中医辨证治疗胃食管反流病疗效观察

Clinical Therapeutic Effect of TCM Syndrome Differentiation and Treatment for Patients with GERD

目的：通过对中药治疗组和西药对照组治疗胃食管反流病的临床疗效观察,分析两组治疗前后症状与体征积分的客观变化,指出中医辨证治疗胃食管反流病具有一定的疗效优势。方法：本研究对85例胃食管反流病患者进行疗效观察,按就诊顺序以2：1随机分配至两组,中药治疗组55例、西药对照组30例,进行随机、平行开放对照临床试验。中药治疗组辨证分型后采用课题组相应协定方治疗;西药对照组采用雷贝拉唑胶囊治疗,每次10 mg,2次/d,口服,连用8周（由上海信谊药物有限公司生产）。疗程8周,疗程结束后随访2周。采用Excel整理数据资料,SPSS 18.0和GraphPad Prism 5软件统计分析。结果：临床主要症状改善情况,组内比较,两组治疗后反酸、烧心、胸骨后不适,反胃,嗳气积分与治疗前比较,均明显下降,有统计学意义（P〈0.05）;组间比较,两组治疗后烧心、胸骨后不适、疼痛,嗳气积分差值比较,差异显著,有统计学意义（P〈0.05）;两组治疗后泛酸积分差值比较,差异不明显,无统计学意义（P〉0.05）;症状有效率,治疗组为90.91%,对照组为73.33%,组间比较无显著性差异（P〉0.05）。结论：中医辨证治疗在改善临床主要症状方面疗效优于作用机制单一的西药。

Objective： To observe the efficacy of the traditional Chinese medicine treatment group and Western medicine control group in the treatment of GERD and objectivly analyze the changes of symptoms and signs of the two groups before and after treatment. To point out the efficacy of TCM treatment of GERD has certain advantages. Methods： Randomized control open trial was conducted in 85 patients with GERD. The 85 cases were divided into 2 groups. Group A 55 cases wre treated with Chinese traditional medicine（TCM syndrome differentiation and treatment） and group B 30 cases as control received western medicine（rabeprazole capsule 10 mg each time,twice a day）. The course of treatment was 8 weeks. Patients were followed up for two weeks after the end of treatment. The data files were provided with Excel and the statistical analysis was executed by SPSS18. 0 and Graph Pad Prism 5 softwares. Results： There was a significant difference in pantothenic acid,heartburn,chest pain and belching symptom scores in the two groups before and after treatment（P〈0. 05）. There was statistical significance in heartburn,chest pain and belching symptom scores before and after treatment（P〈0. 05） and between group A and group B after treatment（P〉0. 05）,which indicated TCM syndrome differentiation and treatment was superior to western medicine treatment. There was no statistical significance in pantothenic acid symptom scores between group A and group B after treatment（P〉0. 05）. Effective rate on symptoms of TCM syndrome differentiation and treatment was 90. 91%. Effective rate on symptoms of western medicine treatment was73. 33%. Two groups had no significant difference（P〉0. 05）. Conclusion： TCM syndrome differentiation and treatment have a good effect on GERD. The effects of improving clinical symptoms in TCM syndrome differentiation and treatment were obviously better than those in western medicine treatment.