基于气机升降理论应用旋覆代赭汤加味治疗胃食管反流性咽喉炎的临床研究

Clinical Study on Treatment of Gastroesophageal Reflux Laryngitis Based on Theory of Qi Movement

目的:探讨基于气机升降理论应用旋覆代赭汤加味治疗胃食管反流性咽喉炎的临床研究。方法:选择2015年3月——2017年6月本院消化内科胃食管反流性咽喉炎患者74例,随机分为两组,分别37例,对照组采用雷贝拉唑钠10mg和莫沙必利15mg口服,观察组基于气机升降理论采用旋覆代赭汤加味治疗,2次/d,1剂/d,持续治疗4周。比较两组患者临床疗效、食管pH及咽喉疼痛、反酸烧心、嗳气、声音嘶哑等中医证候积分,记录不良反应。结果:对照组有效率78.38%低于观察组有效率94.60%,差异有统计学意义(P<0.05)。治疗后对照组和观察组咽喉疼痛分别为(0.76±0.31)分,(0.42±0.27)分,反酸烧心分别为(0.73±0.35)分,(0.42±0.26)分,嗳气分别为(0.82±0.40)分,(0.39±0.25)分,声音嘶哑分别为(0.65±0.32)分,(0.29±0.21)分,第一通道pH<4时间百分比分别为(1.85±0.67)%(0.71±0.53)%,第二通道pH<4时间百分比分别为(4.34±1.64)%(2.45±1.45)%,对照组和观察组上述指标比较,差异有统计学意义(P<0.05)。两组治疗期间无任何不良反应出现。结论:基于气机升降理论采用旋覆代赭汤加味治疗胃食管反流性咽喉炎的疗效确切,有助于改善中医证候,并且安全性高。

Objective:To explore the effect of treatment of gastroesophageal reflux laryngitis based on the theory of Qi movement.Methods:Seventy-four cases of gastroesophageal reflux laryngitis in department of gastroenterology from March 2015 to June 2017 were selected and randomly divided into two groups,37 cases in each.The control group received Rabezole sodium 10 mg and Mosapride 15 mg.The treatment group additionally received Modified Xuanfu Daizhe Decoction twice a day.And two groups were treated for 4 weeks.The clinical effects of two groups were compared,scores of TCM syndromes like throat pain,heartburn,belching and hoarseness were recorded,and esophageal pH was compared,and the adverse reactions were also recorded.Results:The effective rate of the control group(78.38%)was lower than the treatment group's 94.60%,and the difference was statistically significant(P<0.05).After treatment,the scores of throat pain in treatment group and the control group were respectively 0.76±0.31,0.42±0.27,heartburn scores were 0.73±0.35,0.42±0.26,ructus scroes were 0.82±0.40,0.39±0.25,hoarseness scores were 0.65±0.32,0.29±0.21,and the rates of first channel pH<4 were(1.85±0.67)%and(0.71±0.53)%,and the rates of second channel pH<4 were(4.34±1.64)%and(2.45±1.45)%.All above had statistically significant difference(P<0.05).No adverse reaction occurred during the treatment of the two groups.Conclusion:Based on the theory of Qi ascending and descending,the curative effect of the treatment of gastroesophageal reflux laryngitis was effective,which was helpful to improve TCM syndromes and safety.