本文選題：非糜爛性胃食管反流病　切入點：清熱和胃法　出處：《南京中醫(yī)藥大學》2016年碩士論文

【摘要】：研究目的運用清熱和胃法治療非糜爛性胃食管反流病(NERD),并與西藥奧美拉唑隨機對照,觀察其對NERD患者的臨床癥狀的改善情況,以客觀評價清熱和胃法的療效,為臨床應用提供有力的依據(jù)。研究方法選擇40例符合納入標準的NERD患者,隨機分為治療組20例和對照組20例,療程8周,治療組采用中藥協(xié)定方清熱和胃治療,對照組采用奧美拉唑20mg bid治療。分別計算治療前后受試者臨床癥狀積分、耐信量表積分,觀察不良反應,客觀評估清熱和胃法治療非糜爛性胃食管反流病的臨床療效。研究結果1.中醫(yī)證候療效：治療組20例：治愈5例,顯效12例,有效1例,無效2例,總有效率90%,愈顯率60%；對照組20例：治愈0例,顯效4例,有效8例,無效8例,總有效率60%,愈顯率20%。兩組總體中醫(yī)證候療效的比較,治療組優(yōu)于對照組(P0.05)；兩組愈顯率的比較,治療組顯著優(yōu)于對照組(P0.01)。2.臨床癥狀治療前后積分變化：治療組各臨床癥狀積分治療后比治療前均有降低(P0.1、P0.05)；對照組治療后反酸、燒心、噯氣、口苦口干、咽部異物感等癥狀積分較治療前均有下降(P0.01、P0.05),而胃脘悶脹、兩脅脹滿、胸悶胸痛及心煩易怒等臨床癥狀積分改善不明顯(P0.05)。兩組治療后的各個臨床癥狀積分比較,在反流、燒心,胃脘悶脹等方面,治療組優(yōu)于對照組(P0.01、P0.05)；在噯氣、兩脅脹滿、口苦口干、胸悶胸痛、咽部異物感、心煩易怒等方面,治療組與對照組比較無顯著性差異(P0.05)。3.臨床癥狀總積分比較：兩組臨床癥狀總積分治療后較治療前均有明顯下降(P0.01)。兩組之間比較,治療組療效顯著優(yōu)于對照組(P0.01)。4.耐信量表(RDQ)積分變化：治療組治療前后比較,其臨床癥狀頻率及程度較治療前均能明顯改善(P0.01)：對照組治療前后比較,其癥狀頻率及程度較治療前均能改善(P0.01、P0.05)。治療后兩組比較,在反酸頻率及程度、反流頻率及程度、燒心程度上,治療組療效優(yōu)于對照組(P0.05)；在燒心頻率、非心源性心痛頻率及程度上,治療組與對照組比較無顯著性差異(P0.05)。5.不良反應：治療組和對照組在治療過程中未出現(xiàn)不良反應。研究結論清熱和胃法治療非糜爛性胃食管反流病能改善患者的臨床癥狀,治療過程中未出現(xiàn)不良反應。說明清熱和胃法治療NERD安全有效。
[Abstract]:Objective to study the treatment of non erosive gastroesophageal reflux disease using qingrehewei method (NERD), and omeprazole were observed the clinical symptoms of NERD patients, to objectively evaluate the efficacy qingrehewei method, provide the basis for the clinical application. Methods 40 cases included in the study standard NERD patients were randomly divided into treatment group 20 cases and control group 20 cases, treatment for 8 weeks, treatment group were treated with traditional Chinese medicine qingrehewei treatment, the control group were treated with omeprazole 20mg bid treatment before and after treatment. The subjects of clinical symptom score were calculated, Nexium scale scores, observation of adverse reaction, clinical efficacy erosive gastroesophageal reflux disease objective assessment qingrehewei method. Results 1. TCM syndrome curative effect: the treatment group of 20 cases: 5 cases were cured, 12 cases markedly effective, 1 cases effective, 2 cases ineffective, the total efficiency of 90%, the effective rate was 60%; control Group of 20 cases: 0 cases were cured, 4 cases were cured, 8 cases effective, 8 cases ineffective, the total efficiency of 60%, compared to two overall rate of 20%. group of TCM syndrome curative effect, the treatment group than the control group (P0.05); the two group rate comparison, the treatment group was significantly better than the control group (P0.01.2.) changes of clinical symptoms score before and after treatment: the treatment group clinical symptom scores were lower after treatment than before treatment (P0.1, P0.05); the control group after treatment with acid reflux, heartburn, belching, mouth pain, dry mouth, pharyngeal foreign body sensation and symptom score were decreased compared with before treatment (P0.01, P0.05), and epigastric fullness. Two threatened fullness, chest pain and irritability and other clinical symptoms improved obviously (P0.05). Compare the clinical symptom scores of two groups after treatment, the reflux, heartburn, epigastric fullness and so on, the treatment group than the control group (P0.01, P0.05); in two threatened fullness, belching, bitter taste and dry mouth chest tightness, chest pain, pharyngeal foreign body A sense of irritability and other aspects, there is no significant difference between the treatment group and the control group (P0.05.3.) the total score of clinical symptoms: two groups of clinical symptoms total score after treatment than before treatment were significantly decreased (P0.01). A comparison between the two groups, the curative effect of treatment group was significantly better than the control group (P0.01).4. Nexium scale (RDQ) integral change: To compare the treatment group before and after treatment, the clinical symptoms of frequency and extent than before treatment can significantly improve (P0.01): the treatment group before and after treatment, the frequency and severity of symptoms before treatment were improved (P0.01, P0.05). After treatment between the two groups in the frequency and severity of regurgitation the frequency and extent of reflux, heartburn, degree, the treatment group than the control group (P0.05); the frequency of heartburn, non cardiogenic pain frequency and extent, there is no significant difference between the treatment group and the control group (P0.05).5. adverse reactions: treatment group and control group in the treatment of No adverse reactions were observed in the course. Conclusion the treatment of clearing away heat and stomach in treating non erosive gastroesophageal reflux disease can improve the clinical symptoms and no adverse reactions during treatment. It shows that clearing heat and stomach therapy for NERD is safe and effective.

【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R259

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本文編號：1683076