探究清胆和胃降逆方治疗胃食管反流病胆热犯胃证的疗效观察与机理探讨.pdfVIP

提 要 目的：探讨清胆和胃降逆方治疗胃食管反流病（GERD ）胆热犯胃证的临床疗效、 安全性及机理。方法：按照随机、对照的原则将符合本研究标准的 60 例患者分为治 疗组 30 例，对照组 30 例。治疗组口服清胆和胃降逆方煎剂；对照组口服奥美拉唑肠 溶片，每次 10mg（1 片），每天 2 次，莫沙必利，每次 5mg（1 片），每天 3 次，饭前 服。均连续 8 周（1 疗程），治疗期间两组均不再服用其他治疗该病的药物。观察治 疗前后两组的临床症状、体征、胃镜、病理疗效及血、尿常规、心、肝、肾功能等安 全性检测，并进行统计学分析。结果：临床总疗效有效率比较，治疗组为 90.00 ％， 对照组为 83.33 ％，无显著性差异（P ＞0.05 ）；两组患者中医证候疗效比较，有显著 性差异（P＜0.05 ）；两组患者单项症状对比经t检验，除烧心、泛酸、胸痛症状无显 著性差异外，余均有显著性差异（P＜0.05 ）；两组患者内镜下疗效比较，治疗组总有 效率为 88.89 ％，对照组为84.62 ％，无显著性差异（P＞0.05）。结论：清胆和胃降逆 方能显著减轻或消除胃食管反流病胆热犯胃证患者的临床症状，改善和（或）消除炎 症，疗效确切，无不良反应。其机理可能与促进胃肠运动功能，抗炎抑菌，增强胃食 管黏膜屏障功能有关。 关键词 胃食管反流病；清胆和胃降逆方；胆热犯胃证 Clinical Study on Qingdan hewei jiangni Decoction in Treating Gallbladder heat invading stomach Syndrome of Gastroesophageal Reflux Disease Speciality: Internal medicine of integrated traditional Chinese and Western medicine Author ：CHEN YAN Tutor：Prof ．Yao Baotai Abstract Objective:To evaluate the therapeutic effect,mechanism and safety of Qingdan hewei jiangni decoction in treating gastroesophageal reflux disease (GERD) due to gallbladder heat invading stomach. Methods: 60 qualified cases of GERD were randomly divided into the treatment group(30 cases) and the control group(30 cases).The treatment group took Qingdan hewei jiangni decoction and the control group took Omeprazole enteric coated tablets plus Mosapride,respectively,for 8 weeks.The symptoms scoring,gastroscopy and pathology as well as blood and urine routine tests,liver and kidney function were observed to verify the efficacy and safety of Qingdan hewei jingni decoction.Results:There was no significant difference between the treatment and control group in totol clinical rate(90.00% vs 83.33%,P0.05) and gastroscopy examination(88.89% vs 84.62%,P0.05),respe