摘要
目的:观察调肝理脾方治疗伴无效食管动力(IEM)的胃食管反流病(GERD)疗效,并探讨其可能机制。方法:将69例伴IEM的GERD患者分为中药组(35例)和西药组(34例),中药组给予调肝理脾方中药颗粒同时服用奥美拉唑模拟剂,西药组给予奥美拉唑肠溶片同时服用调肝理脾方中药颗粒模拟剂。两组均连续治疗4周,随访期为3个月。分别比较治疗前后两组症状疗效及食管动力改善情况,随访3个月两组再服药人数及不良反应情况。结果:中药组及西药组症状疗效指标GerdQ量表评分在治疗2、4周后均较本组治疗前显著降低(P<0.05)。治疗4周后中药组在下食管括约肌(LES)静息压力、远端收缩积分(DCI)、IEM无效吞咽百分比方面均较治疗前显著好转(P<0.05);中药组IEM恢复正常12例(占34.3%)显著优于西药组恢复正常例数[4例(占11.8%)](P<0.05)。随访3个月,西药组再服药人数比例高于中药组(P<0.05)。两组均未发生严重的不良反应。结论:调肝理脾方能有改善伴IEM的GERD患者食管动力,其症状疗效类似于奥美拉唑,且更少复发。作用机制可能与提高食管廓清功能和改善抗反流屏障有关。
Objective:To observe the effect of Tiaogan Lipi Decoction on gastroesophageal reflux disease(GERD)with ineffective esophageal motility(IEM),and to explore the possible mechanism.Methods:A total of 69 GERD patients with IEM were divided into Chinese medicine group(35 cases)and Western medicine group(34 cases).The Chinese medicine group was given Tiaogan Lipi Decoction and Omeprazole simulant,and the Western medicine group was given Omeprazole Enteric Coated Tablets and Tiaogan Lipi Decoction simulant.The two groups were treated for 4 weeks,and the follow-up period was 3 months.The curative effect of symptoms and improvement of esophageal motility were compared between the two groups before and after treatment.After 3 months of follow-up,the number and adverse reactions of the two groups were observed.Results:The GerdQ scores of symptom curative effect in Chinese medicine group and Western medicine group decreased after 2 weeks and 4 weeks than that before treatment(P<0.05).After 4 weeks of treatment,LES resting pressure,DCI,IEM invalid swallowing ratio in Chinese medicine group were better than that before treatment(P<0.05).Twelve patients(34.3%)in the Chinese medicine group returned to normal,and 4(11.8%)in the Western medicine group,the Chinese medicine group was better than the Western medicine group(P<0.05).After 3 months of follow-up,the proportion of re-medication in the Western medicine group was higher than that in Chinese medicine group(P<0.05).No serious adverse reactions occurred in both groups.Conclusion:Tiaogan Lipi Decoction can improve the esophageal motility of GERD patients with IEM,and its symptom curative effect is similar to Omeprazole,and has less recurrence.The mechanism may be related to the improvement of esophageal clearance function and anti-reflux barrier function.
作者
沈晨
陶琳
张声生
孙晓红
陈苏宁
SHEN Chen;TAO Lin;ZHANG Sheng-sheng;SUN Xiao-hong;CHEN Su-ning(Department of Digestive,Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University,Beijing 100010,China;Department of Digestive,Peking Union Medical College Hospital,Beijing 100730,China;Department of Traditional Chinese Medicine,Shengjing Hospital of China Medical University,Shenyang 110004,China)
出处
《中华中医药杂志》
CAS
CSCD
北大核心
2022年第1期546-550,共5页
China Journal of Traditional Chinese Medicine and Pharmacy
基金
北京市科学技术委员会首都临床特色应用研究项目(No.Z141107002514176)
首都卫生发展科研专项项目(No.2018-2-2231)。
关键词
无效食管动力
胃食管反流病
调肝理脾方
临床观察
机制
食管动力
Ineffective esophageal motility(IEM)
Gastroesophageal reflux disease(GERD)
Tiaogan Lipi Decoction
Clinical observation
Mechanism
Esophageal motility
