探究清热和胃降逆方治疗胃食管反流病肝胃郁热证临床疗效观察与机理探讨.pdfVIP

提 要 目的：观察清热和胃降逆方治疗胃食管反流病（gastroesophageal reflux disease， GERD）肝胃郁热证的临床疗效及安全性，并从理论和临床研究两个方面探 讨其机制。方法：临床选择符合纳入标准的GERD患者64例，随机分为两组，治疗组 （32 例）给予清热和胃降逆方水煎剂，对照组（32 例）给予清胃止痛微丸，两组均 以8周为1疗程，观察治疗前后两组的临床症状、体征、胃镜、病理疗效及安全性监 测。结果：治疗组治愈12例，显效 11例，有效5例，无效4例，总有效率为87.50 ％；对照组治愈 7 例，显效 8 例，有效 7 例，无效 10 例，总有效率为 68.75％。两 组总疗效对比（P＜0.05）有显著性差异。两组患者治疗后单项症状对比，除烧心、 泛酸症状无显著性差异外，余均有显著性差异（P＜0.05；P＜0.01）。胃镜疗效治疗 组总有效率为93.75％，对照组为71.88％，两组对比（P＜0.05）有显著性差异。病 理检查疗效治疗组总有效率90.63％，对照组为68.75％，两组对比（P＜0.05）有显 著性差异。 结论：清热和胃降逆方是治疗 GERD 肝胃郁热证的理想方药，能消除或显著改善 胃食管反流病肝胃郁热证患者的临床症状及病理改变，其机理可能与抑制胃酸分泌， 促进胃肠运动，减弱反流物对胃食管黏膜的侵袭作用，修复损伤黏膜作用有关。 关键词 清热和胃降逆方；胃食管反流病（GERD）；肝胃郁热；临床研究 Clinical Study on Qingre Hewei Jiangni Decoction in Treating Liver-Stomach disharmonyc Syndrome of Gastroesophageal Reflux Disease Speciality: Gastroenterology Internal Medicine of TCM Author ：SunXiaowei Tutor：Professor YaoBaotai Abstract Objective :To evaluate the therapeutic effect,mechanism and safety of Qingre hewei jiangni decoction in treating gastroesophageal reflux disease （GERD ）due to liver-stomach disharmonyc.Methods :64 qualified cases of GERD were randomly divided into the treatment group （32 cases ）and the control group （32 cases ）.The treatment group took Qingre hewei jiangni decoction and the control group took Qingwei zhitong weiwan,respectively,for 8 weeks.The symptom,body symbol, gastroscope,pathological mechanism,oesophagus dynamics curative effect as well as routine tests were observed to verify the efficacy and safety of Qingre hewei jiangni decoction. Results : After one course of treatment,significant difference was apparent in the clinical ef