三及散联合雷贝拉唑治疗难治性反流性食管炎的临床疗效及对复发率的影响分析

The analysis of clinical efficacy and relapse rate of Sanji Powders combined with Rabeprazole in the treatment of refractory reflux esophagitis

目的分析三及散联合雷贝拉唑治疗难治性反流性食管炎(r GERD)的临床疗效。方法选择2016年1~10月于我院就诊60例r GERD患者,根据随机编码的序列将患者平均分为试验组和对照组,对照组给予雷贝拉唑治疗,试验组联合三及散口服。观察两组患者的临床治疗效果,治疗前后症状积分(包括反酸、烧心、上腹饱胀、口干口苦和胸骨后疼痛)及内镜积分(包括黏膜充血水肿、黏膜糜烂、胆汁反流、黏膜白相、血管透见)改善情况。随访两组患者的复发率。结果试验组治疗总有效率高于对照组(P<0.05)。两组治疗前各项症状积分比较差异无统计学意义(P>0.05),治疗后上述积分均显著降低(P<0.05),且试验组各项症状积分均显著低于对照组(P<0.05)。两组治疗前各项内镜积分差异无统计学意义(P>0.05),治疗后上述积分均显著改善(P<0.05),且试验组各项内镜积分均显著优于对照组(P<0.05)。试验组复发率低于对照组(P<0.05)。结论三及散联合雷贝拉唑治疗难治性反流性食管炎疗效确切,可以减轻患者的临床症状,改善胃镜下黏膜血流变化,且临床复发率低。

Objective To analyze the clinical efficacy of Sanji Powder combined with Rabeprazole in the treatment of refractory reflux esophagitis（r GERD）. Methods Sixty patients with r GERD were treated in our hospital from January2016 to October 2016. The patients were equally divided into experimental group and control group according to the randomized coding sequence and the control group received Rabeprazole while experimental group received Sanji Powder combined with Rabeprazole. The clinical efficacy of the two groups were observed including the symptom scores（including acid reflux, heartburn, abdominal fullness, dry mouth and post-sternal pain） and endoscopic scores（including mucosal congestion and edema, mucosal erosion, bile reflux, mucosal whitening, vascular penetrating）. Followed up the recurrence rate of patients of the two groups. Results The total effective rate of experimental group was higher than that of control group（P〈0.05）. There was no significant difference between the two groups before treatment（P〉0.05）. After treatment, the above scores were significantly lower（P〈0.05）, and the symptom scores in the experimental group were significantly lower than those in the control group（P〈0.05）. There was no significant difference in the endoscopic scores between the two groups before treatment（P〉0.05）, and the above scores were significantly improved after treatment（P〈0.05）.The endoscopic scores in the experimental group were significantly better than those in the control group（P〈0.05）. The recurrence rate of the experimental group was lower than that of the control group（P〈0.05）. Conclusion Sanji Powders combined with Rabeprazole in the treatment of refractory reflux esophagitis is effective and can alleviate the clinical symptoms of patients and improve the gastroscopic mucosa blood flow changes, and the clinical recurrence rate is low.