世界中医药

目的:观察加味旋覆代赭汤对反流性食管炎的有效性及临床安全性的作用。方法:选取2011年9月至2016年12月河南省濮阳市第三人民医院收治的反流性食管炎患者100例,随机分为对照组和观察组,对照组口服兰索拉唑;观察组在对照组基础上给予加味旋覆代赭汤。详细记录患者反流症状并根据胃灼热、反酸及胸痛症状严重程度记0、1、2、3分;检测食管压力分别检测受试者食管下括约肌静息压(LESP)、食管下括约肌松弛率(LESR)、食管体部下段蠕动波压力(LEPP)、食管体异常收缩百分数,同时进行食管阻抗-pH联合监测和安全性评价。结果:1)经治疗后2组胃灼热、反酸和胸痛的症状积分均下降(P<0.05),观察组下降程度优于对照组(P<0.05)。2)治疗后除异常收缩百分数外,下括约肌静息压、下段蠕动波压力和下括约肌松弛率均见明显提高(P<0.05),其中观察组优于对照组(P<0.05)。3)pH<4,酸反流的情况下,经治疗后总时间、立位时间和卧位时间均见明显下降(P<0.05),其中观察组下降程度低于对照组(P<0.05)。4)观察组仅有2例出现恶心的不良反应,原因为中药的特殊苦味;对照组不良反应发生率较观察组高(P<0.05),口干10%,头晕2%,恶心8%。结论:加味旋覆代赭汤能有效改善反流性食管炎患者胃灼热、反酸、胸痛等临床症状且临床用药安全性良好。

English Summary:

To observe the effectiveness and clinical safety of Modified Xuanfu Daizhe Decoction in the treatment of reflux esophagitis.Methods:A hundred cases of reflux esophagitis patients treated in the hospital from September 2011 to December 2016 were included and randomly divided into control group and observation group. Patients in the control group were treated with lansoprazole, while patients in the observation group were additionally given Modified Xuanfu Daizhe Decoction. Symptoms of patients with reflux esophagitis, including heartburn, acid reflux and chest pain, were carefully recorded and categorized into the score of 0, 1, 2, or 3 according to the severity of symptoms. Lower esophageal sphincter pressure (LESP), lower esophageal sphincter relaxation rate (LESR), lower esophageal body peristalsis pressure (LEPP) and the percentage of abnormal contraction of esophageal body were detected for the esophageal pressure and esophageal impedance-pH was jointly monitored and its safety was evaluated.Results:1) Symptoms like heartburn, acid reflux and chest pain of the two groups were improved after the treatment (P<0.05), and the observation group improved more greatly than the control group (P<0.05). 2) Except for abnormal systolic percentage, the resting pressure of lower sphincter, lower peristalsis pressure and relaxation rate of lower sphincter were all improved obviously (P<0.05), among which the observation group was better than those of the control group (P<0.05). 3) When PH<4 of acid reflux, the total time after treatment, orthostatic time and supine time were significantly shortened (P<0.05), and the observation group was lower than the control group (P<0.05). 4) There were only two cases of nausea and adverse reactions in the observation group due to the special bitter taste of Chinese medicine. The incidence of adverse reactions in the control group was higher than that in the observation group (P<0.05), with 10% dry mouth, 2% dizziness and 8% nausea.Conclusion:The prescription of Modified Xuanfu Daizhe Decoction may improve acid reflux, heartburn, chest pain and other clinical symptoms for patients with reflux esophagitis and its clinical safety is good.

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