旋复代赭汤联合奥美拉唑对反流性食管炎患者食管动力、酸反流情况及生活质量影响
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摘要
目的:研究旋复代赭汤联合奥美拉唑对反流性食管炎患者食管动力、酸反流情况及生活质量的影响。方法:选取2016年6月—2017年8月期间接受治疗的反流性食管炎患者96例,按照就诊顺序,随机分为治疗组和对照组各48例。对照组给予奥美拉唑肠溶胶囊20 mg/次,2次/d。治疗组联合旋复代赭汤,1剂/d,分早晚2次服用。两组均以4周为1个疗程,连续治疗2个疗程。检测患者治疗前后食管上括约肌压力(UESP)、食管体部远端收缩积分(DCI)、食管下括约肌压力(LESP)、酸反流次数和食管酸暴露时间,评价中医证候、生活质量、内镜和症状疗效,记录不良反应和复发情况。结果:治疗后,治疗组LESP、UESP和DCI高于对照组,酸反流次数和食管酸暴露时间低于对照组,差异有统计学意义(P<0.05);治疗组中医证候评分低于对照组(P<0.05);治疗组躯体健康、心理健康和生活质量总分均高于对照组(P<0.05);对照组症状和内镜总有效率均低于治疗组(P<0.05);治疗组复发率低于对照组(P<0.05)。结论:旋复代赭汤联合奥美拉唑对反流性食管炎疗效优于单独西药治疗,能显著提高患者食管动力,改善酸反流和生活质量,复发率低,值得临床推广应用。
Objective:To study the effect of Xuanfu Daizhe Decoction combined with omeprazole on esophageal motility,acid reflux and quality of life in patients with reflux esophagitis. Methods:96 patients with reflux esophagitis who were treated in our department in June 2016 to August 2017 were randomly divided into 48 cases in the treatment group and the control group. The control group was given Omeprazole Enteric-coated Capsules 20 mg/time,2 times/day. The treatment group combined with Xuanfu Daizhe Decoction,1 dose/day,divided into 2 times in the morning and evening. The two groups were treated for 4 weeks for 1 course,continuous treatment for 2 courses. The LESP,UESP,DCI and the number of acid reflux and the longest acid reflux time before and after treatment were measured,and the TCM syndromes,quality of life,endoscopy and symptoms were evaluated,and adverse reactions and recurrence were recorded.Results:After treatment,the LESP,UESP and DCI in the treatment group were higher than the control group,and the number of acid reflux and the longest acid reflux time were lower than the control group(P<0.05);The score of TCM syndrome in the treatment group was lower than the control group(P<0.05);The total scores of physical health,mental health and quality of life in the treatment group were higher than the control group(P<0.05);The total effective rate of symptoms and endoscopy in the control group was lower than the treatment group(P<0.05);The recurrence rate of the treatment group was lower than the control group(P<0.05). Conclusion:The effect of Xuanfu Daizhe Decoction combined omeprazole on reflux esophagitis is better than that of Western medicine alone,could significantly improve the esophageal motility,improve the acid reflux and the quality of life,and the recurrence rate is low,is worthy of clinical application.
Objective:To study the effect of Xuanfu Daizhe Decoction combined with omeprazole on esophageal motility,acid reflux and quality of life in patients with reflux esophagitis. Methods:96 patients with reflux esophagitis who were treated in our department in June 2016 to August 2017 were randomly divided into 48 cases in the treatment group and the control group. The control group was given Omeprazole Enteric-coated Capsules 20 mg/time,2 times/day. The treatment group combined with Xuanfu Daizhe Decoction,1 dose/day,divided into 2 times in the morning and evening. The two groups were treated for 4 weeks for 1 course,continuous treatment for 2 courses. The LESP,UESP,DCI and the number of acid reflux and the longest acid reflux time before and after treatment were measured,and the TCM syndromes,quality of life,endoscopy and symptoms were evaluated,and adverse reactions and recurrence were recorded.Results:After treatment,the LESP,UESP and DCI in the treatment group were higher than the control group,and the number of acid reflux and the longest acid reflux time were lower than the control group(P<0.05);The score of TCM syndrome in the treatment group was lower than the control group(P<0.05);The total scores of physical health,mental health and quality of life in the treatment group were higher than the control group(P<0.05);The total effective rate of symptoms and endoscopy in the control group was lower than the treatment group(P<0.05);The recurrence rate of the treatment group was lower than the control group(P<0.05). Conclusion:The effect of Xuanfu Daizhe Decoction combined omeprazole on reflux esophagitis is better than that of Western medicine alone,could significantly improve the esophageal motility,improve the acid reflux and the quality of life,and the recurrence rate is low,is worthy of clinical application.
引文
[1]熊光军.疏肝降逆中药治疗反流性食管炎疗效及对胃动素、前列腺素的影响[J].现代中西医结合杂志,2017,26(17):1854-1856,1860.
[2]朱全刚,高佳莺,柴蓉蓉,等.疏肝和胃法治疗胃食管反流病的研究进展[J].中医药导报,2017,23(7):94-96.
[3]郭宝娜,郭子皓,姜佳丽,等.功能性烧心与非糜烂性反流病患者的高分辨率食管测压及24 h食管阻抗-pH监测结果分析[J].胃肠病学和肝病学杂志,2017,26(1):59-62.
[4]潘诗敏,李金香,李莹,等.针灸治疗胃食管反流病的临床及机制概述[J].针灸临床杂志,2017,33(1):79-83.
