益气除痞汤联合西药治疗初诊脾虚郁滞型反流性食管炎的临床效果

Clinical effect of Yiqi Chupi Decoction combined with Western medicine in the treatment of newly diagnosed reflux esophagitis of spleen deficiency and stagnation type

目的探讨益气除痞汤联合西药治疗初诊脾虚郁滞型反流性食管炎(RE)的临床效果。方法采用随机数字表法将129例2018年9月至2020年9月江苏省张家港市中医医院收治的初诊RE患者分为两组,其中对照组(64例)予以常规西医治疗,研究组(65例)在对照组基础上联合益气除痞汤治疗。比较两组疗效、中医证候积分、血清指标[胃动素(MOT)、胃泌素(GAS)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]及不良反应。结果研究组治疗8周后临床总有效率高于对照组(P<0.05)。治疗8周后,两组反酸、嗳气、胃脘部痞胀、纳差、烧心、倦怠等症状评分均低于治疗前,且研究组各症状评分低于对照组(P<0.05);MOT、GAS水平较治疗前升高,且研究组高于对照组(P<0.05);TNF-α、IL-6水平较治疗前降低,且研究组低于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论益气除痞汤联合西药治疗RE效果显著,安全性好,其作用机制可能与调节炎症指标、胃肠激素有关。

Objective To explore the clinical effect of Yiqi Chupi Decoction combined with Western medicine in the treatment of newly diagnosed reflux esophagitis(RE) of spleen deficiency and stagnation type.Methods A total of 129 newly diagnosed RE patients admitted to Zhangjiagang Hospital of Traditional Chinese Medicine from September 2018 to September 2020 were selected and they were divided into two groups by random number table method.The control group(64 cases) was treated with conventional Western medicine,and the study group(65 cases) was treated with Yiqi Chupi Decoction on the basis of the control group.The therapeutic effect,traditional Chinese medicine syndrome score,serum indexes(motilin [MOT],gastrin [GAS],tumor necrosis factor-α [TNF-α],interleukin-6 [IL-6]) and adverse reactions were compared between the two groups.Results After eight weeks of treatment,the total effective rate of the study group was higher than that of the control group(P < 0.05).After eight weeks of treatment,the symptom scores of acid regurgitation,belching,epigastric distension,anorexia,heartburn and burnout in the two groups decreased compared with before treatment,and the symptom scores of the study group were lower than those of the control group(P < 0.05);the levels of MOT and GAS increased than before treatment,and those of the study group were higher than those of the control group(P < 0.05);the levels of TNF-α and IL-6 decreased than before treatment,and those of the study group were lower than those of the control group(P < 0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P > 0.05).Conclusion Yiqi Chupi Decoction combined with Western medicine in the treatment of RE with significant curative effect and good safety.Its mechanism of action may be related to the regulation of inflammatory indicators and gastrointestinal hormones.