栀子甘草豉汤加味治疗反流性食管炎疗效及对食管pH值、动力学及血清CGRP、IL-17的影响

Effect of Using Modified Zhizi Gancao Chitang Decoction in the Treatment ofReflux Esophagitis, and Its Influence on Esophageal pH Value, Kinetics and Serum CGRP and IL-17

目的:研究栀子甘草豉汤加味治疗反流性食管炎的临床疗效及对食管pH值、动力学及对患者血清降钙素基因相关肽(CGRP)、白介素-17(IL-17)的影响。方法:选取我院2019年1月~2020年1月收治的反流性食管炎患者96例作为研究对象,使用随机数字法将其分为观察组(n=48例)与对照组(n=48例),对照组采用常规奥美拉唑治疗;观察组患者使用栀子甘草豉汤加味治疗。比较两组患者用药后临床治疗效率;比较两组患者治疗前后食管pH值变化情况;比较两组患者治疗前后食管动力学变化情况;比较两组患者治疗前及治疗后2周、治疗后4周、治疗后8周血清CGRP及IL-17表达水平差异。结果:治疗后观察组患者临床治疗总有效率93.75%高于对照组79.17%(P<0.05);治疗前两组患者食管pH值差异无统计学意义(P>0.05),治疗后观察组pH<4反流次数、>5min反流次数、PH<4总时间及PH<4百分时间均低于对照组(P<0.05);两组患者治疗前食管动力学各指标差异无统计学意义(P>0.05),治疗后观察组患者食管括约肌压力高于对照组(P<0.05),卧位返流时间百分比、立位反流时间百分比及总反流时间百分比均低于对照组(P<0.05);两组患者治疗前血清CGRP无显著差异(P>0.05),治疗后不同时间观察组患者血清CGRP表达水平显著低于对照组(P<0.05);治疗前两组患者血清IL-17表达水平无显著差异(P>0.05),治疗后不同时间观察组患者血清IL-17表达水平均显著低于对照组(P<0.05)。结论:栀子甘草豉汤加味治疗反流性食管炎可有效提高临床治疗效果,促进患者食管内pH值及动力学恢复,并改善其血清CGRP、IL-17表达水平。

Objective:To study the clinical efficacy of using Modified Zhizi Gancao Chitang Decoction in the treatment of reflux esophagitis and its effects on esophageal pH value,kinetics and serum calcitonin gene-related peptide(CGRP)and interleukin-17(IL-17).Methods:96 patients with reflux esophagitis treated in our hospital from January 2019 to January 2020 were selected as the research object.They were randomly divided into an observation group(n=48 cases)and a controlled group(n=48 cases).The controlled group was treated with routine Omeprazole.The patients in the observation group were treated with Modified Zhizi Gancao Chitang Decoction.The clinical treatment efficiency of the two groups was compared.The changes of esophageal pH before and after treatment were compared between the two groups.The changes of esophageal dynamics before and after treatment were compared between the two groups.The expression levels of serum CGRP and IL-17 were compared between the two groups before and 2 weeks after treatment,4 weeks after treatment and 8 weeks after treatment.Results:After treatment,the total effective rate of clinical treatment in the observation group was 93.75%higher than 79.17%in the controlled group(P<0.05).There was no significant difference in esophageal pH between the two groups before treatment(P>0.05).After treatment,the number of reflux with pH<4,>5 min,the total time of pH<4 and the time of pH<4%in the observation group were lower than those in the controlled group(P<0.05).The esophageal sphincter pressure in the observation group was higher than that in the controlled group(P<0.05),and the percentage of recumbent reflux time,standing reflux time and total reflux time in the observation group were lower than those in the controlled group(P<0.05).There was no significant difference in serum CGRP between the two groups before treatment(P>0.05).The expression level of serum CGRP in the observation group was significantly lower than that in the controlled group at different times after treatment(P<0.05).There was no significant difference in the expression level of serum IL-17 between the two groups before treatment(P>0.05),and the expression level of serum IL-17 in the observation group was significantly lower than that in the controlled group at different times after treatment(P<0.05).Conclusion:Modified Zhizi Gancao Chitang Decoction can effectively improve the clinical treatment effect,promote the recovery of pH value and dynamics in the esophagus,and improve the expression levels of serum CGRP and IL-17.