本文選題：四磨湯口服液　切入點：質(zhì)子泵抑制劑　出處：《湖北中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的本研究通過采取隨機對照法,觀察四磨湯口服液聯(lián)合質(zhì)子泵抑制劑(PPI)治療肝胃不和型胃食管反流病的臨床癥狀療效、胃鏡療效及生活質(zhì)量改善情況,為胃食管反流病的臨床治療提供一種新選擇。方法將本課題中入選的59例患者隨機為A1組30例、A2組29例,A1組患者予以泮托拉唑40mg口服2/日、四磨湯口服液20ml口服2/日,連續(xù)服用2周,2周后繼續(xù)予以泮托拉唑40mg口服1/日、四磨湯口服液10ml口服2/日,連續(xù)服用2周;A2組予以泮托拉唑40mg口服2/日,連續(xù)服用2周,2周后繼續(xù)予以泮托拉唑40mg口服1/日,連續(xù)服用2周,即兩組療程均為4周。在治療前、治療2周、治療4周時記錄兩組患者臨床癥狀積分、生活質(zhì)量評分,以觀察不同治療階段臨床癥狀療效的差異及生活質(zhì)量改善情況;在治療前兩組患者均行胃鏡檢查,治療4周后經(jīng)胃鏡檢查診斷為反流性食管炎的患者需復(fù)查胃鏡,以便觀察兩組患者胃鏡療效的差異;在治療前及4周療程結(jié)束后兩組患者均行血常規(guī)、尿常規(guī)、大便常規(guī)、肝功能、腎功能、心電圖檢查,記錄上述檢查結(jié)果及療程期間內(nèi)不良反應(yīng)發(fā)生情況,以了解藥物安全性的情況。結(jié)果(1)臨床癥狀積分比較:治療后A1組反酸、燒心、胸痛、噯氣、納差、心煩易怒、胃脘嘈雜、痞悶癥狀積分及總積分較治療前均有所下降(p0.05),其中反酸、燒心、噯氣、胃脘嘈雜癥狀積分及總積分下降顯著(p0.01);治療后A2組反酸、燒心、胸痛、噯氣、胃脘嘈雜癥狀積分及總積分較治療前均有所下降(p0.05),其中反酸癥狀積分及總積分下降顯著(p0.01);治療后A1組反酸、燒心、噯氣癥狀積分及總積分均較A2組低(p0.05),其中反酸、噯氣癥狀積分的差異顯著(p0.01)。(2)臨床癥狀療效比較:治療2周及治療4周后A1組痊愈率及總有效率均高于A2組,但治療2周后痊愈率及總有效率的差異均無統(tǒng)計學(xué)意義(p0.05);治療4周后,痊愈率的差異有統(tǒng)計學(xué)意義(p0.05),總有效率的差異無統(tǒng)計學(xué)意義(p0.05)。(3)胃鏡療效比較:4周療程結(jié)束后A1組痊愈率及總有效率均高于A2組,但痊愈率的差異無統(tǒng)計學(xué)意義(p0.05),總有效率的差異有統(tǒng)計學(xué)意義(p0.05)。(4)生活質(zhì)量評分比較:與治療前相比,兩組患者治療2周后生活質(zhì)量評分均下降顯著(p0.01);與治療2周后相比,兩組患者治療4周后生活質(zhì)量評分均下降顯著(p0.01);治療2周后A1組生活質(zhì)量評分較A2組低,但差異無統(tǒng)計學(xué)意義(p0.05);治療4周后A1組生活質(zhì)量評分較A2組低,且差異有統(tǒng)計學(xué)意義(p0.05)。結(jié)論與單純抑酸療法相比,四磨湯口服液聯(lián)合PPI治療肝胃不和型胃食管反流病在改善患者反酸、燒心、噯氣癥狀方面更強,同時還能彌補單純抑酸療法無法緩解患者納差、心煩易怒、痞悶癥狀的不足;治療4周后,在提高患者臨床癥狀的痊愈率及胃鏡療效的總有效率方面更佳,在改善患者生活質(zhì)量方面更優(yōu)。
[Abstract]:Objective to observe the clinical effect of Simo Tang oral liquid combined with proton pump inhibitor PPI in the treatment of gastroesophageal reflux disease (GERD) by using a randomized controlled method, and to observe the effect of gastroscopy and the improvement of quality of life (QOL) in the treatment of gastroesophageal reflux disease (GERD). Methods A total of 59 patients with gastroesophageal reflux disease were randomly divided into A 1 group (n = 30), A _ 2 group (n = 29) and A _ 1 group (n = 29) received pam Tora zol 40 mg orally for 2 days, and Simo decoction 20 ml orally for 2 days. After 2 weeks of continuous administration, 40 mg of pam Tora zole was given orally for 1 day, 10 ml of Simo decoction was given orally for 2 days, and 2 days of treatment with 40 mg of pam Tora azole was given to group A 2 for 2 weeks. After 2 weeks of continuous administration of pam Tora, 40 mg of pam Tora was given orally once a day for 2 weeks, and the course of treatment for both groups was 4 weeks. Before treatment, 2 weeks after treatment, the clinical symptom scores and quality of life scores were recorded at 4 weeks after treatment. In order to observe the difference of clinical symptoms and the improvement of quality of life in different stages of treatment, two groups of patients were examined with gastroscopy before treatment, and the patients diagnosed as reflux esophagitis after 4 weeks of treatment should be reexamined. In order to observe the difference of gastroscopy effect between the two groups, blood routine, urine routine, stool routine, liver function, renal function, electrocardiogram were performed before and after 4 weeks of treatment. The results of the above examination and the adverse reactions during the course of treatment were recorded