摘要
【目的】观察益中降逆汤联合“老十针”加减治疗中虚气逆型胃食管反流病的临床疗效。【方法】将80例中虚气逆型胃食管反流病患者随机分为观察组和对照组,每组各40例。观察组给予益中降逆汤联合“老十针”加减治疗,对照组给予艾司奥美拉唑镁肠溶片、盐酸伊托必利片治疗,连续治疗2周。治疗2周后,评价2组临床疗效,观察2组患者治疗前后中医证候各项积分及总积分的变化情况,以及胃食管反流病量表(GERDQ)评分的情况。比较2组患者治疗前后内镜下食管黏膜分级评分的变化情况,并评价2组的安全性。治疗结束4周后随访,比较2组患者的复发率。【结果】(1)治疗后,2组患者的中医证候评分包括反酸、泛吐清涎、嗳气、胃脘隐痛、食少纳差、胃脘痞满、神疲乏力、大便稀溏等及总积分均较治疗前明显改善(P<0.05),且观察组在改善反酸、泛吐清涎、嗳气、胃脘隐痛、食少纳差、胃脘痞满、神疲乏力等中医证候评分及总积分方面均明显优于对照组,差异均有统计学意义(P<0.05)。(2)治疗后,2组患者的GERDQ积分较治疗前明显改善(P<0.05),且观察组在改善GERDQ积分方面明显优于对照组,差异有统计学意义(P<0.05)。(3)治疗后,2组患者的内镜下食管黏膜分级评分较治疗前无明显改变(P>0.05),且治疗后2组间比较,差异无统计学意义(P>0.05)。(4)观察组总有效率为100.00%(40/40),对照组为77.50%(31/40)。观察组疗效优于对照组,差异有统计学意义(P<0.05)。(5)观察组复发率为7.50%(3/40),对照组复发率为29.03%(9/31)。观察组复发率明显低于对照组,差异有统计学意义(P<0.05)。(6)在治疗期间,2组患者均无明显不良反应情况发生。观察组与对照组的不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】益中降逆汤联合“老十针”加减治疗中虚气逆型胃食管反流病,能明显改善患者的临床症状,疗效显著。
Objective To observe the clinical efficacy of Yizhong Jiangni Decoction combined with modified“Lao Shi Zhen”(a regular combination of 10 acupoints)in the treatment of gastroesophageal reflux disease(GERD)with deficiency in the spleen qi and reversed flow of qi.Methods Eighty cases of GERD with syndrome of spleen-qi deficiency and reversed flow of qi were randomly divided into observation group and control group,40 cases in each group.The observation group was treated with Yizhong Jiangni Decoction combined with modified“Lao Shi Zhen”,while the control group was treated with Esomeprazole Magnesium Enteric-Coated Tablets and Itopride Hydrochloride Tablets.Both groups were treated for 2 weeks.After 2 weeks of treatment,the clinical efficacy of the two groups was evaluated,and the changes in each item of traditional Chinese medicine(TCM)syndrome scores and the total scores,as well as the GERDQ scores were observed before and after treatment.The changes in endoscopic esophageal mucosal grading scores were compared before and after treatment and the safety of the two groups was evaluated.The patients were followed up 4 weeks after treatment,and the recurrence rates of the two groups were compared.Results(1)After treatment,the TCM syndrome scores including acid reflux,generalized salivation,belching,vague pain in the stomach and epigastrium,poor appetite,fullness in the stomach and epigastrium,fatigue and loose stools and the total score of the two groups were significantly improved compared with those before treatment(P<0.05),and the TCM syndrome scores and total score of the observation group were significantly superior to those of the control group in improving acid reflux,generalized salivation,belching,vague pain in the stomach and epigastrium,poor appetite,fullness in the stomach and epigastrium and fatigue(P<0.05).The difference was statistically significant(P<0.05).(2)After treatment,the GERDQ scores of the two groups were significantly improved compared with those before treatment(P<0.05),and the observation group was significantly superior to the control group in improving the GERDQ scores,and the difference was statistically significant(P<0.05).(3)After treatment,the endoscopic esophageal mucosal grading score of patients in the two groups did not change significantly compared with that before treatment(P>0.05),and there was no statistically significant difference between the two groups after treatment(P>0.05).(4)The total effective rate of the observation group was 100.00%(40/40)and that of the control group was 77.50%(31/40).The efficacy of the observation group was superior to that of the control group,and the difference was statistically significant(P<0.05).(5)The recurrence rate was 7.50%(3/40)in the observation group and 29.03%(9/31)in the control group.The recurrence rate in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).(6)During the treatment period,no significant adverse reactions occurred in the two groups.There was no statistically significant difference in the incidence of adverse reactions between the observation group and the control group(P>0.05).Conclusion Yizhong Jiangni Decoction combined with modified“Lao Shi Zhen”can significantly improve the clinical symptoms of GERD patients with syndrome of deficiency in the spleen qi and reversed flow of qi,and the clinical efficacy is significant.
作者
马坚炜
冯伟勋
MA Jian-Wei;FENG Wei-Xun(Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Dept.of Spleen and Stomach,Qingyuan Hospital of Traditional of Chinese Medicine Affliated to Guangzhou University of Chinese Medicine,Qingyuan 511500 Guangdong,China)
出处
《广州中医药大学学报》
CAS
2023年第10期2459-2465,共7页
Journal of Guangzhou University of Traditional Chinese Medicine
关键词
胃食管反流病
中虚气逆型
益中降逆汤
“老十针”加减
临床观察
gastroesophageal reflux disease(CERD)
deficiency in the spleen qi and reversed flow of qi
Yizhong Jiangni Decoction
modified"Lao Shi Zhen"
clinical observation
作者简介
马坚炜(1996-),男,硕士研究生,E-mail:978623571@qq.com;通信作者:冯伟勋(1960-),男,主任医师,博士研究生导师,E-mail:FWX8383@126.com。
