和胃化湿汤联合奥美拉唑对NERD肝胃郁热证患者临床症状及胃肠激素水平的影响

Effect of Hewei Huashi Decoction Combined with Omeprazole on Clinical Symptoms and Gastrointestinal Hormone Levels in NERD Patients with Liver-stomach Stagnation Heat Syndrome

目的:探讨和胃化湿汤与奥美拉唑联合治疗对非糜烂性胃食管反流病(non erosive gastroesophageal reflux disease,NERD)肝胃郁热证患者临床症状、胃食管状态及胃肠激素水平的影响,以期为临床中西医结合治疗NERD提供用药参考。方法:选择2017年1月至2019年12月收治的150例NERD患者,将其按随机数字表法分为2组各75例。对照组给予奥美拉唑肠溶片,观察组在奥美拉唑肠溶片的基础上加服和胃化湿汤剂,比较2组患者治疗后中医证候、24hpH监测指标、食管括约肌功能与胃泌素、胃动素及血管活性肠肽指标水平。结果:观察组治疗后中医证候积分、酸反流总次数、反流时间>5min次数、最长反流时间、pH<4的反流时间百分比,DeMeester评分、血管活性肠肽水平均明显低于对照组,差异有统计学意义(P<0.01);食管上括约肌静息压(upper esophageal sphincter resting pressure,UESP)、食管下括约肌静息压(lower esophageal sphincter pressure,LESP)及胃泌素、胃动素水平明显高于对照组,差异有统计学意义(P<0.01)。结论:和胃化湿汤联合奥美拉唑可有效缓解NERD临床症状,抑制胃酸反流,提高食管下括约肌功能,调节血清胃肠激素水平,具有较好的临床疗效。

Objective:To explore the effect of Hewei Huashi decoction combined with omeprazole on clinical symptoms,gastroesophageal status and gastrointestinal hormone levels of patients with non erosive gastroesophageal reflux disease(NERD)of liver stomach heat stagnation syndrome,so as to provide reference for clinical treatment of NERD with integrated traditional Chinese and Western medicine.Methods:A total of 150 patients of NERD patients in our hospital from Jan.2017 to Dec.2019 were selected and divided into two groups according to random number table method table,75 cases in each group.The control group was given omeprazole enteric coated tablets,and the observation group was given Hewei Huashi decoction on the basis of omeprazole enteric coated tablets.TCM symptom score,24h pH monitoring index,esophageal sphincter function,gastrin,motilin and vasoactive intestinal peptide were compared between the two groups after treatment.Results After treatment,TCM symptom score,total times of acid reflux,times of reflux time>5 minutes,longest reflux time,percentage of reflux time with pH<4,Demester score and vasoactive intestinal peptide level in observation group were significantly lower than those in control group,the difference was statistically significant(P<0.01);and the resting pressure of upper esophageal sphincter(UESP),resting pressure of lower esophageal sphincter(LESP),gastrin and motilin levels were significantly higher in observation group than those in control group,the difference was statistically significant(P<0.01).Conclusion Hewei Huashi decoction combined with omeprazole can effectively reduce the clinical symptoms of NERD,inhibit gastric acid reflux,improve esophageal sphincter function,and regulate serum gastrointestinal hormone levels,for better clinical treatment.