本文選題：疏降和胃Ⅰ號(hào)方 + 肝胃不和�。� 參考：《福建中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:觀察疏降和胃I號(hào)方(小柴胡湯合四逆散化裁)加減治療肝胃不和型非糜爛性反流病的臨床療效,以期為臨床提供客觀有效的治療方案,同時(shí),初步探討肝胃不和型非糜爛性反流病與焦慮抑郁狀態(tài)的相關(guān)性。方法:選擇2016年02月-2017年02月福建中醫(yī)藥大學(xué)附屬第二人民醫(yī)院脾胃病科門診及病房中診斷為肝胃不和型非糜爛性反流病的患者60例,隨機(jī)分為實(shí)驗(yàn)組和對(duì)照組各30例。實(shí)驗(yàn)組予疏降和胃I號(hào)方加減治療,對(duì)照組予蘭索拉唑+莫沙必利治療,療程4周。治療結(jié)束后,比較治療前后GerdQ量表、胃食管反流病肝胃不和癥狀量表、焦慮自評(píng)量表(SAS)、抑郁自評(píng)量表(SDS)積分、食道測(cè)壓、24小時(shí)PH/阻抗監(jiān)測(cè)的結(jié)果,最后以SPSS 20.0軟件進(jìn)行統(tǒng)計(jì)分析,P0.05,表示差異具有統(tǒng)計(jì)學(xué)意義。結(jié)果:1.反流癥狀比較:兩組治療后GerdQ量表積分均較治療前顯著降低(P0.05),提示兩種方案均有療效,組間比較:兩組治療后差異不顯著(P0.05),提示兩組方案療效相當(dāng)。2.中醫(yī)證候比較:兩組治療后肝胃不和癥狀量表積分均較治療前顯著降低(P0.05),提示兩種方案均有療效。組間比較:兩組治療后差異顯著,實(shí)驗(yàn)組優(yōu)于對(duì)照組。同時(shí),對(duì)兩組治療后中醫(yī)證候療效等級(jí)進(jìn)行比較,結(jié)果亦顯示兩組差異顯著(P＜0.05),提示實(shí)驗(yàn)組方案改善作用更明顯。3.食道測(cè)壓指標(biāo)比較:兩組治療后食管下括約肌靜息壓力(LESP)及遠(yuǎn)端收縮積分(DCI)平均值均較治療前顯著升高(P＜0.05),提示兩組方案均能改善食管下括約肌功能及食管體部收縮能力,組間比較:兩組治療后差異均不顯著(P0.05),提示兩組方案療效相當(dāng)。4.24小時(shí)PH/阻抗數(shù)據(jù)比較:兩組治療后DeMeester評(píng)分及總反流次數(shù)均較治療前顯著降低(P＜0.05),提示兩組方案均能改善反流情況;組間比較:兩組治療后差異均不顯著(P0.05),提示兩組方案療效相當(dāng)。5.焦慮抑郁情緒比較:兩組治療后SAS、SDS積分均較治療前顯著降低(P＜0.05),提示兩組方案均可改善焦慮抑郁情緒;組間比較:兩組治療后差異顯著(P0.05),提示實(shí)驗(yàn)組方案改善作用更明顯。6.肝胃不和型非糜爛性反流病中醫(yī)證候總積分與SAS積分的相關(guān)系數(shù)為0.402,與SDS積分的相關(guān)系數(shù)為0.321。結(jié)論:1.疏降和胃Ⅰ號(hào)方對(duì)肝胃不和型非糜爛性反流病患者的反流癥狀、中醫(yī)證候、食管下括約肌功能、食道體部收縮能力、反流情況及焦慮抑郁情緒均具有改善作用。2.肝胃不和型非糜爛性反流病與焦慮抑郁狀態(tài)具有相關(guān)性,相關(guān)系數(shù)分別為:0.402;0.321。
[Abstract]:Objective: to observe the clinical effect of Shujianghe Wei I recipe (Xiaochaihu decoction combined with Sini Powder) in the treatment of non-erosive reflux disease of liver and stomach disharmony type, in order to provide an objective and effective treatment scheme for clinic, at the same time, To explore the relationship between non erosive reflux disease of disharmony between liver and stomach and anxiety and depression. Methods: from February 2016 to February 2017, 60 patients with non-erosive reflux disease of hepatogastric disharmony type were selected and randomly divided into two groups: the experimental group (n = 30) and the control group (n = 30). The experimental group was treated with Shujiang and Wei I recipe and the control group was treated with lansoprazole mosapride for 4 weeks. After treatment, the scores of GerdQ scale, gastroesophageal reflux disease hepatogastric disharmony scale, self-rating anxiety scale and self-rating depression scale were compared before and after treatment, and the results of 24 hours PH/ impedance monitoring of esophageal manometry were compared. Finally, the statistical analysis was carried out with SPSS 20.0 software (P0.05), which indicated that the difference was statistically significant. The result is 1: 1. Comparison of reflux symptoms: the scores of GerdQ scale after treatment in both groups were significantly lower than those before treatment, indicating that the two schemes were effective, and the comparison between the two groups: there was no significant difference between the two groups after treatment, indicating that the curative effect of the two groups was equal to that of the two groups. Comparison of TCM syndromes: after treatment, the scores of liver and stomach disharmony symptom scale in both groups were significantly lower than those before treatment, indicating that the two schemes were effective. Comparison between the two groups: there was a significant difference between the two groups after treatment, the experimental group was superior to the control group. At the same time, the curative effect grades of TCM syndrome were compared between the two groups after treatment. The results also showed that the difference between the two groups was significant (P < 0.05), indicating that the improvement effect of the experimental group was more obvious than that of the control group (P < 0.05). Comparison of esophageal manometry: the mean values of lower esophageal sphincter resting pressure (LESPP) and distal contractile integral (DCI) were significantly higher than those before treatment (P < 0.05), suggesting that both groups could improve the function of lower esophageal sphincter and the contractility of esophageal body. Comparison between the two groups: there was no significant difference after treatment between the two groups (P < 0.05), suggesting that the two groups had the same curative effect and 4.24 hour PH/ impedance data comparison: the DeMeester score and the total reflux times of the two groups were significantly lower than those before treatment (P < 0.05), suggesting that both groups could improve the reflux. Comparison between the two groups: there was no significant difference between the two groups after treatment, indicating that the therapeutic effect of the two groups was equal to .5. Comparison of anxiety and depression: after treatment, the scores of SDS in both groups were significantly lower than those before treatment (P < 0.05), indicating that the two groups could improve anxiety and depression, and the difference between the two groups was significant (P 0.05), indicating that the improvement of the treatment group was more obvious than that of the control group (P < 0.05). The correlation coefficient between the total syndromes of TCM syndromes and SAS integral of non-erosive reflux disease was 0.402, and the correlation coefficient with SDS integral was 0.321. Conclusion 1. Shujiaowi recipe can improve reflux symptoms, syndromes of TCM, lower esophageal sphincter function, esophagus contraction ability, reflux condition and anxiety and depression in patients with non-erosive reflux disease of liver and stomach disharmony type. The relationship between non-erosive reflux of liver and stomach was correlated with anxiety and depression, and the correlation coefficients were 0.402 and 0.321, respectively.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R259

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