the control group,with 30 cases in each group.The control group was treated with omeprazole enteric coated capsules+Tiao-gan Li-pi Formula Chinese medicine granules simulant agent,while the treatment group was treated with Tiao-gan Li-pi Formula Chinese medicine granules+omeprazole enteric coated capsules.The improvement of esophageal mucosal inflammation before and after treatment,Short-Form-36 Health Survey(SF-36)and Gastroesophageal Reflux Disease Questionnaire(GERD-Q),efficacy evaluation of symptoms and syndromes,recurrence rate,and incidence of adverse reactions were compared.Results After treatment,the effective rate of improving esophageal mucosal inflammation under gastroscopy in the treatment group(93.33%)was higher than that in the control group(73.33%)(P<0.05).After treatment,the SF-36 score of two groups significantly increased,while the GERD-Q score significantly decreased;And the SF-36 score in the treatment group was higher than that in control group,while the GERD-Q score was lower than that in the control group(P<0.05).After treatment,the traditional Chinese medicine(TCM)syndromes scores in the treatment group were significantly lower than those in the control group,and the treatment rate of TCM syndromes in treatment group(96.67%)was higher than that in the control group(80.00%)(P<0.05).After treatment,the clinical efficacy in the treatment group(93.33%)was higher than that in the control group(73.33%)(P<0.05).After 6 months of follow-up,the number of patients who did not take medicine in the treatment group was significantly higher than that in t

关 键 词：调肝理脾法 肝胃郁热 难治性胃食管反流病 治疗效果 安全性 

分 类 号：R259[医药卫生—中西医结合]