發(fā)布時(shí)間：2018-07-14 18:48

【摘要】：目的:觀察清熱降逆通腑法治療GERD與IBS-C重疊癥胃熱氣逆腸結(jié)證的臨床療效。方法:將符合納入標(biāo)準(zhǔn)的64例GERD與IBS-C重疊癥胃熱氣逆腸結(jié)證患者隨機(jī)分為兩組:治療組32例,對(duì)照組32例,治療組給予自擬清熱降逆通腑中藥口服,對(duì)照組給予雷貝拉唑膠囊聯(lián)合雙歧桿菌三聯(lián)活菌膠囊,療程共8周,觀察并記錄治療前、治療后、停藥4周,兩組患者主要單項(xiàng)癥狀積分、癥狀總積分變化及中醫(yī)證候積分變化。全部數(shù)據(jù)以SPSS 20統(tǒng)計(jì)軟件進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:1.治療組和對(duì)照組主要單項(xiàng)癥狀積分療效比較中,組內(nèi)比較,兩組治療后主要單項(xiàng)癥狀積分均較治療前下降(P0.05),組間比較,對(duì)腹痛腹脹、大便秘結(jié)癥狀緩解情況,治療組優(yōu)于對(duì)照組(P0.05),對(duì)燒心、反酸癥狀緩解情況,兩組沒有統(tǒng)計(jì)學(xué)差異(P0.05)。2.治療組和對(duì)照組中醫(yī)癥狀總積分比較:組內(nèi)比較,兩組治療后中醫(yī)癥狀總積分均較治療前下降(P0.05)。組間比較,治療組中醫(yī)癥狀總積分降低程度較對(duì)照組顯著(P0.05)。3.治療組和對(duì)照組中醫(yī)癥候療效評(píng)價(jià)比較:治療組治愈1例,顯效6例,有效23例,無效2例,總有效率93.3%,對(duì)照組治愈0例,顯效1例,有效24例,無效7例,總有效率78.1%,對(duì)比兩組療效,經(jīng)統(tǒng)計(jì)學(xué)檢驗(yàn)P0.05,治療組癥候有效率優(yōu)于對(duì)照組。4.遠(yuǎn)期療效評(píng)價(jià):兩組停藥后與治療后癥狀總積分之差具有統(tǒng)計(jì)學(xué)差異(P0.05),治療組停藥后癥狀積分增加的程度小于對(duì)照組,治療組遠(yuǎn)期療效優(yōu)于對(duì)照組。結(jié)論:清熱降逆通腑法治療GERD與IBS-C重疊癥胃熱氣逆腸結(jié)證,能夠很好的改善相關(guān)癥狀,具有較高的有效率,遠(yuǎn)期療效良好。值得進(jìn)一步研究推廣。
[Abstract]:Objective: to observe the clinical effect of clearing away heat and lowering the inverses of entrails in the treatment of GERD and IBS-C overlapping syndrome of stomach heat, qi and intestine. Methods: 64 patients with GERD and IBS-C overlap syndrome were randomly divided into two groups: treatment group (n = 32) and control group (n = 32). The control group was treated with Rabeprazole capsule combined with Bifidobacterium triple live bacilli capsule for 8 weeks. The main symptom scores were observed and recorded before treatment, 4 weeks after treatment and 4 weeks after treatment. Symptom total integral change and TCM syndrome integral change. All the data were analyzed by SPSS 20 statistical software. The result is 1: 1. In the treatment group and the control group main single symptom integral comparison, the two groups after treatment main single symptom integral is all lower than before treatment (P0.05), the inter-group comparison, to abdominal pain abdominal distension, the big constipation knot symptom relief situation, The treatment group was better than the control group (P0.05), for heartburn, acid regurgitation symptom relief, there was no statistical difference between the two groups (P0.05). 2. Comparison of the total scores of TCM symptoms in the treatment group and the control group: compared with the control group, the total score of TCM symptoms in the two groups decreased after treatment (P0.05). The total score of TCM symptom in the treatment group was significantly lower than that in the control group (P0.05). Comparison of curative effects of TCM symptoms between the treatment group and the control group: 1 case was cured, 6 cases were markedly effective, 23 cases were effective, 2 cases were ineffective, the total effective rate was 93.33.0 cases were cured in the control group, 1 case was markedly effective, 24 cases were effective, 7 cases were ineffective. The total effective rate was 78.1%, compared with the two groups, the treatment group was superior to the control group in symptom response rate by statistical test (P0.05). Long-term curative effect evaluation: the difference between the two groups after withdrawal and after treatment symptom total score has statistical difference (P0.05), the treatment group after withdrawal symptom score increase degree is smaller than the control group, the treatment group long-term curative effect is superior to the control group. Conclusion: the treatment of GERD and IBS-C overlap syndrome of stomach heat qi and intestinal knot with the method of clearing away heat and lowering the inverses and unblocking the Fu organs can improve the symptoms well and has a high effective rate and good long-term curative effect. It is worth studying and popularizing further.
【學(xué)位授予單位】：南京中醫(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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