旋复代赭汤加减联合雷贝拉唑钠肠溶胶囊治疗反流性食管炎肝胃郁热证临床疗效观察

Clinical Efficacy of Using Modified Xuanfu Daizhe Decoction Combined with Rabeprazole Sodium Enteric Coated Capsule in the Treatment of Reflux Esophagitis

目的:探讨旋复代赭汤加减联合雷贝拉唑钠肠溶胶囊治疗反流性食管炎(RE)肝胃郁热证的临床疗效。方法:选择2016年3月~2018年4月北京市门头沟区中医医院和北京市中西医结合医院共同收治的初诊RE患者120例。采用奇偶排序法将研究对象分为对照组和观察组,各60例。对照组患者予以雷贝拉唑钠肠溶胶囊治疗,观察组患者在对照组基础上联合旋复代赭汤加减治疗,对比两组疗效、中医症状评分、炎症因子、氧化应激指标、胃肠激素及不良反应。结果:与对照组相比,观察组的临床总有效率更高(P<0.05)。两组治疗8周后反酸、易怒、胸骨后灼痛、心烦、大便秘结、口干口苦评分均较治疗前下降,且观察组低于对照组(P<0.05)。两组治疗8周后白细胞介素-6(IL-6)、丙二醛(MDA)、肿瘤坏死因子-α(TNF-α)较治疗前下降,且观察组低于对照组(P<0.05),超氧化物歧化酶(SOD)较治疗前升高,且观察组高于对照组(P<0.05)。两组不良反应发生率对比差异无统计学意义(P>0.05)。两组治疗8周后胃泌素(GAS)、胃动素(MTL)较治疗前升高,且观察组高于对照组(P<0.05)。结论:旋复代赭汤加减联合雷贝拉唑钠肠溶胶囊治疗RE患者,可有效改善症状及胃肠激素指标,降低机体炎性及氧化应激反应,不良反应发生率低,疗效确切。

Objective:To investigate the clinical efficacy of using Modified Xuanfu Daizhe Decoction combined with Rabeprazole Sodium Enteric Coated Capsules in the treatment of reflux esophagitis(RE)with liver and stomach stagnation heat syndrome.Methods:120 newly diagnosed RE patients in our hospital from March 2016 to April 2018 were selected.The subjects were divided into a controlled group and a combination group with 60 cases in each group.The controlled group was given Rabeprazole Sodium Enteric Coated Capsules,while the study group was treated with Xuanfu Daizhe Decoction on the basis of the controlled group.The efficacy,TCM symptom score,inflammatory factors,oxidative stress index,gastrointestinal hormones and adverse reactions were compared between the two groups.Results:Compared with the controlled group,the clinical total effective rate of the study group was higher(P<0.05).After 8 weeks of treatment,the scores of acid regurgitation,irritability,poststernal burning pain,upset,constipation,dry mouth and bitter mouth of the two groups decreased compared with those before treatment,and the observation group was lower than the controlled group(P<0.05).After 8 weeks of treatment,the levels of IL-6,MDA and TNF-αin the observation group were lower than those in the controlled group(P<0.05),and the superoxide dismutase(SOD)in the observation group was higher than that in the controlled group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).After 8 weeks of treatment,the levels of gastrin(GAS)and motilin(MTL)in the two groups were higher than those before treatment,and those in the observation group were higher than those in the controlled group(P<0.05).Conclusion:Xuanfu Daizhe Decoction combined with Rabeprazole Sodium Enteric Coated Capsule in the treatment of RE patients can effectively improve the symptoms and gastrointestinal hormone indicators,reduce the body inflammatory and oxidative stress reaction,and does not increase the incidence of adverse reactions,with exact curative effect.