和胃降逆止嗽方治疗胃食管反流性咳嗽(胃气上逆证)临床研究

Clinical study of Hewei Jiangni Zhisou Formula in Treating Gastroesophageal Reflux Cough(Stomach-qi Inverse Syndrome)

目的观察和胃降逆止嗽方治疗胃食管反流性咳嗽(胃气上逆证)临床效果。方法96例胃食管反流性咳嗽(胃气上逆证)患者按照随机数字表法分为对照组和观察组各48例。对照组采用调整生活方式联合常规西药治疗,观察组采用调整生活方式联合和胃降逆止嗽方治疗。治疗12周后,评价两组中医证候积分(阵发性咳嗽、咳嗽时泛酸水、嘈杂、上腹不适)、莱塞斯特咳嗽生命质量问卷(lesser cough quality of life questionnaire,LCQ)评分、反流性疾病问卷(reflux disease questionnaire,RDQ)评分、食管运动功能(食管收缩波幅、食管蠕动波传导速度、平均收缩持续时间)、临床治疗效果、疾病复发概率以及治疗安全性。结果比较发现观察组治疗有效率明显高于对照组,对比有统计学差异;对比两组患者治疗后出现阵发性咳嗽等临床症状的概率,发现患者RDQ评分均有下降,但是观察组评分下降较为明显(P<0.05)。两组治疗后LCQ评分均升高(P<0.05),且观察组LCQ评分高于对照组(P<0.05)。治疗后,发现两组患者食管收缩波幅、食管蠕动波传导速度都出现了升高的情况(P<0.05),持续收缩时间明显缩短(P<0.05),且观察组食管运动功能指标改善情况都高于对照组,两组患者对比有统计学差异P<0.05,观察组3个月复发率和治疗后6个月复发率都较低,分别低于对照组3个月复发率(16.67%)和治疗后6个月的复发率(39.58%)(P<0.05)。治疗期间两组患者不良反应发生率相比无统计学意义。结论和胃降逆止嗽方可以有效缓解患者临床症状,同时,还能够促进患者食管运动,减少临床复发,改善生活质量,且治疗安全性高。

Objective To observe the clinical effect of Hewei Jiangni Zhisou formula in the treatment of gastroesophageal reflux cough(stomach-qi inverse syndrome).Methods 96 patients with gastroesophageal reflux cough were divided into control group and observation group randomly,48 cases in each group.The control group was treated with adjusted lifestyle combined with conventional western medicine,and the observation group was treated with adjusted lifestyle combined with Hewei Jiangni Zhisou formula prescription.After 12 weeks of treatment,two groups of traditional Chinese medicine syndrome scores(paroxysmal cough,acid reflux during coughing,noise,upper abdominal discomfort),Lesser cough quality of life questionnaire(LCQ)score,reflux disease questionnaire(RDQ)score,esophageal motility function(esophageal systolic wave amplitude,esophageal peristaltic wave conduction velocity,average systolic duration),clinical treatment efficacy,disease recurrence probability,and treatment safety were evaluated.Results The effective rate of treatment in the observation group was significantly higher than that in the control group,and there was a statistically significant difference between the two groups of patients.It was found that the RDQ scores of both patients decreased,but the observation group showed a more significant decrease in scores(P<0.05).After treatment,both groups showed an increase in LCQ scores(P<0.05),with the observation group having a higher LCQ score than the control group(P<0.05).After treatment,it was found that the amplitude of esophageal contraction wave and the conduction velocity of esophageal peristaltic wave increased in both groups of patients(P<0.05),and the duration of continuous contraction was significantly shortened(P<0.05).In addition,the improvement of esophageal motility indicators in the observation group was higher than that in the control group(P<0.05).The observation group had lower recurrence rates at 3 months and 6 months after treatment,which were lower than the control group’s 3-month recurrence rate(16.67%)and 6 months after treatment(39.58%),respectively(P<0.05).There was no statistically significant difference in the probability of adverse reactions between the two groups of patients during the treatment period.Conclusion Hewei Jiangni Zhisou formula can effectively relieve the clinical symptoms of the patients,at the same time,it can promote the esophageal movement,reduce the clinical recurrence,improve the quality of life,and the treatment is safe.