自拟和胃降逆汤治疗反流性食管炎的疗效及胃肠动力学机制研究

Curative Effect of Using Self-made Hewei Jiangni Decoction in the Treatment of Reflux Esophagitis and It’s Mechanism of Gastrointestinal Dynamics

目的:观察自拟和胃降逆汤治疗反流性食管炎(RE)的疗效及对胃肠动力学的影响。方法:选取2018年2月~2019年2月医院消化内科收治的118例RE患者,并用随机数字表法将其分为对照组和观察组,每组各59例,对照组采用常规西医治疗,观察组在对照组的基础上联合给予医院自拟的和胃降逆汤治疗;比较2组患者治疗前、后的中医证候积分;记录2组治疗前、后的胃排空时间、胃肠排空率;比较2组患者治疗前、后的胃泌素(GAS)、胃动素(MTL)以及血管活性肠肽(VIP)胃肠激素水平变化;统计2组患者的临床治疗效果以及治疗期间出现的不良反应总发生率。结果:观察组的治疗有效率为91.53%高于对照组的77.97%(P<0.05);观察组经过治疗后,RE主症状的中医证候积分低于对照组(P<0.05);观察组经过治疗后,胃排空时间短于对照组(P<0.05),胃排空率和肠排空率高于对照组(P<0.05);观察组经过治疗后,GAS、MTL水平高于对照组(P<0.05),VIP水平低于对照组(P<0.05);观察组的不良反应总发生率为10.17%低于对照组的25.42%(P<0.05)。结论:自拟和胃降逆汤治疗RE疗效确切,能够显著缓解患者的临床症状,改善胃肠动力功能,安全有效。

Objective:To investigate the curative effect of Self-made Hewei Jiangni Decoction on reflux esophagitis(RE) and its influences on gastrointestinal dynamics.Methods:A total of 118 RE patients who were admitted to gastroenterology department of the hospital from February 2018 to February 2019 were enrolled.They were divided into controlled group and observation group by random number table method, 59 cases in each group.The controlled group was treated with routine western medicine.On this basis, the observation group was additionally given hospital Self-made Hewei Jiangni Decoction.Traditional Chinese medicine(TCM) syndrome scores before and after treatment were compared between the two groups.The gastric emptying time and gastrointestinal emptying rate in both groups before and after treatment were recorded.The changes in levels of gastrin(GAS), motilin(MTL), vasoactive intestinal peptide(VIP) and gastrointestinal hormone before and after treatment were compared between the two groups.The clinical curative effect and total incidence of adverse reactions during treatment period in both groups were statistically analyzed.Results:The response rate of treatment in the observation group was higher than that in the controlled group(91.53% vs 77.97%)(P<0.05).After treatment, TCM syndromes scores of RE main symptoms in the observation group were lower than those in the controlled group(P<0.05).After treatment, gastric emptying time in the observation group was shorter than that in the controlled group(P<0.05), while gastric emptying rate and intestinal emptying rate were higher than those in the controlled group(P<0.05).After treatment, GAS and MTL levels in the observation group were higherthan those in the controlled group(P<0.05), while VIP level was lower than that in the controlled group(P<0.05).The total incidence of adverse reactions in the observation group was lower than that in the controlled group(10.17% vs 25.42%)(P<0.05).Conclusion:The curative effect of Self-made Hewei Jiangni Decoction is significant on RE, which can significantly alleviate clinical symptoms of patients, and improve gastrointestinal motility.It is safe and effective.