柴胡疏肝散联合雷贝拉唑治疗返流性食管炎(肝胃不和)随机平行对照研究

Randomized controlled Trial of Chaihu Shugan Powder combined with Rabeprazole in the Treatment of Reflux Esophagitis(Hepatic and Gastric Disharmony)

[目的]观察柴胡疏肝散联合雷贝拉唑治疗返流性食管炎(肝胃不和)疗效。[方法]使用随机平行对照方法,将98例住院患者按病志号抽签随机分两组;禁食辛辣刺激性及寒凉食物,忌烟酒。对照组49例雷贝拉唑,20mg/次,2次/d。治疗组49例柴胡疏肝散(柴胡、白芍各15g,川芎、枳壳、香附、甘草炙、陈皮各10g,泛酸加减浙贝母12g、瓦楞子煅15g,海螵蛸30g;烧心加蒲公英20g;胃脘针刺痛、舌紫有瘀斑加延胡索15g,丹参20g),1剂/d,水煎600mL,分早晚2次服,300mL/次;雷贝拉唑治疗同对照组。连续治疗8周为1疗程。观测临床表现、证候积分、食管黏膜、复发率、不良反应。治疗1疗程,随访4周,判定疗效。[结果]治疗组治愈16例,显效24例,有效6例,无效3例,总有效率93.88%;对照组治愈8例,显效21例,有效20例,无效10例,总有效率79.59%;治疗组疗效优于对照组(P<0.05)。内镜疗效治疗组治愈17例,显效22例,有效4例,无效6例,总有效率87.76%;对照组治愈15例,显效21例,有效5例,无效8例,总有效率83.67%;两组间无明显差异(P>0.05)。随访4周,治疗组复发率明显低于对照组(P<0.05)。[结论]柴胡疏肝散联合雷贝拉唑治疗返流性食管炎(肝胃不和),疗效满意,无严重不良反应,值得推广。

[Objective]To observe the curative effect of Chaihu Shugan Powder combined with rabeprazole in the treatment of reflux esophagitis(hepatic and gastric disharmony).[Methods]98 hospitalized patients were randomly divided into two groups by parallel control method.During the period,fasting spicy and cold foods such as pepper,tea,coffee,etc.were avoided.In the control group,49 cases were given rabeprazole,20 mg/time,2 times/d.In the treatment group,49 cases were given Chaihu Shugan Powder(15 g of Bupleurum and Radix Paeoniae Alba,10 g of Chuanxiong,Clam Shell,Xiangfu,Licorice,and Tangerine,12 g of Pantothenic Acid,15 g of Calyx,and 15 g of Radix Paeoniae);heartburn plus dandelion 20 g;stomach sputum acupuncture pain,tongue purple with freckle plus Yanhusuo 15 g,salvia 20 g),1 dose/d,decoction 600 mL,divided into morning and evening 2 times,300 mL/time;The rabeprazole treatment was given according to the control group.Continuous treatment for 8 weeks is a course of treatment.Observe clinical manifestations,recurrence rates,and adverse reactions were observed.after 1 course of treatment,the efficacy was evaluated.[Results]The clinical curative effect,the treatment group:16 cases werecured,24 cases were markedly effective,6 cases were effective,3 cases were ineffective,and the total effective rate was 93.88%.The control group:8 cases were cured,21 caseswere markedly effective,20 cases were effective,10 cases were ineffective in,and the total effective rate was 79.59%;The treatment group was better than the control group(P<0.05).Endoscopic treatment:the treatment group 17 cases were cured,22 cases were markedly effective,4 cases were effective,6 cases were ineffective,the total effective rate was 87.76%;The control group:15 cases were cured,21 cases were markedly effective,5 cases were effective,8 cases were ineffective,the total effective rate was 83.67%,there was no significant difference between the two groups(P>0.05).The recurrence rate of the treatment group was significantly lower than that of the control group(P<0.05).[Conclusion]Chaihu Shugan powder combined with rabeprazole in the treatment of reflux esophagitis(hepatic and gastric disharmony)has satisfactory curative effect and no serious adverse reactions,which is worthy of promotion.