化肝解郁方治疗肝胃郁热型反流性食管炎的临床研究

Clinical study on Huagan Jieyu Formula in treatment of reflux esophagitis with type of liver and stomach stagnant heat

目的:评价化肝解郁方治疗肝胃郁热型反流性食管炎(RE)的临床疗效。方法:将78例肝胃郁热型RE患者随机分为研究组和对照组,每组各39例。研究组患者予化肝解郁方口服,对照组患者予雷贝拉唑口服,两组疗程均为8周。评价两组患者的临床症状总积分,比较两组的临床疗效及胃镜下食管黏膜改善疗效,采用抑郁自评量表(PHQ-9)、广泛性焦虑量表(GAD-7)评价患者的抑郁、焦虑情况。结果:研究过程中,研究组1例、对照组1例患者剔除或脱落,最终纳入统计分析者研究组38例、对照组38例。①治疗后,两组患者的临床症状总积分均显著降低(P<0.05),且研究组患者的积分降低程度较对照组更显著(P<0.05)。②治疗后,研究组患者的临床总有效率为89.47%,对照组为76.32%,研究组患者的疗效优于对照组(P<0.05)。③治疗后,研究组患者的胃镜下食管黏膜改善疗效总有效率为86.11%,对照组为60.61%,研究组患者的疗效优于对照组(P<0.05)。④治疗后,两组患者的PHQ-9、GAD-7积分较治疗前均显著降低(P<0.05),且研究组患者的积分降低程度较对照组更显著(P<0.05)。结论:化肝解郁方可明显改善肝胃郁热型RE患者的临床症状,减轻食管黏膜炎症,并可有效缓解患者的焦虑、抑郁情绪。

Objective:To evaluate the clinical efficacy of Huagan Jieyu Formula in treating reflux esophagitis(RE)with type of liver and stomach stagnant heat.Methods:Seventy-eight patients of RE with type of liver and stomach stagnant heat were randomly divided into the study group and control group,39 cases in each group.The patients in the study group were orally treated with Huagan Jieyu Formula,and the patients in the control group were orally treated with rabeprazole,with a course of 8 weeks.The total scores of clinical symptoms in the two groups were evaluated,the clinical efficacy and the improvement efficacy of esophageal mucosa under gastroscopy were compared between the two groups,and the Patient Health Questionnaire-9(PHQ-9)and the Generalized Anxiety Disorder-7(GAD-7)were applied to assess the depression and anxiety of patients.Results:During the study,one case in the study group and one case in the control group were excluded or shed off.Finally,38 cases in the study group and 38 cases in the control group were included in the statistical analysis.①After treatment,the total scores of clinical symptoms in both groups were significantly decreased(P<0.05),and the degree of score reduction in the study group was more significant than that in the control group(P<0.05).②After treatment,the total clinical effective rate was 89.47%in the study group and 76.32%in the control group,and the effect of the study group was superior to the control group(P<0.05).③After treatment,the total effective rate on the improvement of esophageal mucosa under gastroscopy was 86.11%in the study group and 60.61%in the control group,and the effect of the study group was superior to the control group(P<0.05).④After treatment,the scores of PHQ-9 and GAD-7 in both groups were significantly decreased compared with those before treatment(P<0.05),and the degree of score reduction in the study group was more significant than that in the control group(P<0.05).Conclusion:Huagan Jieyu Formula can significantly improve the clinical symptoms of RE patients with type of liver and stomach stagnant heat,alleviate esophageal mucosal inflammation,and effectively relieve the anxiety and depression of the patients.