左金加味方联合针灸治疗肝胃郁热型胃食管反流病的疗效及对脑肠肽的影响研究

Effect of Zuojin Jiawei Formula combined with acupuncture and moxibustion in treating gastroesophageal reflux disease of liver-stomach stagnation heat type and its impact on brain-gut peptides

目的探讨左金加味方联合针灸治疗肝胃郁热型胃食管反流病的疗效及对脑肠肽的影响。方法选取2021年7月—2022年12月在扬州市中医院脾胃科门诊诊治的160例胃郁热型胃食管反流病患者为研究对象,随机分为西药组、中药组、针刺组、中药结合针刺组,每组40例。西药组以雷贝拉唑为主进行治疗,中药组单用左金加味方治疗,中药结合针刺组在左金加味方基础上予以针灸足三里、中脘、太冲、内关治疗,针刺组予以单纯针灸足三里、中脘、太冲、内关。4组均治疗8周,比较4组临床疗效、治疗前后耐信量表评分、中医主要症状积分、食管黏膜评分、血管活性肠肽水平。结果治疗后,中药结合针刺组治疗总有效率高于其他3组,中医主要症状积分、耐信量表评分、食管黏膜评分、血浆血管活性肠肽水平低于其他3组和治疗前,差异有统计学意义(P<0.05)。结论左金加味方联合针灸可有效减轻胃食管反流病临床症状,促进黏膜愈合,提高治疗效果。

Objective To investigate the therapeutic effect of Zuojin Jiawei Formula combined with acupuncture and moxibustion in gastroesophageal reflux disease(GERD)of liver-stomach stagnation heat type and its impact on brain-gut peptides.Methods A total of 160 patients with GERD of liver-stomach stagnation heat type who were diagnosed and treated at the outpatient department of spleen and stomach of Yangzhou Hospital of Traditional Chinese Medicine from July 2021 to December 2022 were randomly divided into four groups:western medicine group,traditional Chinese medicine group,acupuncture group,and traditional Chinese medicine combined with acupuncture group,with 40 patients in each group.The western medicine group was treated with rabeprazole as the main drug,the traditional Chinese medicine group was treated with Zuojin Jiawei Formula alone,the traditional Chinese medicine combined with acupuncture group was treated with acupuncture at Zusanli,Zhongwan,Taichong,and Neiguan on the basis of Zuojin Jiawei Formula,and the acupuncture group was treated with acupuncture at Zusanli,Zhongwan,Taichong,and Neiguan alone.All four groups were treated for 8 weeks,and the clinical efficacy along with Reflux Disease Questionnaire score,main symptoms score of traditional Chinese medicine,esophageal mucosa score,and vasoactive intestinal peptide level before and after treatment were compared among the four groups.Results After treatment,the total effective rate of the traditional Chinese medicine combined with acupuncture group was higher than the other three groups,and the scores of main symptoms of traditional Chinese medicine,Reflux Disease Questionnaire score,esophageal mucosa score,and plasma vasoactive intestinal peptide levels were lower than the other three groups and before treatment(P<0.05).Conclusion Zuojin Jiawei Formula combined with acupuncture can effectively alleviate the clinical symptoms of GERD,promote mucosal healing,and improve treatment outcomes.