[1]姚国召,李志红△.四逆香苏乌贝散治疗反流性食管炎疗效研究*[J].陕西中医,2019,(9):1190-1194.
　YAO Guozhao,LI Zhihong..Clinical observation on treatment of reflux esophagitis with Sini Xiangsu Wubei San[J].,2019,(9):1190-1194.
点击复制

四逆香苏乌贝散治疗反流性食管炎疗效研究*
分享到：

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2019年9期
页码:
1190-1194
栏目:
临床研究
出版日期:
2019-09-05

文章信息/Info

Title:
Clinical observation on treatment of reflux esophagitis with Sini Xiangsu Wubei San
文章编号:
DOI:10.3969/j.issn.10007369.2019.09.011
作者:
姚国召1; 李志红2△
1.北京市第一中西医结合医院老年病院区中医科（北京 100103）；2.北京中医药大学东直门医院脾胃科（北京 100700）
Author(s):
YAO Guozhao ; LI Zhihong.
Traditional Chinese Medicine in the Geriatrics District,Beijing First Integrated Chinese and Western Medicine Hospital( Beijing 100103)
关键词:
肝胃不和; 反流性食管炎; 四逆散; 香苏散; 乌贝散; 疗效比较
Keywords:
Key words Liverstomach disharmony syndrome; Reflux esophagitis; Sini San; Xiangsu San; Wubei San; Comparison of curative effects
分类号:
R574
文献标志码:
A
摘要:
摘 要 目的:探讨应用四逆香苏乌贝散加减治疗肝胃不和型反流性食管炎的临床疗效。方法:依据纳入标准选取符合本病的门诊患者82例，以随机数字表法分为治疗组与对照组各41例。两组均予以西医常规治疗，治疗组同时给予四逆香苏乌贝散加减治疗；连续治疗 8周后，观察两组临床疗效、两组治疗前后中医证候积分比较、主要症状改善情况及主症消失时间、不良反应和复发情况。结果：治疗组的总有效率为92.7%，高于对照组的70.7%(P＜0.05)。治疗结束后治疗组的证候积分为（9.51±5.311）分，低于对照组的（12.56±6.038）分(P＜0.05)。治疗后治疗组主症反酸、烧心、胸骨后疼痛、嗳气的发生率（61.0%、58.6%、43.9%、39.0%）均低于对照组（80.5%、80.5%、65.9%、68.3%）(P＜0.05)。治疗后治疗组主症反酸、烧心、胸骨后疼痛、嗳气的消失时间（9.60±4.356、10.38±4.209、9.47±4.903、8.95±4.391）d明显低于对照组（17.00±2.098、17.00±3.207、16.22±3.801、15.54±3.382）d(P＜0.05)。治疗组和对照组内镜疗效总有效率分别为81.8%和75.6%，两组差异无统计学意义（P＞0.05）；两组在治疗期间未见明显不良反应；治疗结束后治疗组4周和8周后复发率（5.56%、15.00%）低于对照组（25.81%、38.46%），差异具有统计学意义 (P＜0.05)。 结论:对肝胃不和型的反流性食管炎患者应用四逆香苏乌贝散加减治疗具有较好的临床疗效，能快速、有效地减轻和改善临床症状，安全性好且复发率低，优于西医常规治疗方法。
Abstract:
Abstract Objective:To investigate the clinical effect of Sini Xiangsu Wubei San on disharmony esophagitis of liver and stomach.Methods:According to the inclusion criteria,82 outpatients with the disease were selected and divided into the treatment group and the control group by random number table method.Both groups were treated with conventional western medicine,and the treatment group was treated with Sini Xiangsu Wubei San.After 8 weeks of continuous treatment,the clinical efficacy of the two groups was observed,the TCM syndrome scores of the two groups before and after treatment were compared,and the improvement of main symptoms,disappearance time of main symptoms,adverse reactions and recurrence of the two groups were observed.Results:The total effective rate of the treatment group 92.7% was higher than that of the control group 70.7%(P＜0.05).After treatment,the symptom score of the treatment group was (9.51±5.311),lower than that of the control group (12.56±6.038) (P＜0.05).The incidence of acid regurgitation,heartburn,retrosternal pain and belching (61.0%,58.6%,43.9%,39.0%) in the treatment group was lower than that in the control group (80.5%,80.5%,65.9%,68.3%)(P＜0.05).After treatment,the disappearance time of acid regurgitation,heartburn,retrosternal pain and belching in the treatment group (9.60±4.356,10.38±4.209,9.47±4.903,8.95±4.391) d was significantly lower than that in the control group (17.00±2.098,17.00±3.207,16.22±3.801,15.54±3.382)d (P＜0.05).The total effective rate observed under endoscope was 81.8% in the treatment group and 75.6% in the control group.The differences between the two groups showed no statistical significance (P ＞0.05).No adverse reactions were observed in the two groups during the treatment.The recurrence rate (5.56%,15.00%) in the treatment group was lower than that in the control group (25.81%,38.46%) at 4 weeks and 8 weeks after the end of treatment, the difference was statistically significant〖LM〗(P＜0.05).Conclusion:The application of Sini Xiangsu Wubei San in the treatment of patients with reflux esophagitis with disharmony between liver and stomach has good clinical efficacy,can rapidly and effectively reduce and improve clinical symptoms,has good safety and low recurrence rate,and is better than the conventional treatment of western medicine.

