柴胡疏肝散合左金丸联合内镜下贲门松弛紧缩术治疗胃食管反流病的疗效  

Therapeutic effect of Chaihu Shugan San combined with Zuojin Wan and the endoscopic cardiac relaxation and contraction surgery in the treatment of gastroesophageal reflflux disease

作　　者：梁志涛 李明彦[1] 陈晓乐[1] 朱沛文 李波[1] LIANG Zhitao;LI Mingyan;CHEN Xiaole;ZHU Peiwen;LI Bo(Department of Hepatobiliary Spleen and Stomach Diseases,Henan Provincial Hospital of Traditional Chinese Medicine,Zhengzhou 450003,China)

机构地区：[1]河南省中医院肝胆脾胃病科,郑州450003

出　　处：《吉林中医药》2024年第8期955-959,共5页Jilin Journal of Chinese Medicine

基　　金：河南省中医药科学研究专项课题计划(2023ZY2074)。

摘　　要：目的探讨柴胡疏肝散合左金丸联合内镜下贲门松弛紧缩术治疗胃食管反流病的疗效。方法选取90例胃食管反流病患者作为研究对象,采用随机数字表法分为A、B、C组,均为30例。A组给予柴胡疏肝散合左金丸。B组给予内镜下贲门松弛紧缩术。C组给予联合治疗。结果治疗4周后,C组总有效率高于A组、B组(P<0.05)。与治疗前比较,治疗4周后,C组中医证候积分、胃食管反流病量表(GerdQ)评分、胃食管反流病程度、食管动力指标、Hill分级、细胞因子变化均优于B组、A组,B组优于A组(P<0.05)。治疗期间,3组不良反应发生率比较,差异无统计学意义(P>0.05);C组出院时间短于B组、A组,B组短于A组(P<0.05)。结论柴胡疏肝散合左金丸联合内镜下贲门松弛紧缩术可显著缓解胃食管反流病患者临床症状及胃食管反流病程度,改善患者食管动力指标、Hill分级及相关因子水平,缩短住院时间,进而提高疗效,且安全性良好,而内镜下贲门松弛紧缩术较柴胡疏肝散合左金丸优势明显。Objective To explore the therapeutic effect of Chaihu Shugan San combined with Zuojin Wan and the endoscopic cardiac relaxation and contraction surgery in the treatment of gastroesophageal reflux disease(GERD).Methods A total of 90 patients with gastroesophageal reflux disease were selected as the research subjects.They were divided into the groups A,B,C by the random number table method,with 30 cases in each.Group A was given Chaihu Shugan San combined with Zuojin Wan,while Group B underwent the endoscopic relaxation and contraction surgery of the cardia,and Group C was given the combined therapy of both the two drugs and the surgery.Results After 4 weeks of treatment,the total effective rate of Group C was higher than that of Group A and Group B(P<0.05).Compared with before treatment,after 4 weeks of treatment,the TCM syndrome scores,Gastroesophageal Reflux Disease Questionnaire(GerdQ)scores,degree of gastroesophageal reflux disease,esophageal motility indicators,Hill grading,and cytokine changes were better in Group C than those in Group B and Group A,and Group B was better than Group A(P<0.05).During the treatment period,there was no significant difference in the incidence of adverse reactions in the three groups(P>0.05).The discharge time of Group C was shorter than that of Group B and Group A,and Group B was shorter than Group A(P<0.05).Conclusion The combination of Chaihu Shugan San and Zuojin Wan and the endoscopic cardiac relaxation and contraction surgery can significantly alleviate the clinical symptoms and degree of the disease,improve their esophageal motility indicators,Hill grading,and levels of related cytokines,help shorten the hospitalization time,and thus improve efficacy,with a good safety.Certainly,the endoscopic cardiac relaxation and contraction surgery has an advantage over Chaihu Shugan San combined with Zuojin Wan.

关 键 词：胃食管反流病 柴胡疏肝散 左金丸 内镜下贲门松弛紧缩术 胃肠功能 

分 类 号：R256.3[医药卫生—中医内科学]