丹栀逍遥散加减治疗胃食管反流病肝胃郁热证的临床疗效及对患者血清炎性因子的影响

The Clinical Efficacy of Modified Free Wanderer Powder of Cortex Moutan and Fructus Gardeniae Fruit on Gastroesophageal Reflux Disease with Liver-Stomach Stagnation-Heat Syndrome and its Influence on Serum Inflammatory Factors

目的:探讨丹栀逍遥散加减治疗胃食管反流病(gastroesophageal reflux disease,GERD)肝胃郁热证的临床疗效及对患者炎性因子的影响。方法:选取柳州市中医医院脾胃病科2017年6月至2018年7月住院治疗的GERD肝胃郁热证患者80例,按照随机数字表法分为治疗组和对照组各40例。对照组给予兰索拉唑胶囊、枸橼酸莫沙必利胶囊治疗,治疗组在对照组治疗的基础上加用丹栀逍遥散加减治疗。观察两组患者治疗前后主要临床症状积分,血清胃动素(motilin,MTL),胃蛋白酶原(pepsinogen,PG),超氧化物歧化酶(serum superoxide dismutase,SOD)和脂质过氧化物(lipid peroxide,LPO)的水平。结果:对照组有效率为78. 38%,治疗组有效率为94. 74%,治疗组有效率高于对照组,差异有统计学意义(χ2=5. 192,P <0. 05);治疗组治疗后烧心、反酸、胸痛、反胃积分均明显低于对照组,差异有统计学意义(P <0. 05);治疗组治疗后血清MTL、PG、SOD和LPO水平低于对照组,差异有统计学意义(P <0. 05)。结论:丹栀逍遥散加减治疗GERD肝胃郁热证疗效佳,在改善患者主要临床症状方面优于西药,能降低患者血清MTL、PG、SOD和LPO水平,减轻胃、食管黏膜炎症反应和氧化应激反应。

Objective: To observe the clinical efficacy of Modified Free Wanderer Powder of Cortex Moutan and Fructus Gardeniae Fruit on gastroesophageal reflux disease( GERD) with liver-stomach stagnation-heat syndrome and its influence on serum inflammatory factors. Methods: Eighty GERD patients with liver-stomach stagnation-heat syndrome were selected from the Department of Spleen and Stomach Disease of Liuzhou Hospital of TCM from June 2017 to July 2018. They were divided into the treatment group and the control group according to random number table method,with 40 cases in each group. The control group was treated with Lansoprazole Capsules and Mosapride Citrate Capsules,while the treatment group was additionally treated with Modified Free Wanderer Powder of Cortex Moutan and Fructus Gardeniae Fruit on the basis of the control group. The main clinical symptom scores,serum motilin( MTL),pepsinogen( PG),superoxide dismutase( SOD) and lipid peroxide( LPO) levels were observed before and after treatment. Results: The effective rate of the control group was 76. 67%,and that of the treatment group was96. 67%. The effective rate of the treatment group was higher than that of the control group,and the difference was statistically significant(χ~2= 5. 192,P < 0. 05). The scores of heartburn,acid reflux,chest pain and stomach reflux in the treatment group were significantly lower than those in the control group,and the difference was statistically significant( P < 0. 05). The levels of MTL,PG,SOD and LPO in the treatment group were lower than those in the control group after the treatment,and all the differences were statistically significant( P < 0. 05). Conclusion: Modified Free Wanderer Powder of Cortex Moutan and Fructus Gardeniae Fruit has a remarkable efficacy on GERD with liver-stomach stagnation-heat syndrome. It is superior to Western medicine in improving the main clinical symptoms of patients. It can reduce the levels of serum MTL,PG,SOD and LPO,alleviate the inflammatory reaction and oxidative stress reaction of gastric and esophageal mucosa.