疏肝和胃降逆汤联合隔药灸脐法对肝胃不和证反流性食管炎患者的疗效分析

Analysis of curative effect of Shugan Hewei Jiangni decoction combined with herb-separated moxibustion on navel in the treatment of reflux esophagitis patients with liver and stomach dishonant syndrome

目的 探讨疏肝和胃降逆汤联合隔药灸脐法对肝胃不和证反流性食管炎(reflux esophagitis,RE)患者的疗效。方法 选取2019年9月至2020年9月本院收治的112例肝胃不和证RE患者,分为对照组(常规+隔药灸脐)和研究组(常规+隔药灸脐法+疏肝和胃降逆汤),每组56例。比较两组临床疗效、治疗前后胃肠激素水平、胃肠动力学指标、血清炎症因子水平以及6个月的复发率。结果 研究组总有效率(94.64%)高于对照组(82.14%)(P=0.039)。研究组的中医症状积分较对照组降低(P<0.05)。研究组的血清胆囊收缩素、血管活性肠肽以及5-羟色胺水平较对照组降低(P<0.05)。研究组胃泌素、胃动素以及生长抑素水平较对照组升高(P<0.05)。研究组C反应蛋白、肿瘤坏死因子-α以及白介素-1β水平较对照组降低(P<0.05)。研究组6个月复发率(1.79%)低于对照组(16.07%)(P<0.05)。结论 疏肝和胃降逆汤联合隔药灸脐法可有效改善肝胃不和证RE患者的临床症状,调节胃肠激素水平,改善胃动力学,以及调节血清炎症因子和降低复发率。

Objective To investigate the curative effect of Shugan Hewei Jiangni decoction combined with herbseparated moxibustion on navel in the treatment of reflux esophagitis(RE)patients with liver and stomach dishonant syndrome.Methods A total of 112 cases of RE patients with liver and stomach disordered syndrome admitted to our hospital from September 2019 to September 2020 were selected and divided into control group(routine+herb-separated moxibustion on navel)and research group(routine+herb-separated moxibustion on navel+Shugan Hewei Jiangni decoction),with 56 cases in each group.The clinical efficacy,gastrointestinal hormone levels,gastrointestinal dynamics indexes,serum inflammatory factor levels before and after treatment and 6-month recurrence rate were compared between the two groups.Results After treatment,the total effective rate of the study group(94.64%)was higher than that of the control group(82.14%)(P=0.039).Compared with the control group,the levels of traditional Chinese medicine symptom score,serum cholecystokinin,vasoactive intestinal peptide,5-hydroxytryptamine,C-reactive protein,tumor necrosis factor-αand interleukin-1βwere significantly decreased in the study group(P<0.05),but the levels of gastrin,motilin and somatostatin were significantly increased(P<0.05).The 6 months recurrence rate of the study group(1.79%)was lower than that of the control group(16.07%)(P<0.05).Conclusion Shugan Hewei Jiangni decoction combined with herbseparated moxibustion on navel can effectively improve the clinical symptoms,regulate gastrointestinal hormone levels,improve gastric dynamics,regulate serum inflammatory factors and reduce the recurrence rate of patients with liver and stomach dishonant syndrome RE.