旋覆代赭湯合左金丸聯(lián)合奧美拉唑治療胃食管反流病痰濕內(nèi)阻證的臨床研究
發(fā)布時(shí)間：2018-12-13 08:27
【摘要】：目的： 1.觀察旋覆代赭湯合左金丸聯(lián)合奧美拉唑治療胃食管反流病痰濕內(nèi)阻證的臨床療效。 2.從理論上分析旋覆代赭湯合左金丸聯(lián)合奧美拉唑治療胃食管反流病痰濕內(nèi)阻證的作用機(jī)理。 方法： 收集2012年6月～2013年12月湖北省中醫(yī)院消化內(nèi)科專家門診就診的60例患者，均符合胃食管反流病西醫(yī)診斷標(biāo)準(zhǔn)和中醫(yī)痰濕內(nèi)阻證標(biāo)準(zhǔn)。隨機(jī)將患者分為治療組和對照組，每組各為30人。統(tǒng)計(jì)學(xué)分析后，兩組病人在年齡、病程、病情程度、性別、證候總積分等方面具有可比性，不存在統(tǒng)計(jì)學(xué)意義（P0.05）。 兩組患者均予以奧美拉唑膠囊口服。在此基礎(chǔ)上，治療組加用旋覆代赭湯合左金丸。旋覆代赭湯合左金丸是導(dǎo)師胡運(yùn)蓮教授應(yīng)用多年的經(jīng)驗(yàn)方（其組成為旋覆花15g,代赭石30g,法半夏10g,吳茱萸5g,黃連18g,人參15g,生甘草5g,生姜10g,大棗6枚），水煎服，每日1劑，早晚飯后半小時(shí)各1次，每次200ml；奧美拉唑膠囊口服，每次20mg,每日2次，早晚飯前服用。兩組患者均連續(xù)服藥一療程（八周）。觀察兩組患者治療前后反酸、燒心、口苦等癥狀、體征及臨床總積分的變化，并且對血尿糞常規(guī)、肝功能、腎功能、心電圖及其它可能出現(xiàn)的不良反應(yīng)進(jìn)行安全性評價(jià)。 療程結(jié)束后，予以統(tǒng)計(jì)學(xué)分析：數(shù)據(jù)應(yīng)用SPSS16.0統(tǒng)計(jì)軟件統(tǒng)計(jì)，等級資料用Ridit檢驗(yàn)（秩和檢驗(yàn)），計(jì)量資料采用t檢驗(yàn)，計(jì)數(shù)資料采用χ2檢驗(yàn)。 結(jié)果： 1.兩組患者療程結(jié)束后臨床綜合療效的比較：治療組總有效率96.66%，痊愈7例，顯效12例，有效10例，無效1例，對照組總有效率76.67%，痊愈3例，顯效8例，有效12例，無效7例。治療組總有效率、臨床治愈率均高于對照組（P0.05）。 2.對反酸、燒心、咽部異物感等癥狀，治療組明顯優(yōu)于對照組，改善明顯；對早飽、噯氣等癥狀的改善，兩組相當(dāng)。對于臨床癥狀總積分的改善，治療組明顯優(yōu)于對照組（P0.05）,且治療前后兩組患者臨床癥狀總積分均有顯著差異（P0.05）。 結(jié)論： 本臨床研究表明，中西醫(yī)結(jié)合治療胃食管反流病痰濕內(nèi)阻證明顯優(yōu)于單純西藥組，主要表現(xiàn)在可以明顯減少反酸、燒心、咽部異物感的發(fā)生頻率，能縮短患者的治療時(shí)間，不僅能減輕患者的痛苦，而且能減輕患者的經(jīng)濟(jì)負(fù)擔(dān)。依現(xiàn)代藥理理論分析，，旋覆代赭湯合左金丸有抑制胃酸分泌，從而促進(jìn)粘膜修復(fù)、抑制潰瘍形成的功能；可增強(qiáng)食管收縮幅度收縮頻率，增加胃腸蠕動(dòng)節(jié)律，從而起到加快胃腸排空的作用，可刺激或調(diào)節(jié)免疫系統(tǒng)，調(diào)整胃腸功能，有解痙止痛的作用。此外還有顯著抑菌、消炎的作用。結(jié)合相關(guān)西藥聯(lián)合治療可增強(qiáng)治療效果。說明旋覆代赭湯合左金丸湯的組方切合臨床實(shí)際，在治療胃食管反流病痰濕內(nèi)阻證方面有確切的療效，值得在臨床應(yīng)用及推廣。
[Abstract]:Objective: 1. To observe the clinical effect of Xuanhudezhe decoction combined with omeprazole in treating phlegm dampness and internal obstruction of gastroesophageal reflux disease. 2. The mechanism of Xuanhudezhe decoction combined with omeprazole in treating phlegm dampness and internal obstruction of gastroesophageal reflux disease was analyzed theoretically. Methods: from June 2012 to December 2013, 60 patients with gastroesophageal reflux disease were collected from the department of internal medicine, Department of Digestive Medicine, Hubei traditional Chinese Medicine Hospital. All the patients met the criteria of western medicine diagnosis of gastroesophageal reflux disease and internal obstruction of phlegm and dampness in traditional Chinese medicine. Patients were randomly divided into treatment group and control group, each group was 30 people. After statistical analysis, the two groups of patients in age, course of disease, degree of illness, gender, syndromes total score and other aspects are comparable, there is no statistical significance (P0.05). Both groups were given omeprazole capsule orally. On this basis, the treatment group plus Zuo Jin Pill with Zuo Jin Pill. Xianfu Daochhe Tang he Zuo Jin Pill is an experienced prescription used by Professor Hu Yunlian for many years (its composition is 15g, 30g, 10g, 5g, 18g, 15g, 5g, 5g, 10g, 10g, 6g, respectively). 1 dose daily, half an hour after morning and evening, every time 200ml; Omeprazole capsule oral, 20 mg each time, 2 times a day, morning and evening before meals. The patients in both groups were treated with a course of treatment (8 weeks). The changes of regurgitation, heartburn, bitter mouth and other symptoms, signs and total clinical scores were observed before and after treatment, and the safety of hematuria and fecal routine, liver function, renal function, electrocardiogram and other possible adverse reactions were evaluated. After the course of treatment, statistical analysis was performed: the data were analyzed by SPSS16.0 statistical software, Ridit test was used for grade data, t test was used for measurement data, 蠂 2 test was used for counting data. Results: 1. Comparison of the clinical comprehensive efficacy of the two groups after the end of the course of treatment: the total effective rate of the treatment group was 96.666.The total effective rate was 96.666,7 cases cured, 12 cases effective, 10 cases effective, and 1 case ineffective. In the control group, the total effective rate was 76.67%, 3 cases were cured, and 8 cases were remarkable effect. 