针药结合治疗肝胃郁热型反流性食管炎46例临床观察

Clinical Observation on Acupuncture Combined with Chinese Herbs in Treating 46 Cases of Reflux Esophagitis with Syndrome of Heat Stagnation in Liver and Stomach

目的观察针药结合治疗肝胃郁热型反流性食管炎的临床疗效及安全性。方法将92例反流性食管炎患者随机分为针药组和西药组各46例。针药组给予针刺加中药(旋覆代赭汤合左金丸加减,每日1剂,水煎服)治疗,西药组给予奥美拉唑肠溶胶囊(每次20 mg,每日2次,早、晚餐前口服)和枸橼酸莫沙必利分散片(每次5 mg,每日3次,餐前口服),两组患者均连续治疗8周。比较治疗前后两组患者反流性疾病问卷(RDQ)积分、内镜积分及安全性指标,治疗结束后比较两组临床疗效,治疗结束后6个月比较两组复发率。结果治疗后两组RDQ积分和内镜积分均较治疗前明显下降(P<0.01),针药组RDQ积分及内镜积分均明显低于西药组(P<0.05或P<0.01)。针药组总有效率(95.7%)高于西药组(82.6%)(P<0.05)。治疗结束后6个月复发率西药组(84.2%)高于针药组(34.1%)(P<0.01)。针药组中未见明显不良反应,西药组中2例出现头晕、3例出现腹痛,经对症处理后缓解。结论针药结合治疗反流性食管炎疗效显著,且复发率低、不良反应少。

Objective To observe the clinical efficacy and safety of acupuncture combined with Chinese herbs in treating reflux esophagitis with syndrome of heat stagnation in liver and stomach. Methods Ninety two cases of reflux esophagitis patients were randomly divided into acupuncture combined with Chinese herbs group and western medicine group,with 46 cases in each group. The combined acupuncture and medicine group was given the combination of acupuncture and medicine [Modified Xuanfu Daizhe Decoction（ 旋覆代赭汤） combined with Zuojin Wan（ 左金丸）,1 dose daily,decocted with water]. The western medicine group was given Omeprazole Enteric-coated Capsules,taken orally（ 20 mg each time,twice a day,taken before breakfast and dinner） and Mosapride Citrate Dispersible Tablets（ 5mg each time,three times a day,taken orally before meals）. Both groups were treated for 8 weeks continuously. Reflux disease questionnaire（ RDQ） score,endoscopic score and safety indicators before and after treatment in the two groups were compared and the clinic effects were compared after treatment. Recurrence rate of 6months after treatment in the two groups was compared. Results RDQ score and endoscopic score in both groups were significantly decreased compared with those before treatment（ P〈0. 01）. RDQ score and endoscopic score in combined acupuncture and medicine group were significantly lower than those in western medicine group（ P〈0. 05 or P〈0. 01）. The total effective rate in combined acupuncture and medicine group（ 95. 7%） was higher than that in western medicine group（ 82. 6%）（ P〈0. 05）. Recurrence rate of 6 months after treatment in western medicine group（ 84. 2%） was higher than that in combined acupuncture and medicine group（ 34. 1%）（ P〈0. 01）. The combined acupuncture and medicine group had no obvious adverse reactions. In the western medicine group,there were 2 dizziness cases and 3 abdominal pain cases,but they were relieved after expectant treatment. Conclusion Combination of acupuncture and medicine seems to have obvious curative effect,low recurrence rate and few adverse reactions in the treatment of reflux esophagitis.