半夏厚朴汤加减联合针刺治疗痰气郁结型胃食管反流病临床研究

Clinical Study on Modified Banxia Houpu Tang Combined with Acupuncture for Gastroesophageal Reflux Disease of Phlegm-Qi Depression Type

目的:观察半夏厚朴汤加减联合针刺治疗痰气郁结型胃食管反流病的临床疗效。方法:选取60例痰气郁结型胃食管反流病患者作为研究对象,按随机数字表法分为观察组和对照组各30例。对照组给予常规西医治疗,观察组给予半夏厚朴汤加减联合针刺治疗。比较2组治疗前后中医证候积分、食管黏膜环氧合酶-2(COX-2)、蛋白激酶受体-2(PAR-2)mRNA表达量以及临床治疗效果。结果:观察组总有效率为93.3%,高于对照组70.0%,差异有统计学意义(P<0.05)。治疗前,2组胸脘气闷、咽部灼热、反酸、嗳气叹息积分比较,差异无统计学意义(P>0.05)。治疗后,2组胸脘气闷、咽部灼热、反酸、嗳气叹息积分较治疗前降低(P<0.05),且观察组胸脘气闷、咽部灼热、反酸、嗳气叹息评分均低于对照组(P<0.05)。治疗前,2组食管黏膜COX-2、PAR-2 mRNA表达比较,差异无统计学意义(P>0.05)。治疗后,2组COX-2、PAR-2mRNA表达较治疗前降低,且观察组COX-2、PAR-2 mRNA表达低于对照组,差异有统计学意义(P<0.05)。结论:半夏厚朴汤加减联合针刺治疗痰气郁结型胃食管反流病疗效较好,可改善患者中医证候,降低食管黏膜COX-2、PAR-2 mRNA表达。

Objective:To observe the clinical effect of modified Banxia Houpu tang combined with acupuncture for gastroesophageal reflux disease of phlegm-qi depression type.Methods:A total of60 cases of patients with gastroesophageal reflux disease of phlegm-qi depression type were selected as the study objects,and were divided into the observation group and the control group according to the random number table method,with 30 cases in each group.The control group was treated with routine western medicine,and the observation group was treated with modified Banxia Houpu tang combined with acupuncture.Chinese medicine syndrome scores and mRNA expression levels of cyclooxygenase-2(COX-2)and protease activated receptor-2(PAR-2)in esophageal mucosa before and after treatment as well as clinical effects in the two groups were compared.Results:The total effective rate was 93.3%in the observation group,higher than that of 70.0%in the control group,the difference being significant(P<0.05).Before treatment,there were no significant difference being found in the comparison of the scores of chest oppression,pharyngeal burning,acid reflux and belching and sighing between the two groups(P>0.05).After treatment,the scores of chest oppression,pharyngeal burning,acid reflux and belching and sighing in the two groups were decreased when compared with those before treatment(P<0.05),and the above scores in the observation group were lower than those in the control group(P<0.05).Before treatment,there was no significant difference being found in the comparison of mRNA expressions of COX-2 and PAR-2 in esophageal mucosa between the two groups(P>0.05).After treatment,the mRNA expressions of COX-2 and PAR-2 in the two groups were decreased when compared with those before treatment,and the m RNA expressions of COX-2 and PAR-2 in the observation group were lower than those in the control group,the difference being significant(P<0.05).Conclusion:The therapy of modified Banxia Houpu tang combined with acupuncture for gastroesophageal reflux disease of phlegm-qi depression type has a good curative effect,which can improve the Chinese medicine syndromes of patients and reduce the mRNA expressions of COX-2 and PAR-2 in esophageal mucosa.