辛开苦降法治疗咽喉反流性疾病30例临床观察

Clinical Observation on Acrid-Opening and Bitter-Downbearing Method in Treating 30 Cases of Laryngopharyngeal Refulx Disease

目的观察辛开苦降法治疗咽喉反流性疾病的临床疗效。方法将60例咽喉反流性疾病患者随机分为治疗组和对照组各30例,治疗组以辛开苦降立法,给予半夏泻心汤合四逆散为基础方的中药加减治疗,每日1剂,对照组予以兰索拉唑口崩片每次20 mg,每日2次。两组均治疗4周后评价主观及客观疗效,并于治疗前后分别进行反流症状指数评分量表(RSI)、胃食管反流病问卷(Gerd Q)评分。结果两组患者治疗后RSI各症状评分均较治疗前明显降低,治疗后治疗组声嘶评分明显低于对照组(P<0.05)。两组患者治疗后Gerd Q反酸、烧心、失眠评分明显低于治疗前,治疗后治疗组反酸评分明显低于对照组(P<0.05)。治疗组客观疗效总有效率为96.67%,主观疗效总有效率为96.67%,对照组分别为90.00%、83.33%,治疗组主观疗效优于对照组(P<0.05),客观疗效两组比较差异无统计学意义(P>0.05)。结论辛开苦降法在改善咽喉反流性疾病患者的主观症状,特别是缓解患者声嘶及反酸方面明显优于兰索拉唑口崩片。

Objective To observe clinical curative effect of acrid-opening and bitter-downbearing method in treating laryngopharyngeal refulx disease. Methods Randomly divided 60 patients with laryngopharyngeal reflux disease into treatment group and control group,with 30 cases in each group. The treatment group was treated with acridopening and bitter-downbearing method,given modified Banxia Xiexin Decoction（ 半夏泻心汤） combined with Sini Powder（ 四逆散）,1 dose daily. The control group received Lansoprazole Orally Disintegrating Tablets 20 mg each time,twice a day. Evaluated objective and subjective curative effect after 4 weeks. Before and after treatment,respectively evaluated the reflux symptom index scale（ RSI） and the gastroesophageal reflux disease questionnaire（ Gerd Q） score. Results Symptom scores of RSI in both groups after treatment all significantly decreased compared with those before treatment,with hoarseness scores in the treatment group after treatment significantly lower than those in the control group（ P〈0. 05）. After treatment,Gerd Q acid reflux,heartburn,insomnia scores in the two groups were significantly lower than that before treatment. Acid reflux scores in the treatment group after treatment were significantly lower than the control group（ P〈0. 05）. The total effective rate of objective curative effect in the treatment group was 96. 67%,and the total effective rate of the subjective curative effect was 96. 67%,with the control group 90% and 83. 33% respectively. The subjective curative effect in the treatment group was better than the control group（ P〈0. 05）. There was no significant difference in objective curative effect between the two groups（ P〈0. 05）. Conclusion Acrid-opening and bitter-downbearing method was superior to Lansoprazole Orally Disintegrating Tablets in improving subjective symptoms of patients with laryngopharyngeal refulx disease,especially in hoarseness and acid reflux.