穴位贴敷联合质子泵抑制剂治疗胃食管反流病疗效研究

Study on the efficacy of acupoint application combined with proton pump inhibitors in treatment of gastroesophageal reflux disease

目的 观察穴位贴敷联合质子泵抑制剂(PPI)治疗胃食管反流病(GRD)临床疗效。方法 将我院130例GRD患者随机分为观察组与对照组各65例。对照组给予PPI治疗,观察组给予穴位贴敷联合PPI治疗。比较两组总有效率,洛杉矶分级标准,中医证候评分,生活质量量表评分,24 h反流时间≥5 min次数、pH<4时间,食管上括约肌静息压(UESP)、食管下括约肌静息压(LESP),泌素(GAS)、血管活性肠肽(VIP)、白介素-6(IL-6)、C反应蛋白(CRP)。结果 治疗后,观察组总有效率高于对照组(P<0.05);两组洛杉矶食管分级优于治疗前观察组洛杉矶食管分级均优于对照组(P<0.05);两组中医证候评分,24h内反流时间≥5min次数、pH<4时间,VIP、IL-6、CRP含量均低于治疗前观察组上述指标均低于对照组(P<0.05);两组生活质量量表评分,UESP、LESP,GAS含量高于治疗前,观察组上述指标均高于对照组(P<0.05)。结论 穴位贴敷联合PPI治疗GRD近期疗效优,促进食管黏膜恢复,降低中医证候评分,降低反流次数和pH<4时间,提高生活质量,恢复食管括约肌静息压,调节胃肠激素,降低促炎因子水平。

Objective To observe the efficacy of acupoint application combined with proton pump inhibitors(PPIs)in treatment of gastroesophageal reflux disease(GRD).Methods A total of 130 GRD patients were randomly divided into observation group and control group,with 65 cases in each group.Control group was treated with PPI,and observation group was treated with acupoint application on the basis of control group.The total effective rate,Los Angeles grading criteria,TCM pattern score,quality of life scale score,24 h reflux time≥5 min times,pHP<4 time,upper esophageal sphincter resting pressure(UESP),lower esophageal sphincter resting pressure(LESP),secretin(GAS),vasoactive intestinal peptide(VIP),interleukin-6(IL-6)and C-reactive protein(CRP)were compared between the two groups.Results After treatment,the total effective rate of observation group was higher than that of control group(P<0.05);the Los Angeles esophageal grade in both groups was better than that before treatment,and were better in observation group than control group(P<0.05);the TCM pattern scores,24 h reflux time≥5 min times,pHP<4 time,VIP,IL-6 and CRP content of both groups were lower than those before treatment,and were lower in observation group than control group(P<0.05);the quality of life scale scores,UESP,LESP,and GAS contents in both groups were higher than those before treatment,and were higher in observation group than control group(P<0.05).Conclusion Acupoint application combined with PPI has excellent short-term efficacy in treatment of GRD,promoting the recovery of esophageal mucosa,reducing TCM pattern scores,reducing the number of reflux and pHP<4 time,improving quality of life,restoring esophageal sphincter resting pressure,regulating gastrointestinal hormones,and reducingproinflammatory factor levels.