蒲苓连夏方治疗难治性反流性食管炎临床观察

Clinical observation of Puling Lianxia decoction in the treatment of refractory reflux esophagitis

目的:研究蒲苓连夏方治疗难治性反流性食管炎的临床观察。方法:选取60例难治性反流性食管炎病例,按照随机数字表法,分为观察组(予蒲苓连夏方)和对照组(予雷贝拉唑钠肠溶胶囊和枸橼酸莫沙必利片),每组30例,疗程均为8周。治疗结束后分析两组治疗前后的中医证候疗效、24 h食管pH监测、胃镜下食管黏膜积分、中医证候积分结果、胃蛋白酶浓度,治疗结束随访3个月,观察两组的复发率。结果:观察组总有效率比对照组高(P<0.05);两组患者治疗后pH<4总时间百分比差异无统计学意义(P>0.05),两组患者的反流持续≥5 min次数、最长反流持续时间、De Meester得分均降低(P<0.05),且观察组低于对照组(P<0.05);两组治疗后胃镜下食管黏膜积分、中医证候积分、胃蛋白酶浓度均降低(P<0.05),且观察组低于对照组(P<0.05);观察组复发率较对照组低(P<0.05)。结论:蒲苓连夏方有效率高,且复发率低,临床疗效确切。

Objective:To study the clinical observation of Puling Lianxia decoction in the treatment of refractory reflux esophagitis.Methods:60 cases of refractory reflux esophagitis were randomly divided into observation group(treated with Puling Lianxia decoction)and control group(treated with rabeprazole sodium enteric-coated capsules and mosapride citrate tablet),30 cases in each group,and the course of treatment was 8 weeks.After treatment,the TCM syndrome efficacy,24-hour esophageal pH monitoring,endoscopic esophageal mucosal score,TCM syndrome score and pepsin concentration of the two groups before and after treatment were analyzed.After treatment,the patients were followed up for 3 months to observe the recurrence rate of the two groups.Results:The total effective rate of the observation group was higher than that of the control group(P<0.05).There was no significant difference in the total time percentage of pH<4 between the two groups after treatment(P>0.05).The number of reflux lasting≥5 min,the longest reflux duration and De Meester scoring of the two groups were decreased(P<0.05),and the observation group was lower than the control group(P<0.05).After treatment,the scores of esophageal mucosa,TCM syndrome score and pepsin concentration in the observation group were lower than those in the control group(P<0.05).The recurrence rate of the observation group was lower than that of the control group(P<0.05).Conclusion:The effective rate of Puling Lianxia decoction is high,and the recurrence rate is low.