中医“治未病”理念下治疗胃食管反流病的效果分析

Effect analysis of treating gastroesophageal reflux disease under the concept of"preventive treatment of disease"of traditional Chinese medicine

目的探讨中医“治未病”理念下治疗胃食管反流病患者的临床效果。方法68例胃食管反流病患者,采用投掷硬币法分为参照组和研究组,每组34例。参照组采用常规西医治疗,研究组在参照组基础上采用中医“治未病”理念下治疗方法治疗。比较两组患者的治疗效果、生活方式评分(规律服药评分、健康饮食评分、作息规律评分以及适当锻炼评分)、不良反应发生率、不良症状(嗳气、反酸以及胃痛)缓解时间、中医证候(嗳气、反酸以及胃痛)积分以及胃肠激素(血清胃泌素、胃动素、血管活性肠肽以及P物质)水平。结果研究组患者治疗总有效率97.06%明显高于参照组的76.47%(P<0.05)。研究组患者规律服药评分(90.25±2.52)分、健康饮食评分(91.74±3.15)分、作息规律评分(90.68±4.22)分以及适当锻炼评分(91.74±5.25)分明显高于参照组的(80.33±3.15)、(81.22±4.15)、(80.28±3.11)、(81.27±4.27)分(P<0.05)。两组患者不良反应发生率比较无明显差异(P>0.05)。研究组患者嗳气、反酸以及胃痛缓解时间分别为(3.25±0.75)、(2.19±0.45)、(1.19±0.31)d,明显短于参照组的(6.63±0.45)、(6.96±0.39)、(3.33±0.89)d(P<0.05)。治疗后,研究组患者嗳气、反酸、胃痛积分分别为(2.12±0.25)、(2.15±0.33)、(2.16±0.37)分,均低于参照组的(4.15±0.33)、(4.16±0.35)、(4.19±3.12)分(P<0.05)。治疗后,研究组患者血清胃泌素(64.59±5.55)pg/ml、胃动素(263.49±14.61)pg/ml、P物质(29.75±1.86)pg/ml高于参照组的(55.63±8.95)、(210.36±16.85)、(26.49±5.52)pg/ml,血管活性肠肽(53.75±7.35)pg/ml低于参照组的(58.49±9.81)pg/ml(P<0.05)。结论临床中医“治未病”理念下治疗方法的有效应用,可显著提升胃食管反流病患者的总体疗效,显著改善患者的生活方式、中医证候以及胃肠激素水平,有效缩短不良症状缓解时间,并且不会导致不良反应增加,值得临床推广应用。

Objective To explore the clinical effect of treating gastroesophageal reflux disease under the concept of"preventive treatment of disease"of traditional Chinese medicine.Methods 68 patients with gastroesophageal reflux disease were divided into a reference group and a study group by coin tossing method,with 34 cases in each group.The reference group was treated with conventional Western medicine,and the study group was treated under the concept of"preventive treatment of disease"of traditional Chinese medicine.Patients in both groups were compared in terms of treatment rate,lifestyle score(regular medication score,healthy diet score,regular rest score and appropriate exercise score),incidence of adverse reactions,relief time of adverse symptoms(belching,acid reflux and stomachache)and traditional Chinese medicine syndrome(belching score,acid reflux score and stomachache score)and gastrointestinal hormone(serum gastrin,motilin,vasoactive intestinal peptide,and substance P)levels.Results The total effective rate of 97.06%in the study group was significantly higher than 76.47%in the reference group(P<0.05).In the study group,the regular medication score was(90.25±2.52)points,the healthy diet score was(91.74±3.15)points,the regular rest score was(90.68±4.22)points and the appropriate exercise score was(91.74±5.25)points,which were significantly higher than(80.33±3.15),(81.22±4.15),(81.22±4.15),(80.28±3.11)and(81.27±4.27)points in the reference group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).The time to remission of belching,acid reflux and stomachache in the study group were(3.25±0.75),(2.19±0.45)and(1.19±0.31)d,which were significantly shorter than(6.63±0.45),(6.96±0.39)and(3.33±0.89)d in the reference group(P<0.05).After treatment,the scores of belching,acid reflux and stomachache in the study group were(2.12±0.25),(2.15±0.33)and(2.16±0.37)points,which were lower than(4.15±0.33),(4.16±0.35)and(4.19±3.12)points in the reference group(P<0.05).After treatment,the study group had serum gastrin of(64.59±5.55)pg/ml,motilin of(263.49±14.61)pg/ml and substance P of(29.75±1.86)pg/ml,which were higher than(55.63±8.95),(210.36±16.85)and(26.49±5.52)pg/ml in the reference group;the vasoactive intestinal peptide of(53.75±7.35)pg/ml in the study group was lower than(58.49±9.81)pg/ml in the reference group(P<0.05).Conclusion The effective application of the concept of"preventive treatment of disease"of traditional Chinese medicine can significantly improve the overall curative effect of patients with gastroesophageal reflux disease,improve the lifestyle,traditional Chinese medicine syndrome and gastrointestinal hormone levels of patients,effectively shorten the time for alleviating adverse symptoms,and will not lead to increased adverse reactions.It is worthy of clinical promotion.