【摘要】：目的:觀察益氣百合湯治療胃食管反流病的臨床療效,并從理論上探討益氣百合湯治療胃食管反流病的作用機制。方法:病例來源:98例胃食管反流病患者,均來自2015年1月-2016年9月于青島大學附屬醫(yī)院中醫(yī)科門診就診患者。隨機分為治療組和對照組:治療組50例,對照組48例。治療方案:治療組給予益氣百合湯治療,對照組給予奧美拉唑腸溶片聯(lián)合枸櫞酸莫沙必利片進行治療,4周為1個療程,兩組均連續(xù)服用2個療程。治療2個療程后進行臨床療效觀察,對血常規(guī)、尿常規(guī)、糞常規(guī)、肝腎功、心電圖等其他可能出現的不良反應做出安全性評價,分析患者治療前后的癥狀、體征、中醫(yī)癥候積分、胃鏡下食管黏膜變化情況和長期療效。結果:(1)臨床綜合療效:治療組的總有效率93.88%,脫落1例,治愈13例,顯效22例,有效11例,無效3例;對照組的總有效率80.43%,脫落2例,治愈7例,顯效16例,有效14例,無效9例,治療組總有效率明顯優(yōu)于對照組(P0.05)。(2)中醫(yī)癥候比較:治療后兩組患者中醫(yī)癥候總積分較治療前均有所下降,差異有統(tǒng)計學意義(P0.05)。治療后燒心、反酸、胸骨后灼痛、噯氣或呃逆、咽部不適和納呆等癥狀的改善治療組明顯優(yōu)于對照組,差異有統(tǒng)計學意義(P0.05)。(3)胃鏡下黏膜改善:胃鏡下黏膜炎癥的改善治療組與對照組比較無統(tǒng)計學意義(P0.05)。(4)長期療效:停服藥物6個月后隨訪治愈患者,治療組13例,復發(fā)2例;對照組7例,復發(fā)5例。差異有統(tǒng)計學意義(P0.05)。結論:益氣百合湯治療胃食管反流病療效確切,能有效減輕患者臨床癥狀,改善患者生活質量,同時不良反應低,使用安全,患者可以接受長期治療。
[Abstract]:Objective: to observe the clinical effect of Yiqilihe decoction in treating gastroesophageal reflux disease, and to explore the mechanism of YQLi decoction in treating gastroesophageal reflux disease theoretically. Methods: 98 cases of gastroesophageal reflux disease from January 2015 to September 2016 in Qingdao University Hospital. They were randomly divided into treatment group (n = 50) and control group (n = 48). The treatment plan: the treatment group was treated with Yiqilui decoction, the control group was treated with omeprazole enteric-coated tablet combined with mosapride citrate tablet for 4 weeks as a course of treatment, and the two groups were taken continuously for 2 courses. After two courses of treatment, the clinical curative effect was observed, and the safety of blood routine, urine routine, fecal routine, liver and kidney function, electrocardiogram and other possible adverse reactions were evaluated, and the symptoms and signs of the patients before and after treatment were analyzed. TCM symptom score, gastroscope esophageal mucosal changes and long-term efficacy. Results: (1) Clinical comprehensive curative effect: the total effective rate was 93.88 in the treatment group, 1 case in the treatment group, 13 cases in cure, 22 cases in remarkable effect, 11 cases in effectiveness and 3 cases in ineffectiveness, while in the control group, the total effective rate was 80.43%, 2 cases fell out, 7 cases were cured, 16 cases were effective, and 14 cases were effective. The total effective rate in the treatment group was significantly better than that in the control group (P0.05). (2). After treatment, the total score of TCM symptoms in the two groups decreased compared with that before treatment, and the difference was statistically significant (P0.05). The improvement of symptoms such as heartburn, regurgitation, post-sternal pain, belching or hiccup, pharynx discomfort and anorexia were significantly better in the treatment group than in the control group. The difference was statistically significant (P0.05). (3): there was no significant difference in the improvement of mucosal inflammation between the treatment group and the control group (P0.05). (4). There were 7 cases in the control group and 5 cases in the recurrence group. The difference was statistically significant (P0.05). Conclusion: Yiqihe decoction is effective in the treatment of gastroesophageal reflux disease. It can effectively alleviate the clinical symptoms and improve the quality of life of the patients. At the same time, the adverse reaction is low, the use is safe, and the patients can be treated for a long time.
【學位授予單位】：青島大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R259

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