参考文献/References:

[1] 李影华,苏冬梅,白 桦.柴胡疏肝散加减治疗肝胃不和型反流性食管炎98例的临床观察[J] .世界中医药,2016,11(8):14371439.
[2] 谢 莉,党中勤,赵长普,等.理中和胃方治疗反流性食管炎肝胃不和证40例[J] .中国中医药现代远程教育,2017,15(12):106107.
[3] Wang M,Zhang JZ,Kang XJ,et al.Relevance between GerdQ score and the severity of reflux esophagitis in Uygur and Han Chinese[J] .Oncotarget,2017,8(43):7437174377.
[4] 黎琮毅,林春李,黄子珪.中西医结合治疗反流性食管炎30例临床观察[J] .湖南中医杂志,2018,34(10):5860.
[5] 杨宏升.四逆温胆汤治疗肝胃不和型反流性食管炎随机平行对照研究[J] .中医临床研究,2017,9(10):5557.
[6] 叶少情,蔡 丽,邱承智,等.反流性食管炎中医治疗研究进展[J] .湖南中医杂志,2019,35(4):165167.
[7] 陆星华,张泰昌.反流性食管炎诊断及治疗指南(2003年)[J] .中华消化内镜杂志,2004,30(4):45.
[8] 李 岩,陈治水,危北海.胃食管反流病中西医结合诊疗共识意见(2010)[J] .中国中西医结合杂志,2011,31(11):15501553.
[9] 国家食品药品监督管理总局.中药新药临床研究指导原则（试行）[M] .北京:中国医药科技出版社,2002:134139.
[10] 赵雪香.反流性食管炎中医证素特点的调查研究[D] .北京：北京中医药大学,2016.
[11] 余俊奇,孙晓娜,牛秋霞,等.中西医结合治疗反流性食管炎43例临床研究[J] .江苏中医药,2018,50(6):3739.
[12] 张北华,唐旭东,李保双,等.中医药治疗胃食管反流病的优势探讨[J] .中医杂志,2012,53(8):658660.
[13] Kinoshita Y,Ishimura N,Ishihara S.Advantages and disadvantages of Longterm proton pump inhibitor use[J] .Journal of Neurogastroenterology & Motility,2018,24(2):182196.
[14] Xie Y,Bowe B,Li T,et al.Risk of death among users of proton pump inhibitors:a longitudinal observational cohort study of United States veterans[J] .Bmj Open,2017,7(6):e015735.
[15] 宋瑞平,朱 宝.胃食管反流病的中西医诊治进展[J] .实用中西医结合临床,2016,16(8):8689.
[16] 贾 宁,唐艳萍,李 杨.胃食管反流病中医诊疗研究进展[J] .国医论坛,2017,32(4):6870.
[17] 李晓林,田德禄.田德禄教授治疗胃食管反流病经验[J] .北京中医药大学学报(中医临床版),2011,18(6):3031.
[18] 崔 亚,姜礼双,卜 平.127例反流性食管炎患者中医证候特征分析[J] .山东中医杂志,2018,37(9):745747.
[19] 阙任烨,沈艳婷,林柳兵,等.疏肝和胃方联合雷贝拉唑治疗肝胃不和型难治性反流性食管炎的临床疗效观察[J] .中华中医药学刊,2017,35(8):19481953.
[20] 闫 兵,杨卓欣,皮 敏,等.四逆散病机及其临床应用的研究进展[J] .中国当代医药,2017,24(33):1720.
[21] 张声生,朱生樑,王宏伟,等.胃食管反流病中医诊疗专家共识意见(2017)[J] .中国中西医结合消化杂志,2017,25(5):321326.
[22] 马卫国,胡晓玲,李志红,等.田德禄教授化裁运用香苏散临床经验[J] .现代中医临床,2017,24(1):5355.
[23] 辛 国,赵昕彤,黄晓巍.柴胡化学成分及药理作用研究进展[J] .吉林中医药,2018,38(10):11961198.
[24] 张霄潇,李正勇,马玉玲,等.中药枳实的研究进展[J] .中国中药杂志,2015,40(2):185190.
[25] 胡栋宝,陆卓东,伍贤学.中药香附子化学成分及药理活性研究进展[J] .时珍国医国药,2017,28(2):430432.
[26] 何育佩,郝二伟,谢金玲,等.紫苏药理作用及其化学物质基础研究进展[J] .中草药,2018,49(16):39573968.
[27] 李卫霞.陈皮的药理分析及临床应用研究[J] .医学理论与实践,2018,31(10):15211522,1555.
[28] 范薏淇,赵嫣虹.海螵蛸的研究进展[J] .中国民族民间医药,2016,25(4):4748.
[29] 马鸿雁,邓雨娇,马 倩,等.甘草的研究概况[J] .中药与临床,2018,9(1):5962.