in order to understand the situation of drug safety. Results: after treatment, the scores of clinical symptoms in group A1 were as follows: regurgitation, heartburn, chest pain, belching, anorexia, irritability, stomachache, stomachache, anorexia, anorexia, irritability and stomachache. The integral and total score of the symptoms of ruffiness were lower than that of before treatment. The scores of regurgitation, heartburn, belching, gastralgia and total score were significantly decreased in group A2 after treatment, the scores of regurgitation, heartburn, chest pain, belching, and belching were significantly decreased after treatment. The score and total integral of stomach-noisy symptoms were lower than those before treatment, among which the integral and total integral of regurgitation symptoms decreased significantly (p 0.01), and the scores of regurgitation, heartburn, belching and total score in group A1 were lower than those in group A _ 2 (P 0.05), among which, acid regurgitation was found in group A, and the total score in group A was lower than that in group A (P < 0.05). Comparison of clinical symptom efficacy: the recovery rate and total effective rate of A1 group were higher than that of A2 group after 2 weeks and 4 weeks of treatment. However, there was no significant difference in the recovery rate and the total effective rate after 2 weeks of treatment (P 0.05), but after 4 weeks of treatment, there was no significant difference in the recovery rate and the total effective rate. The difference of cure rate was statistically significant (p 0.05). There was no significant difference in total effective rate (P 0.05) and the total effective rate in group A 1 was higher than that in group A 2 after 4 weeks of treatment. However, there was no significant difference in recovery rate (P 0.05), but the difference in total effective rate was statistically significant (P < 0.05). Compared with before treatment, the scores of quality of life (QOL) of the two groups were significantly decreased after 2 weeks of treatment, and those of the two groups were significantly lower than those of the patients after 2 weeks of treatment, and those of the two groups were significantly lower than those of the patients after 2 weeks of treatment. After 4 weeks of treatment, the scores of quality of life in group A 1 were significantly lower than those in group A 2, but there was no significant difference between group A 2 and group A 2, the scores of quality of life in group A1 were lower than those in group A 2 after 4 weeks of treatment. Conclusion the combination of Simo Tang oral liquid and PPI in the treatment of gastroesophageal reflux disease with disharmony of liver and stomach is more effective in improving the symptoms of regurgitation, heartburn and belching in patients with gastroesophageal reflux. At the same time, it can also make up for the deficiency of anorexia, irritability and suffocating symptoms, which can not be alleviated by acid suppressive therapy alone. After 4 weeks of treatment, it is better to improve the recovery rate of clinical symptoms and the total effective rate of gastroscopy. Better in improving the quality of life of patients.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R571

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