栀子厚朴汤、栀子豆豉汤合乌梅丸化裁治疗难治性胃食管反流病的临床观察

Clinical Effect of Zhizi Houpo Decoction(栀子厚朴汤)and Zhizi Douchi Decoction(栀子豆豉汤)Combined with Modified Wumei Pill(乌梅丸)in Treatment of Refractory Gastro-Esophageal Reflux Disease

目的探究栀子厚朴汤、栀子豆豉汤合乌梅丸化裁治疗难治性胃食管反流病(refractory Gastro-esophageal reflux disease,RGERD)的临床效果。方法选择2019年1月—2020年12月入院治疗的RGERD患者68例作为研究对象,随机分为观察组及对照组,每组34例。对照组采用常规药物治疗,观察组在对照组基础上加用栀子厚朴汤、栀子豆豉汤合乌梅丸化裁治疗,比较两组临床疗效;对两组治疗前后中医症状评分及反流性疾病问卷量表(RDQ)评分进行比较;比较两组不良反应发生情况。结果观察组治疗后总有效率为94.12%(32/34),明显高于对照组(76.47%,26/34)(P<0.05);观察组治疗后反酸、烧心、嗳气、胃脘胀满症状评分较对照组明显降低(P<0.05);观察组治疗后较对照组胸骨后烧心感、胸骨后疼痛感、口中酸/苦味、胃内容物上涌症状发作频率及严重程度评分明显降低(P<0.05);观察组治疗期间不良反应发生率为5.88%(2/34),与对照组的11.76%(4/34)相比差异无统计学意义(P>0.05)。结论栀子厚朴汤、栀子豆豉汤合乌梅丸化裁对RGERD的治疗效果良好,可明显改善患者临床症状,且不良反应发生率较低,具有良好的临床应用价值。

Objective To explore the clinical effect of Zhizi Houpu Decotion(栀子厚朴汤),Zhizi Douchi Decoction(栀子豆豉汤)combined with Modified Wumei Pill(乌梅丸)in the treatment of refractory gastro-esophageal reflux disease(RGERD).Methods A total of 68 RGERD patients treated in the hospital from January 2019 to December 2020 were enrolled as the research objects.They were randomly divided into observation group and control group,34 cases in each group.The control group was treated with routine drugs,while the observation group was given Zhizi Houpo Decoction(栀子厚朴汤)and Zhizi Douchi Decoction combined with Modified Wumei Pill on the basis of the control group.The clinical curative effect,scores of TCM symptoms and reflux disease questionnaire(RDQ)before and after treatment,and the occurrence of adverse reactions were compared between the two groups.Results The total response rate after treatment in the observation group was significantly higher than that in the control group[94.12%(32/34)vs 76.47%(26/34)](P<0.05).After treatment,scores of TCM symptoms such as acid reflux,heartburn,belching and gaseous distention in the observation group were significantly lower than those in the control group(P<0.05),and scores about the onset frequency and severity of sternal heartburn,sternal pain,sour/bitterness in mouth and upwelling of stomach contents were significantly lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions during treatment between observation group and control group[5.88%(2/34)vs 11.76%(4/34)](P>0.05).Conclusion The curative effect of Zhizi Houpo Decoction and Zhizi Douchi Decoction combined with Modified Wumei Pill is good at treating GERD,which can significantly improve clinical symptoms of patients,with low incidence of adverse reactions and good clinical application value.