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纸质出版日期:2014
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周海新. 和胃降逆汤加减治疗胃食管反流病64例[J]. 中国实验方剂学杂志, 2014,20(18):204-207.
ZHOU Hai-xin. Addition and Subtraction Treatment of Hewei Jiangni Decoction in Treating Gastro-esophageal Reflux Disease(Stagnancy Heat of the Liver and Stomach) with 64 Cases[J]. Chinese journal of experimental traditional medical formulae, 2014, 20(18): 204-207.
周海新. 和胃降逆汤加减治疗胃食管反流病64例[J]. 中国实验方剂学杂志, 2014,20(18):204-207. DOI: 10.13422/j.cnki.syfjx.2014180204.
ZHOU Hai-xin. Addition and Subtraction Treatment of Hewei Jiangni Decoction in Treating Gastro-esophageal Reflux Disease(Stagnancy Heat of the Liver and Stomach) with 64 Cases[J]. Chinese journal of experimental traditional medical formulae, 2014, 20(18): 204-207. DOI: 10.13422/j.cnki.syfjx.2014180204.
目的: 观察和胃降逆汤加减治疗胃食管反流病(GERD)(肝胃郁热证)的近期和远期疗效及对生活质量的影响。方法: 随机按数字表法将128例GERD患者分为西药组和观察组各64例。西药组服用奥美拉唑镁肠溶片,20 mg/次,早、晚各1次;枸橼酸莫沙必利片,5 mg/次,3次/d。观察组服用奥美拉唑镁肠溶片同西药组,并采用和胃降逆汤加减治疗,1 剂/d。两组疗程均为8周。进行治疗前后肝胃郁热证评分、食管黏膜内镜和反流性疾病问卷(RDQ)量表及生活质量评价;对痊愈患者进行6个月的随访观察,计算复发率及复发时食管黏膜内镜评分。结果: 观察组中医证候疗效总有效率为93.75%,优于西药组的81.25%(P<0.05);观察组胃镜下炎症疗效总有效率为90.62%,优于西药组的75.0%(P<0.05);观察组治疗后肝胃郁热证评分、食管黏膜内镜评分和RDQ量表评分均低于西药组(P<0.01);治疗后观察组SF-36健康量表除身体疼痛维度外其他维度评分均高于西药组(P<0.01);随访6个月,观察组复发率为23.5%低于西药组的64%,观察组复发时食管黏膜内镜评分也低于西药组(P<0.01)。结论: 在质子泵抑制剂治疗的基础,和胃降逆汤加减能减轻GERD(肝胃郁热证)近期症状,提高治愈率,提高患者生活质量,并能降低远期复发率。
Objective: Short-term and long-term effects of modified Hewei Jiangni decoction in treating Gastro-esophageal reflux disease(GERD)(stagnancy heat of the liver and stomach type) and to quality of lives were investigated. Method: One hundred and twenty-eight patients with GERD were randomly divided into western medicine groupand observation group (64 cases
respectively). Patients in western medicine group received Omeprazole Magnesium enteric-coated tablets
20 mg each time
taken at the morning and evening. Mosapride citrate tablets
5 mg each time
three times per day. Patients in observation group received Omeprazole Magnesium enteric-coated tablets and the dose was same as which in western medicine group
and also received treatment of modified Hewei Jiangni decoction
1 dose per day. Course of treatment in both groups was 8 weeks. Scores of symptoms of stagnancy heat of the liver and stomach
endoscopic of esophageal mucosa
reflux diagnostic questionnaire(RDQ) and life quality were evaluated before and after treatment. Recovered patients received a 6-moth follow-up
recurrence rates and scores of endoscopic of esophageal mucosa were graded. Result: The total effective rate of improvement of traditional Chinese medicine syndrome in observation group was 93.75%
which is superior to that in western medicine group(81.25%)(P<0.05). The total effective rate of elimination of inflammation in observation group was 90.62%
which is superior to that in western medicine group(75%)(P<0.05). Scores symptoms of stagnancy heat of the liver and stomach
endoscopic of esophageal mucosa and RDQ in observation group were all lower than those in western medicine group (P<0.01). Except for score of physical pain
the SF36 scores of health scale in observation group were higher than those in western medicine group (P<0.01). During the 6-mouth follow-up
recurrence rate in observation group was 23.5%
which is lower than that in western medicine group(64%)
and when it relapse
score of endoscopic of esophageal mucosa in observation group was lower than that in western medicine group(P<0.01). Conclusion: Based on the treatment of proton pump inhibitor
treatment of modified Hewei Jiangni decoction not only relieve short-term symptoms of GERD(stagnancy heat of the liver and stomach type)
but also improve cure rate and quality of lives
furthermore reduce long-term recurrence rate.
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