平调寒热法治疗寒热错杂型难治性反流性食管炎临床研究
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摘要
目的:观察平调寒热法治疗寒热错杂型难治性反流性食管炎的临床疗效。方法:将寒热错杂型难治性反流性食管炎患者120例作为研究对象,随机分为观察组和对照组,每组60例。对照组给予奥美拉唑和莫沙必利治疗,观察组给予平调寒热法中药汤剂治疗,对比2组患者治疗后的临床症状疗效及内镜疗效,并随访复发率。结果:治疗后,2组临床症状积分均下降,与治疗前比较,差异有统计学意义(P <0.05);治疗后2组间进行对比,观察组各项积分改善情况均优于对照组,差异有统计学意义(P <0.05)。观察组临床症状总有效率为86.6%,明显高于对照组临床总有效率73.3%,2组间比较,差异有统计学意义(P <0.05)。治疗后,2组内镜下食管黏膜分级均得到提升,积分下降,与治疗前比较,差异有统计学意义(P <0.05)。治疗后2组之间对比,观察组的内镜疗效优于对照组,差异有统计学意义(P <0.05)。在治疗结束后1年随访时,对照组有24例复发,复发率为40.0%;观察组有10例复发,复发率为16.6%,2组复发率比较,差异有统计学意义(P <0.05)。结论:平调寒热法治疗寒热错杂型难治性反流性食管炎临床疗效确切,较奥美拉唑和莫沙必利能更好的缓解患者的临床症状,改善黏膜损伤,提高临床疗效,降低复发率。
Objective:To observe the clinical effect of the method of regulate cold and warm mildly for refractory reflux esophagitis of cold and heat in complexity type. Methods:A total of 120 cases of patients with refractory reflux esophagitis of cold and heat in complexity type were selected as the study subjects,and were randomly divided into the observation group and the control group, 60 cases in each group. The control group was treated with omeprazole and mosapride, and the observation group was treated with Chinese herbal decoction with the method of regulate cold and warm mildly. The curative effect of clinical symptoms and endoscopy after treatment in the two groups was compared,and the recurrence rate in the two groups was followed up. Results:After treatment,the scores of clinical symptoms in the two groups were decreased when compared with those before treatment,the difference being significant(P < 0.05);compared the scores between the two groups,the improvement of each score in the observation group was superior to that in the control group,the difference being significant(P < 0.05). The total effective rate of clinical symptoms was 86.6% in the observation group,obviously higher than that of 73.3% in the control group, the difference being significant(P < 0.05). After treatment, the classification of esophageal mucosa under endoscopy in the two groups was improved when compared with that before treatment,while the scores were decreased,the difference being significant(P < 0.05). After treatment,the curative effect of endoscopy in the observation group was superior to that in the control group,the difference being significant(P < 0.05). During the one-year follow-up after treatment, there were 24 recurrent cases in the control group and 10 in the observation group, and the recurrence rate was 40.0% and 16.6% respectively,the difference being significant(P < 0.05). Conclusion:Compared with omeprazole and mosapride,the method of regulate cold and warm mildly has significant clinical effect in treating refractory reflux esophagitis of cold and heat in complexity type, which can better alleviate the clinical symptoms, reduce mucosal injury and improve clinical effect,and reduce the recurrence rate.
Objective:To observe the clinical effect of the method of regulate cold and warm mildly for refractory reflux esophagitis of cold and heat in complexity type. Methods:A total of 120 cases of patients with refractory reflux esophagitis of cold and heat in complexity type were selected as the study subjects,and were randomly divided into the observation group and the control group, 60 cases in each group. The control group was treated with omeprazole and mosapride, and the observation group was treated with Chinese herbal decoction with the method of regulate cold and warm mildly. The curative effect of clinical symptoms and endoscopy after treatment in the two groups was compared,and the recurrence rate in the two groups was followed up. Results:After treatment,the scores of clinical symptoms in the two groups were decreased when compared with those before treatment,the difference being significant(P < 0.05);compared the scores between the two groups,the improvement of each score in the observation group was superior to that in the control group,the difference being significant(P < 0.05). The total effective rate of clinical symptoms was 86.6% in the observation group,obviously higher than that of 73.3% in the control group, the difference being significant(P < 0.05). After treatment, the classification of esophageal mucosa under endoscopy in the two groups was improved when compared with that before treatment,while the scores were decreased,the difference being significant(P < 0.05). After treatment,the curative effect of endoscopy in the observation group was superior to that in the control group,the difference being significant(P < 0.05). During the one-year follow-up after treatment, there were 24 recurrent cases in the control group and 10 in the observation group, and the recurrence rate was 40.0% and 16.6% respectively,the difference being significant(P < 0.05). Conclusion:Compared with omeprazole and mosapride,the method of regulate cold and warm mildly has significant clinical effect in treating refractory reflux esophagitis of cold and heat in complexity type, which can better alleviate the clinical symptoms, reduce mucosal injury and improve clinical effect,and reduce the recurrence rate.
引文
[1]中华医学会消化病学分会.2014年中国胃食管反流病专家共识意见[J].胃肠病学,2015,20(3):155-168.
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[3]许国铭,方裕强,程能能,等.质子泵抑制剂(奥美拉唑)试验在胃食管反流病中的诊断价值[J].中华消化杂志,2002,22(1):7-10.
[4] LUNDELL L R, DENT J, BENNETTC J R, et al.Endoscopic assessment of esophagitis:clinical and functional correlate and further validation of the Losangeles classification[J].Gut,1999,45(2):172-180.
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[6]黄圆圆,张元,康利平,等.党参属植物化学成分及药理活性研究进展[J].中草药,2018,49(1):239-250.
[7]孟凡志,安晓亮,徐吉村.半夏泻心汤加减联合雷贝拉唑治疗反流性食管炎的临床观察[J].中医临床研究,2015,7(26):87-88.
[8]饶文龙,张浩,张熹玮,等.白及药理作用研究进展[J].上海中医药杂志,2015,49(8):91-93.
[2]中华中医药学会脾胃病分会.胃食管反流病中医诊疗专家共识意见(2017)[J].中国中西医结合消化杂志,2017,25(5):321-326.
[3]许国铭,方裕强,程能能,等.质子泵抑制剂(奥美拉唑)试验在胃食管反流病中的诊断价值[J].中华消化杂志,2002,22(1):7-10.
[4] LUNDELL L R, DENT J, BENNETTC J R, et al.Endoscopic assessment of esophagitis:clinical and functional correlate and further validation of the Losangeles classification[J].Gut,1999,45(2):172-180.
[5]李乾构,周学文,单兆伟,等.中医消化病诊疗指南[M].北京:中国中医药出版社,2006:10-11.
[6]黄圆圆,张元,康利平,等.党参属植物化学成分及药理活性研究进展[J].中草药,2018,49(1):239-250.
[7]孟凡志,安晓亮,徐吉村.半夏泻心汤加减联合雷贝拉唑治疗反流性食管炎的临床观察[J].中医临床研究,2015,7(26):87-88.
[8]饶文龙,张浩,张熹玮,等.白及药理作用研究进展[J].上海中医药杂志,2015,49(8):91-93.