降逆和胃汤治疗反流性食管炎45例临床观察

Clinical Observation on Jiangni Hewei Decoction in Treatment of 45 Patients with Reflux Esophagitis

目的观察降逆和胃汤治疗反流性食管炎(reflux esophagitis,RE)的疗效。方法75例符合纳入标准的RE患者,随机分为两组。治疗组45例,口服降逆和胃汤,每天1剂;对照组30例,口服奥美拉唑20mg,每天1次;两组疗程均为8周。于治疗前后进行临床症状疗效、胃镜下RE分级和积分评价。结果应用降逆和胃汤和奥美拉唑治疗RE,均能明显改善患者的临床症状,治疗组痊愈率37·8%(17例),总有效率为84·5%;对照组痊愈率为36·7%(11例),总有效率为83·3%;两组治疗后各症状积分和总积分均明显低于治疗前(P<0·01)。胃镜下,治疗后两组0级均明显增多,Ⅲ级均为0;治疗组治愈率为48·9%(22例),总有效率为91·1%;对照组治愈率为46·7%(14例),总有效率为93·3%;治疗后组内胃镜疗效比较,差异均有显著性(P<0·01)。该结果显示,降逆和胃汤在改善RE患者的烧心、反酸和胸痛等临床症状、胃镜下食管黏膜炎症以及促进胃镜下食管炎的愈合等方面的疗效与奥美拉唑的疗效相近,但停药12周后复发情况比较却明显低于奥美拉唑(P<0·05),且未见不良反应发生。结论降逆和胃汤治疗RE具有较好的疗效。

Objective To observe the therapeutic efficacy of Jiangni Hewei Decoction （JHD） in treating reflux esophagitis （RE）. Methods Seventy-five RE patients conformed with the inclusive criteria were randomly divided into the treated group （45 patients） and the control group （30 patients）. Patients in the treated group received JHD orally,one dose per day, while those in the control group received Omeprazole,20 mg once per day. The therapeutic course was 8 weeks. The efficacy on clinical symptoms, RE grades and scores determined by gastroscope were evaluated. Results Patients＇ symptoms were obviously improved after treatment of JHD and Omeprazole. The cured rate and the total effective rate in the treatedgroup were 37.8 % （17cases） and 84.5 % , respectively, while in the control group were 36.7% （11 cases） and 83.3% respectively. The symptomatic score and the total score in both groups after treatment were obviously lowered （P 〈 0.01 ）. Gastroscopic examination showed that the patients in the two groups with RE of 0 grade were significantly increased and no patients with RE of Ⅲ grade. The healing rate and the total effective rate were 48.9% （22 cases） and 91.1% respectively in the treated group, and the corresponding numbers in the control group were 46.7% （14 cases） and 93.3 % respectively. Significant difference was found in comparison of the gastroscopic figures in the same group before and after treatment （P〈0.01）. The therapeutic effect of JHD on RE was similar to that of Omeprazole in aspects of improving clinical symptoms such as heartburn, acid regurgitation,chest pain, etc. , and in curing oesophageal mucous inflammation （under gastroscope） and esophagitis. But the recurrence in the JHD group was obviously lower than that in the control group in 12 weeks after withdrawal of treatment （P 〈 0.05）. Besides, no adverse reaction happened in the JHD group. Conclusion JHD showed favorable therapeutic efficacy in treating RE.