化肝煎加味联合奥美拉唑治疗肝胃郁热型胃食管反流病的疗效

Effect of Huagan Decoction Combined with Omeprazole in Treating Gastroesophageal Reflux with Stagnation of Liver and Stomach heat

目的探讨化肝煎加味联合奥美拉唑对肝胃郁热型胃食管反流病的疗效。方法肝胃郁热型胃食管反流患者80例随机分为对照组和观察组,每组各40例,对照组采用奥美拉唑肠溶片、枸橼酸莫沙必利分散片和铝镁加混悬液治疗,观察组在对照组基础上加用化肝煎加味,共治疗4周后观察疗效,分别于治疗前后采用中医症状积分量表和胃食管反流病问卷量表(Gerd Q)评价两组患者症状改善情况和发生率,分别于治疗前后检测血清胃动素(MOT)、促胃液素和前列腺素(PGE2)水平,参照《中药新药临床研究指导原则》(2002年版)中疗效评价标准比较两组疗效。结果两组治疗后症状积分和Gerd Q评分均明显降低(P<0.05)。治疗后组间比较,观察组症状积分和Gerd Q评分均明显低于对照组(P<0.05),治疗后两组MOT、促胃液素和PGE2水平较治疗前均明显升高(P<0.05),治疗后组间比较,观察组MOT、促胃液素和PGE2水平均明显高于对照组(P<0.05)。观察组总有效率明显高于对照组(Z=-2.488,P=0.013)。结论两种治疗方式均能有效改善肝胃郁热型胃食管反流病的症状,化肝煎加味联合治疗能减少病情复发,改善生活质量,可能与提高胃肠蠕动功能、减轻消化道黏膜损伤有关。

Objective To explore the curative effect of Huagan Decoction combined with omeprazole on gastroesophageal reflux disease with stagnation of liver and stomach heat.Method 80 cases of gastroesophageal reflux patients with stagnation of liver and stomach heat were randomly divided into control group and observation group,with 40 cases in each group.The control group was treated with Omeprazole Magnesium Enteric-coated Tablets,Mosapride Citrate Dispersible Tablets and Aluminum Magnesium Suspension.The observation group was treated with Huagan Decoction on the basis of the control group.The curative effect was observed after a total of 4 weeks of treatment.The TCM Symptom Score Scale and Gastroesophageal Reflux Disease Questionnaire(Gerd Q)scores were used to evaluate the improvement and frequency of symptoms in the two groups before and after treatment.Serum motilin(MOT),gastrin and prostaglandin(PGE2)levels were measured before treatment and 4 weeks after treatment.The efficacy of the two groups was compared with reference to the Guiding Principles for Clinical Research of New Chinese Medicines(2002 Edition).Result The symptom score and Gerd Q score of the two groups were significantly reduced after treatment(P<0.05).After treatment,the symptom score and Gerd Q score of the observation group were significantly lower than those of the control group(P<0.05).The levels of MOT,gastrin and PGE2 in the two groups were significantly higher than before treatment(P<0.05).The levels of MOT,gastrin and PGE2 in the observation group were significantly higher than those of the control group(P<0.05).The total effective rate of the observation group was significantly higher than that of the control group(Z=-2.488,P=0.013).Conclusion Both treatment methods can effectively improve the symptoms of gastroesophageal reflux disease with stagnation of liver and stomach heat.The combined treatment of Huagan Decoction can reduce the recurrence of the disease and improve the quality of life,which may be related to the improvement of gastrointestinal motility and the reduction of gastrointestinal mucosal damage.