[5]中华医学会消化内镜学分会.反流性食管炎诊断及治疗指南[J].中华消化内镜杂志,2004,21(4):221-222.
[6]陆再英,钟南山.内科学[M].北京:人民卫生出版社,2008:372-375.
[7]中华中医药学会脾胃病分会.胃食管反流病中医诊疗共识意见[J].中医杂志,2010,51(9):844-847.
[8]李鲁,王红妹,沈毅.SF-36健康调查量表中文版的研制及其性能测试[J].中华预防医学杂志,2002,36(2):109-113.
[9]国家中医药管理局.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:74-79.
[10]王轶,朱生樑.“从胃治咳”法治疗胃食管反流性咳嗽的临床观察[J].时珍国医国药,2015,26(6):1397-1399.
[11]唐艳萍,刘思邈,魏玮,等.辛开苦降法对反流性食管炎模型大鼠食管黏膜细胞间隙的影响[J].中国中西医结合杂志,2014,34(11):1335-1341.
[12]耿昌海,姚轶,洪兵.旋复代赭汤加味治疗肝胃郁热型胃食管反流病疗效及其机制[J].辽宁中医药大学学报,2016,18(9):177-180.
[13]陶琳,沈晨,张声生,等.调肝理脾和胃方对胃食管反流病患者食管动力影响的研究[J].北京中医药,2013,32(6):421-423.
[14]诸葛丽,周斌.通降舒膈汤治疗胃食管反流病肝胃不和证疗效观察[J].中医学报,2010,25(6):1170-1172.
[15]詹观生,杨幼新,降晨皓,等.旋复代赭汤及其拆方对反流性食管炎模型大鼠食管线粒体UCP2表达的影响[J].四川中医,2016,34(10):34-37.
[16]丁宗富.旋复代赭汤合逍遥散加减辨治肝郁脾虚型胃食管反流病临床疗效观察[J].四川中医,2016,34(6):69-71.
[17]侯天恩,曾德辉,汪福群.反流性食管炎和非糜烂性食管反流病患者食管动力和pH监测的临床价值[J].齐齐哈尔医学院学报,2016,37(9):1181-1182.
[18]易智慧,冯丽,文茂瑶,等.不同类型胃食管反流病患者的食管动力、酸反流情况的差异[J].四川大学学报(医学版),2014,45(3):480-483.
[19]徐淑琴.旋复代赭汤合温胆汤化裁联合西药治疗胆胃不和型胃食管反流病临床观察[J].新中医,2015,47(10):57-58.
[2]朱全刚,高佳莺,柴蓉蓉,等.疏肝和胃法治疗胃食管反流病的研究进展[J].中医药导报,2017,23(7):94-96.
[3]郭宝娜,郭子皓,姜佳丽,等.功能性烧心与非糜烂性反流病患者的高分辨率食管测压及24 h食管阻抗-pH监测结果分析[J].胃肠病学和肝病学杂志,2017,26(1):59-62.
[4]潘诗敏,李金香,李莹,等.针灸治疗胃食管反流病的临床及机制概述[J].针灸临床杂志,2017,33(1):79-83.
[5]中华医学会消化内镜学分会.反流性食管炎诊断及治疗指南[J].中华消化内镜杂志,2004,21(4):221-222.
[6]陆再英,钟南山.内科学[M].北京:人民卫生出版社,2008:372-375.
[7]中华中医药学会脾胃病分会.胃食管反流病中医诊疗共识意见[J].中医杂志,2010,51(9):844-847.
[8]李鲁,王红妹,沈毅.SF-36健康调查量表中文版的研制及其性能测试[J].中华预防医学杂志,2002,36(2):109-113.
[9]国家中医药管理局.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:74-79.
[10]王轶,朱生樑.“从胃治咳”法治疗胃食管反流性咳嗽的临床观察[J].时珍国医国药,2015,26(6):1397-1399.
[11]唐艳萍,刘思邈,魏玮,等.辛开苦降法对反流性食管炎模型大鼠食管黏膜细胞间隙的影响[J].中国中西医结合杂志,2014,34(11):1335-1341.
[12]耿昌海,姚轶,洪兵.旋复代赭汤加味治疗肝胃郁热型胃食管反流病疗效及其机制[J].辽宁中医药大学学报,2016,18(9):177-180.
[13]陶琳,沈晨,张声生,等.调肝理脾和胃方对胃食管反流病患者食管动力影响的研究[J].北京中医药,2013,32(6):421-423.
[14]诸葛丽,周斌.通降舒膈汤治疗胃食管反流病肝胃不和证疗效观察[J].中医学报,2010,25(6):1170-1172.
[15]詹观生,杨幼新,降晨皓,等.旋复代赭汤及其拆方对反流性食管炎模型大鼠食管线粒体UCP2表达的影响[J].四川中医,2016,34(10):34-37.
[16]丁宗富.旋复代赭汤合逍遥散加减辨治肝郁脾虚型胃食管反流病临床疗效观察[J].四川中医,2016,34(6):69-71.
[17]侯天恩,曾德辉,汪福群.反流性食管炎和非糜烂性食管反流病患者食管动力和pH监测的临床价值[J].齐齐哈尔医学院学报,2016,37(9):1181-1182.
[18]易智慧,冯丽,文茂瑶,等.不同类型胃食管反流病患者的食管动力、酸反流情况的差异[J].四川大学学报(医学版),2014,45(3):480-483.
[19]徐淑琴.旋复代赭汤合温胆汤化裁联合西药治疗胆胃不和型胃食管反流病临床观察[J].新中医,2015,47(10):57-58.