理中汤合半夏厚朴汤加减治疗老年胃食管反流病寒证的疗效及随访分析

Curative effect and follow-up results of modified Lizhong Decoction combined with Banxia Houpu Decoction on elderly patients with gastroesophageal reflux disease of cold syndrome

目的观察理中汤合半夏厚朴汤加减治疗老年胃食管反流病(GERD)寒证的疗效及随访结果。方法将72例老年GERD寒证患者按照随机数字表法分为2组,对照组33例予常规西药治疗,治疗组39例在对照组治疗基础上加用理中汤合半夏厚朴汤加减治疗,2组均治疗1个月。比较2组治疗前后中医证候评分、胃食管反流病诊断问卷(Gerd-Q)评分及简明健康测量量表(SF-36)评分变化;比较2组临床疗效;比较2组不良反应及复发情况。结果2组治疗后中医证候评分、Gerd-Q评分均较本组治疗前降低(P<0.05),SF-36评分较本组治疗前升高(P<0.05);治疗后治疗组中医证候评分、Gerd-Q评分均低于对照组(P<0.05),SF-36评分高于对照组(P<0.05)。治疗组总有效率94.87%(37/39),对照组总有效率75.76%(25/33),治疗组疗效优于对照组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。治疗组复发率16.67%(2/12),对照组复发率33.33%(2/6),2组复发率比较差异有统计学意义(P<0.05)。结论理中汤合半夏厚朴汤加减治疗老年GERD寒证临床疗效确切,能改善患者症状,且安全性好,能预防GERD复发。

Objective To observe the curative effect and follow-up results of modified Lizhong Decoction combined with Banxia Houpu Decoction on elderly patients with gastroesophageal reflux disease(GERD)of cold syndrome.Methods A total of 72 elderly patients with GERD(cold syndrome)were randomly assigned into the treatment group(n=39)and the control group(n=33).All patients were managed by conventional Western medicine,and those in the treatment group were additionally treated with modified Lizhong Decoction combined with Banxia Houpu Decoction.Treated for 1 month,aiming to compare traditional Chinese medicine(TCM)syndrome score,GERD-questionnaire(GERD-Q)score,short-form 36 health survey scale(SF-36).The curative effect,adverse reaction,recurrence were assessed.Results After treatment,significantly decreased TCM syndrome score and GERD-Q score,and significantly increased SF-36 score were detected in the two groups(all P<0.05),and the treatment group was superior to the control group for TCM syndrome score,GERD-Q and SF-36 scores(all P<0.05).The overall effective rate was significantly higher in the treatment group(94.87%[37/39])compared with the control group(75.76%[25/33]),(P<0.05).The difference was not statistically significant in the incidence of adverse reactions between groups(P>0.05).The recurrence rate in the treatment group was significantly lower than that in the control group(16.67%[2/12]vs 33.33%[2/6],[P<0.05],respectively).Conclusion For elderly patients with GERD(cold syndrome),modified Lizhong Decoction combined with Banxia Houpu Decoction has definite clinical efficacy,can improve symptoms,prevent recurrence,and with good safety.