相似文献/References:

[1]裴书飞,夏永欣.康复新液联合奥美拉唑治疗Ⅱ~Ⅲ级反流性食管炎效果研究*[J].陕西中医,2019,(1):61.
　PEI Shufei,XIA Yongxin..Effect of omeprazole combined with Kangfuxin liquid on treatment of grade II to grade III reflux esophagitis[J].,2019,(9):61.
[2]黎 妍,罗伟生 △,禤传凤.罗伟生教授治疗胃脘痛临床经验*[J].陕西中医,2019,(5):658.
　LI Yan,LUO Weisheng,XUAN Chuanfeng..Professor Luo Weisheng’s clinical experience in the treatment of epigastric pain[J].,2019,(9):658.
[3]李翠莲,刘 霞,刘巧梅.清胃顺气汤治疗小儿气郁型反流性食管炎疗效及对患者PGE2、MOT的影响*[J].陕西中医,2019,(6):781.
[4]王 健,林柳兵,沈 莹,等.疏肝和中汤联合雷贝拉唑治疗肝胃郁热型反流性食管炎临床研究*[J].陕西中医,2020,(2):168.
　WANG Jian,LIN Liubing,SHEN Ying,et al.Efficacy of Shugan Hezhong decoction combined with rabeprazole in treatment of reflux esophagitis stagnated heat of liver and stomach syndrome[J].,2020,(9):168.
[5]王三强,许敏光,魏会珍,等.反流性食管炎中医学研究进展*[J].陕西中医,2020,(2):266.
　WANG Sanqiang,XU Minguang,WEI Huizhen,et al.Research progress of reflux esophagitis in traditional Chinese medicine[J].,2020,(9):266.
[6]曹志娟,宋珍珍,向英歌.疏肝和中降逆方治疗反流性食管炎中虚气逆证研究进展[J].陕西中医,2023,(9):1327.[doi:DOI:10.3969/j.issn.1000-7369.2023.09.041]
[7]付 勤,袁爱红,解鸿宇,等.名中医杨骏从气机升降论治反流性食管炎经验[J].陕西中医,2024,(4):541.[doi:DOI:10.3969/j.issn.1000-7369.2024.04.024]
　FU Qin,YUAN Aihong,XIE Hongyu,et al.Yang Jun's experience in treating reflux esophagitis from ascending and descending of qi movement[J].,2024,(9):541.[doi:DOI:10.3969/j.issn.1000-7369.2024.04.024]

备注/Memo

备注/Memo:
*吴阶平医学基金会临床科研专项资助项目（320.6750.17233）
更新日期/Last Update: 2019-09-24