和胃理气降浊方、穴位按摩联合西药治疗肝胃郁热型老年反流性食管炎临床研究

Effect of Hewei Liqi Jiangzhuo Decoction and acupoint massage combined with Western medicine on reflux esophagitis with liver-stomach heat syndrome in the elderly patients

目的观察和胃理气降浊方、穴位按摩联合西药治疗肝胃郁热型老年反流性食管炎(RE)的临床效果。方法选取120例肝胃郁热型老年RE患者作为研究对象,采用随机数字表法分为2组。对照组60例予雷贝拉唑钠肠溶胶囊联合枸橼酸莫沙必利片治疗,治疗组60例在对照组治疗基础上加和胃理气降浊方及穴位按摩治疗,2组均治疗8周后统计疗效,比较2组治疗前后中医症状积分、最长反流时间和总反流次数、血清胃泌素(GAS)和血浆胃动素(MTL)水平、健康状况调查简表(SF-36)评分变化情况,对2组痊愈和显效病例随访12周,统计复发率。结果治疗组总有效率88.33%(53/60),复发率23.25%(10/43),对照组分别为70.00%(42/60)、56.25%(18/32),治疗组总有效率高于对照组(P<0.05),复发率低于对照组(P<0.05)。治疗后,治疗组除易饥外、对照组除易怒外,其余各中医症状评分均较本组治疗前下降(P<0.05);治疗后,治疗组烧心或烧灼感、易怒评分及总分均低于对照组(P<0.05)。治疗后,2组最长反流时间均较本组治疗前缩短(P<0.05),总反流次数减少(P<0.05),且治疗组最长反流时间短于对照组(P<0.05),总反流次数少于对照组(P<0.05)。治疗后,2组GAS和MTL水平及SF-36各维度评分均较本组治疗前升高(P<0.05),且治疗组均显著高于对照组(P<0.05)。结论和胃理气降浊方、穴位按摩联合西药治疗能有效改善肝胃郁热型老年RE患者的临床症状,提高其生活质量,降低复发率。

Objective To observe the effect of Hewei Liqi Jiangzhuo Decoction and acupoint massage combined with Western medicine in treating reflux esophagitis(RE)with liver-stomach heat syndrome in the elderly patients.Methods A total of 120 elderly patients with RE(liver-stomach heat syndrome)were randomly assigned into control group(n=60)and treatment group(n=60).On the basis of conventional Western medicine(Rabeprazole Capsules+Mosapride Citrate Tablets),the treatment group was additionally treated with Hewei Liqi Jiangzhuo Decoction and acupoint massage.After 8 weeks of treatment,the clinical efficacy,traditional Chinese medicine(TCM)syndrome score,the longest reflux duration and total reflux events,the levels of serum gastrin(GAS)and plasma motilin(MTL),and the short form 36 health survey questionnaire(SF-36)scores were include as comparisons between the two groups.A 12-week follow-up was performed to count the recurrence rate.Results After 8 weeks of treatment,the clinical effect in the treatment group(88.33%[53/60]vs 70.00%[42/60])and the recurrence rate(23.25%[10/43]vs 56.25%[18/32])were better than those in the control group(all P<0.05).Except for hunger in the treatment group and irritability in the control group,the other scores of TCM symptoms in the both groups were significantly lower than those before treatment(P<0.05).The scores of heartburn,burning sensation,irritability and total score in the treatment group were significantly lower than those in the control group(P<0.05).The longest reflux duration and total reflux events in the two groups were better than those before treatment(both P<0.05),and the improvements were more pronounced in the treatment group(both P<0.05).The levels of GAS and MTL and the scores of SF-36 in the both groups were significantly increased(P<0.05),and the increase in the treatment group was more significant(P<0.05).Conclusion For elderly patients with RE(liver-stomach heat syndrome),Hewei Liqi Jiangzhuo Decoction and acupoint massage combined with Western medicine can effectively improve the clinical symptoms,improve the quality of life,reduce the recurrence rate of these patients.