疏肝和胃方合左金丸加减治疗肝胃郁热型胃食管反流病的疗效及对胃肠激素水平的影响

Efficacy of Shugan Hewei formula combined with modified Zuojin pill in the treatment of GERD with liver-stomach heat stagnation syndrome and its effect on gastrointestinal hormone levels

目的探讨疏肝和胃方合左金丸加减治疗肝胃郁热型胃食管反流病的疗效及其对胃肠激素水平的影响。方法选择2018年4月至2019年5月东莞康华医院中医科收治的肝胃郁热型胃食管反流病患者80例,采用随机数字表法将患者分为试验组和对照组,每组各40例。对照组给予奥美拉唑肠溶胶囊治疗。试验组除了口服奥美拉唑肠溶胶囊外,同时给予疏肝和胃方联合左金丸加减治疗。比较两组治疗前后的症状(烧心、反酸、反食、胸骨后灼痛)评分及胃泌素、胃动素、血管活性肠肽变化情况,同时记录两组不良反应发生情况。结果治疗后,试验组的烧心、反酸、反食、胸骨后灼痛评分低于对照组,差异有统计学意义(P<0.05)。两组治疗后胃泌素、胃动素均高于本组治疗前,而血管活性肠肽均明显低于本组治疗前,差异有统计学意义(P<0.05)。试验组治疗后的胃泌素、胃动素水平高于对照组,血管活性肠肽低于对照组,差异有统计学意义(P<0.05)。试验组总有效率高于对照组,差异有统计学意义(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)。结论在西药基础上,给予疏肝和胃方合左金丸治疗肝胃郁热型胃食管反流病,可获得更好的效果,患者症状明显改善,纠正其胃肠激素的紊乱状态,且安全性良好。

Objective To investigate the efficacy of Shugan Hewei formula combined with modified Zuojin Pill in the treatment of gastroesophageal reflux disease(GERD)with liver-stomach heat stagnation syndrome and its effect on gastrointestinal hormones.Methods A total of 80 GERD patients with liver-stomach heat stagnation syndrome admitted to the Department of Traditional Chinese Medicine in Dongguan Kanghua Hospital from April 2018 to May 2019 were selected and divided into the experimental group and the control group according to the random number table method,with 40 cases in each group.The control group was treated with omeprazole enteric-coated capsules,while the experimental group was treated with Shugan Hewei formula combined with modified Zuojin pill in addition to the oral administration of omeprazole enteric-coated capsules.The symptoms(heartburn,acid reflux,regurgitation,and burning pain behind the sternum)scores and changes in gastrin,motilin and vasoactive intestinal peptide before and after treatment were compared between the two groups,and the incidence of adverse reactions in both groups was also recorded.Results After treatment,the scores of heartburn,acid reflux,regurgitation and post sternal burning pain in the experimental group were lower than those in the control group,with statistically significant differences(P<0.05).The levels of gastrin and motilin in both groups after treatment were higher than those before treatment,while the level of vasoactive intestinal peptide in both groups after treatment was significantly lower than that before treatment,with statistically significant differences(P<0.05).After treatment,the levels of gastrin and motilin in the experimental group were higher than those in the control group,while the level of vasoactive intestinal peptide was lower than that in the control group,with statistically significant differences(P<0.05).The overall effective rate of the experimental group was higher than that of the control group,with statistically significant difference(P<0.05).There was no statistically significant difference between the two groups in the incidence of adverse reaction(P>0.05).Conclusion Based on western medicine,the combination of Shugan Hewei formula and Zuojin pill can achieve better efficacy in the treatment of GERD with liverstomach heat stagnation syndrome,with significantly improved symptoms and corrected gastrointestinal hormone disorders of patients,and high safety.