疏肝和胃降逆汤联合雷贝拉唑治疗肝胃不和证 反流性食管炎患者的疗效

Effect of Shugan Hewei Jiangni Decoction Combined with Rabeprazole in the Treatment of Reflux Esophagitis with Liver and Stomach Disharmony Syndrome

摘要:

〔摘 要〕 目的：探究疏肝和胃降逆汤加减联合雷贝拉唑治疗肝胃不和证反流性食管炎（RE）患者的临床疗效。 方法：选取莆田市涵江区中医院 2021 年 2 月至 2022 年 2 月期间收治的 100 例肝胃不和证 RE 患者，随机分为对照组 与观察组，各 50 例。对照组患者采用雷贝拉唑、莫沙必利治疗，观察组患者采用疏肝和胃降逆汤加减联合雷贝拉唑 治疗。比较两组患者的临床疗效、中医证候积分、血清相关指标及 6 个月复发率。 结果：观察组患者治疗总有效率为 94.00 %，高于对照组的 76.00 %，差异具有统计学意义（P ＜ 0.05）。治疗后观察组患者各项中医证候积分低于对照组， 差异具有统计学意义（P ＜ 0.05）。治疗后观察组患者血清胃动素（MTL）、胃泌素（GAS）水平高于对照组，生长 抑素（SS）水平低于对照组，差异具有统计学意义（P ＜ 0.05）。治疗后观察组患者血清白细胞介素 –1β（IL–1β）、 IL–2、瘦素（Leptin）、降钙素基因相关肽（CGRP）水平低于对照组，差异具有统计学意义（P ＜ 0.05）。随访 6 个月， 观察组失访 4 例，对照组失访 3 例。观察组患者 6 个月复发率为 2.13 %，低于对照组的 18.42 %，差异具有统计学意 义（P ＜ 0.05）。 结论：采用疏肝和胃降逆汤加减联合雷贝拉唑治疗 RE，可促进患者胃肠道蠕动，提高胃肠道功能， 抑制机体炎症因子表达，显著改善临床症状，从而提高临床疗效，降低复发风险。

Abstract:

〔Abstract〕 Objective To explore the clinical effect of Shugan Hewei Jiangni decoction combined with rabeprazole in the treatment of reflux esophagitis (RE) with liver and stomach disharmony syndrome. Methods A total of 100 cases of RE with liver and stomach disharmony syndrome patients admitted to Putian Hanjiang District Hospital of Traditional Chinese Medicine from February 2021 to February 2022 were randomly divided into a control group and an observation group, with 50 cases in each group. The control group was treated with rabeprazole and mosapride, and the observation group was treated with Shugan Hewei Jiangni decoction plus or minus combined with rabeprazole. The clinical efficacy, traditional Chinese medicine (TCM) syndrome score, serum related indexes and 6-month recurrence rate were compared between the two groups. Results The total effective rate of the observation group was 94.00 %, higher than 76.00 % of the control group, and the difference was statistically significant (P < 0.05). After treatment, the scores of TCM syndrome in the observation group were lower than those in the control group, and the differences were statistically significant (P < 0.05). After treatment, the levels of serum motilin (MTL) and gastrin (GAS) in the observation group were higher than those in the control group, the level of somatostatin (SS) was lower than that in the control group, and the differences were statistically significant (P < 0.05). After treatment, the levels of serum interleukin-1β (IL-1β), IL-2, leptin and calcitonin gene-related peptide (CGRP) in the observation group were lower than those in the control group, and the differences were statistically significant (P < 0.05). After 6 months of follow-up, 4 cases were lost to follow-up in the observation group and 3 cases in the control group. The 6-month recurrence rate of the observation group was 2.13 %, lower than 18.42 % of the control group, and the difference was statistically significant (P < 0.05). Conclusion Shugan Hewei Jiangni decoction plus or minus combined with rabeprazole in the treatment of RE can promote gastrointestinal peristalsis, improve gastrointestinal function, inhibit the expression of inflammatory factors in the body, significantly improve clinical symptoms, so as to improve clinical efficacy and reduce the risk of recurrence.