【摘要】：目的:旨在觀察疏肝和胃方聯(lián)合雷貝拉唑治療肝胃不和型難治性反流性食管炎(refractory reflux esophagitis,RRE)的臨床療效及安全性。方法:采用隨機(jī)、對照、雙盲、雙模擬的方法將72例肝胃不和型RRE患者分為兩組,對照組與治療組各36例,分別予雷貝拉唑+疏肝和胃方模擬劑與疏肝和胃方+雷貝拉唑治療,療程為8周。最終完成病例64例,其中對照組34例,治療組30例;基于患者治療前后中醫(yī)證候積分、胃鏡下食管黏膜積分、生活質(zhì)量積分、焦慮和抑郁自評量表積分的比較分析,研究疏肝和胃方聯(lián)合雷貝拉唑治療肝胃不和型難治性反流性食管炎的有效性;同時(shí)觀察治療前后三大常規(guī)、肝腎功能和心電圖的變化情況,對其進(jìn)行安全性評價(jià)。結(jié)果:(1)治療組中醫(yī)證候痊愈率為16.67%,顯效率為36.67%,有效率為26.67%,總有效率為80.00%,無效率為20.00%;對照組中醫(yī)證候痊愈率為5.88%,顯效率為20.59%,有效率為41.18%,總有效率為67.65%,無效率為32.35%;治療組中醫(yī)證候總體療效顯著優(yōu)于對照組(P0.05)。在改善燒心、噯氣、情緒不暢、打呃方面療效優(yōu)于對照組(P0.05);(2)治療組能夠改善肝胃不和型RRE患者食管黏膜炎癥,但其作用低于對照組(P0.05);(3)治療組能夠有效改善患者生存質(zhì)量,可明顯改善SF-36量表中總體健康、心理健康、生命活力、生理功能、生理職能、情感職能等6個(gè)維度積分(P0.05),且在生理功能、生理職能、心理健康3個(gè)維度方面療效優(yōu)于對照組(P0.05);(4)治療組能夠有效改善患者焦慮抑郁的情緒,且療效優(yōu)于對照組(P0.05);(5)治療前后兩組患者的安全性指標(biāo)無統(tǒng)計(jì)學(xué)意義。結(jié)論:疏肝和胃方聯(lián)合雷貝拉唑療效確切,安全性好,并且優(yōu)化了治療RRE的方案,值得應(yīng)用推廣。
[Abstract]:Objective: to observe the clinical efficacy and safety of Shugan Hewei recipe combined with rabeprazole in the treatment of refractory reflux esophagitis of hepatogastric disharmony type (refractory reflux esophagitis,RRE). Methods: 72 patients with hepatogastric disharmony type RRE were randomly divided into control group (n = 36) and treatment group (n = 36). The patients in the control group and the treatment group were treated with rabeprazole Shugan and Weifang simulator and rabeprazole respectively. The course of treatment was 8 weeks. 64 cases were finally completed, including 34 cases in the control group and 30 cases in the treatment group. Based on the comparative analysis of TCM syndrome score, gastroscopic esophageal mucous membrane score, quality of life score, anxiety and depression scale score before and after treatment, To study the efficacy of Shugan Hewei recipe combined with rabeprazole in the treatment of refractory reflux esophagitis of hepatogastric disharmony. At the same time, the changes of three routine, liver and kidney function and electrocardiogram were observed before and after treatment, and the safety of them was evaluated. Results: (1) in the treatment group, the cure rate of TCM syndrome was 16.67%, the effective rate was 36.67%, the effective rate was 26.67%, the total effective rate was 80.00%, and the ineffective rate was 20.00%. In the control group, the cure rate of TCM syndrome was 5.88%, the effective rate was 20.59%, the effective rate was 41.18%, the total effective rate was 67.65%, and the ineffective rate was 32.35%. The overall curative effect of TCM syndrome in the treatment group was significantly better than that in the control group (P 0.05). In improving heartburn, belching, poor mood, er, the curative effect of the treatment group was better than that of the control group (P 0.05); (2), but the effect of the treatment group was lower than that of the control group (P 0.05), but the effect of the treatment group was lower than that of the control group (P 0.05). (3) the treatment group can effectively improve the quality of life of the patients, and can significantly improve the overall health, mental health, vitality, physiological function, emotional function and other six dimensions of the SF- 36 scale (P 0.05). The curative effect was better than that of the control group in three dimensions: physiological function, physiological function and mental health (P 0.05). (4) the treatment group could effectively improve the anxiety and depression mood of the patients, and the curative effect was better than that of the control group (P 0.05); (5). There was no significant difference in the safety index between the two groups before and after treatment. Conclusion: Shugan Hewei recipe combined with rabeprazole is effective and safe, and optimizes the treatment of RRE, which is worth popularizing.
【作者單位】： 上海中醫(yī)藥大學(xué)附屬市中醫(yī)醫(yī)院脾胃病科;
【基金】：國家自然科學(xué)基金項(xiàng)目(81573775) 上海市“新百人”人才計(jì)劃項(xiàng)目(XBR2013120) 上海市科委重大支撐項(xiàng)目(13401902802)
【分類號】：R571

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