旋覆代赭汤联合针刀治疗难治性胃食管反流病的临床疗效观察

Clinical Observation of Xuanfu Daizhe Decoction Combined with Acupotomy in the Treatment of Refractory Gastroesophageal Reflux Disease

目的观察旋覆代赭汤联合针刀治疗难治性胃食管反流病的临床疗效。方法选取2019年10月-2020年10月在天津市南开区三潭医院诊治的60例难治性胃食管反流病患者为研究对象,采用随机数字表法分为对照组和研究组,各30例。对照组给予埃索美拉唑镁肠溶片联合莫沙必利治疗,研究组给予旋覆代赭汤联合针刀治疗。比较两组临床治疗疗效、胃食管反流病问卷(RDQ)评分、T_(3)~T_(8)棘突下压痛程度、复发率以及不良反应。结果研究组治疗总有效率为90.00%,高于对照组的76.67%(P<0.05);两组治疗后烧心、胸骨后疼痛、泛酸、嗳气各RDQ评分均低于治疗前,且研究组低于对照组(P<0.05);两组治疗后T_(3)~T_(8)棘突下旁开1.5 cm处压痛程度均减轻,且研究组压痛减轻程度优于对照组,但仅有T_(3)、T_(5)、T_(6)处疼痛度低于对照组(P<0.05);随访6个月,研究组复发率为13.33%,低于对照组的30.00%(P<0.05);研究组不良反应发生率为6.67%,低于对照组的16.67%(P<0.05)。结论旋覆代赭汤联合针刀治疗难治性胃食管反流病效果确切,可显著减轻患者临床症状,改善患者疼痛度,降低复发率和不良反应发生率,是一种安全、有效的治疗方案。

Objective To observe the clinical efficacy of Xuanfu Daizhe decoction combined with acupotomy in the treatment of refractory gastroesophageal reflux disease.Methods A total of 60 patients with refractory gastroesophageal reflux disease who were treated in Santan Hospital of Nankai District of Tianjin from October 2019 to October 2020 were selected as the research objects.They were divided into control group and study group by random number table method,with 30 cases in each group.The control group was treated with esomeprazole magnesium enteric-coated tablets combined with mosapride,and the study group was treated with Xuanzhan Daizhe decoction combined with acupotomy.The clinical efficacy,gastroesophageal reflux disease questionnaire(RDQ)score,T_(3)-T_(8)subspinous tenderness,recurrence rate and adverse reactions were compared between the two groups.Results The total effective rate of the study group was 90.00%,which was higher than 76.67%of the control group(P<0.05).The RDQ scores of heartburn,retrosternal pain,pantothenic acid and belching in the two groups after treatment were lower than those before treatment,and those in the study group were lower than the control group(P<0.05).After treatment,the degree of tenderness at 1.5 cm below spinous process of T_(3)-T_(8)in both groups was reduced,and the degree of tenderness in the study group was better than that in the control group,but only the degree of pain at T_(3),T_(5)and T_(6)was lower than that in the control group(P<0.05).After 6 months of follow-up,the recurrence rate of the study group was 13.33%,which was lower than 30.00%of the control group(P<0.05).The incidence of adverse reactions in the study group was 6.67%,which was lower than 16.67%in the control group(P<0.05).Conclusion Xuanfu Daizhe decoction combined with acupotomy is effective in the treatment of refractory gastroesophageal reflux disease,which can significantly relieve the clinical symptoms,improve the pain degree of patients,reduce the recurrence rate and the incidence of adverse reactions.It is a safe and effective treatment plan.