健脾降逆法治疗脾虚型反流性食管炎疗效评价

Clinical Evaluation on Spleen-invigorating Counterflow-descending Method in the Treatment for Reflux Esophagitis of Spleen-deficiency Pattern

目的:探讨健脾降逆法治疗脾虚型反流性食管炎的临床疗效。方法:将120例患者按7∶5比例随机分为观察组70例,对照组50例,观察组以健脾降逆为法予四君子汤、四逆散、二陈汤、左金丸合方随症加减治疗,每日1剂,分早晚2次服用;对照组以奥美拉唑肠溶片20 mg,口服,2次/d。2组均连续治疗8周。按照GerdQ量表疗效评价标准、中医症状及证候疗效评定标准、安全性评价标准于治疗8周后进行临床疗效评定。结果:GerdQ疗效有效率观察组为94.29%,对照组为90.00%,2组比较差异无统计学意义(P>0.05)。GerdQ量表阳性积分及GerdQ量表生活质量影响积分治疗前后2组组内比较,差异有统计学意义(P<0.05);治疗后组间比较差异也有统计学意义(P<0.05)。烧心、反酸/吐清水、脘胁胀痛、嗳气等症状的临床控制度及总有效率2组比较,差异有统计学意义(P<0.05)。便溏不爽、食少等症状的临床控制率2组比较,差异有统计学意义(P<0.05);总有效率2组比较,差异无统计学意义(P>0.05)。中医证候愈显率观察组为87.14%,对照组为66.00%,2组比较差异有统计学意义(P<0.05);总有效率观察组为97.14%,对照组为92.00,2组比较差异无统计学意义(P>0.05)。证候积分治疗前后2组组内比较,差异有统计学意义(P<0.05);治疗后组间比较差异也有统计学意义(P<0.05)。结论:健脾降逆法治疗脾虚型反流性食管炎安全有效。

Objective: To explore clinical effects of spleen-invigorating counterflow-descending method in the treatment for reflux esophagitis of spleen-deficiency pattern. Methods: A total of 120 patients were allocated to 70 cases of the observation group and 50 cases of the control group in the ratio of 7:5, the observation group were treated by spleen-invigorating counterflow-descending method and Sijunzi decoction, Sini powder, Erchen decoction, Zuojin pills which were modified according to the symptoms, one dose each day, twice in the morning and evening;the control group were given omeprazole enteric tablets, 20 mg, oral administration, twice each day.both groups were treated for eight consecutive weeks. Curative effects were assessed in eight weeks after treating according to clinical evaluation standard of GerdQ scales, curative assessment standard for TCM symptoms and the syndromes and assessment standard of the safety. Results: GerdQ curative effective rate of the observation group was94.29%, higher than 90.00% of the control group, and the difference had no statistical meaning(P >0.05). The difference had statistical meaning in GerdQ scale positive scores and the influencing integrals of GerdQ scale quality of life within two groups before and after treating(P<0.05);the difference had statistical meaning between both groups after treating(P<0.05). The difference could be found in total effective rates and clinical control rates of the symptoms including heartburn, sour regurgitation/hydroptysis, epigastric distension and pain, belching and others between both groups(P <0.05). The difference could be found in clinical control rates of the symptoms such as loose stool, poor appetite and others(P <0.05);the difference had no statistical meaning in total effective rate between both groups. Marked effective rate of TCM syndrome in the observation group was 87.14%, higher than 66.00% of the control group, and the difference showed statistical meaning(P <0.05). Total effective rate of the observation group was 97.14%, higher than 92.00% of the control group, and the difference showed no statistical meaning(P >0.05). The difference was statistically significant in syndrome scores within two groups before and after treating(P<0.05);the difference was statistically significant between both groups after treating(P<0.05).Conclusion: Spleen-invigorating counterflow-descending method is safe and effective in the treatment for reflux esophagitis of spleen-deficiency pattern.