12 cases were effective and 7 cases were ineffective. The total effective rate and clinical cure rate in the treatment group were higher than those in the control group (P0.05). 2. For the symptoms of regurgitation, heartburn and pharynx, the treatment group was obviously better than the control group, and the improvement of the symptoms such as early satiety and belching was similar between the two groups. For the improvement of the total score of clinical symptoms, the treatment group was significantly better than the control group (P0.05), and the two groups of patients before and after treatment were significantly different in the total score of clinical symptoms (P0.05). Conclusion: this clinical study shows that the treatment of internal obstruction of phlegm and dampness in patients with gastroesophageal reflux disease is better than that in western medicine group, which mainly shows that the frequency of foreign body sensation in reflux, heartburn and pharynx can be significantly reduced. It can shorten the time of treatment, not only alleviate the patient's pain, but also reduce the patient's economic burden. According to the modern pharmacological theory, Xuan Fu Dai Zuo Jin Pill has the function of inhibiting gastric acid secretion, thus promoting mucosal repair and inhibiting ulcer formation. It can increase the frequency of contraction amplitude of esophagus, increase the rhythm of gastrointestinal peristalsis, accelerate the emptying of gastrointestinal tract, stimulate or regulate the immune system, adjust the function of gastrointestinal tract, and relieve spasmolysis and pain. In addition, there are significant bacteriostasis, anti-inflammatory effect. Combined therapy with related western medicine can enhance the therapeutic effect. It shows that the prescription of Xuan Fu Dai Zhe Tang and Zuo Jin Pill decoction is suitable for clinical practice and has definite curative effect in treating gastroesophageal reflux disease with phlegm dampness and internal obstruction, which is worth applying and popularizing in clinic.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R571
本文編號：2376240
[Abstract]:Objective: 1. To observe the clinical effect of Xuanhudezhe decoction combined with omeprazole in treating phlegm dampness and internal obstruction of gastroesophageal reflux disease. 2. The mechanism of Xuanhudezhe decoction combined with omeprazole in treating phlegm dampness and internal obstruction of gastroesophageal reflux disease was analyzed theoretically. Methods: from June 2012 to December 2013, 60 patients with gastroesophageal reflux disease were collected from the department of internal medicine, Department of Digestive Medicine, Hubei traditional Chinese Medicine Hospital. All the patients met the criteria of western medicine diagnosis of gastroesophageal reflux disease and internal obstruction of phlegm and dampness in traditional Chinese medicine. Patients were randomly divided into treatment group and control group, each group was 30 people. After statistical analysis, the two groups of patients in age, course of disease, degree of illness, gender, syndromes total score and other aspects are comparable, there is no statistical significance (P0.05). Both groups were given omeprazole capsule orally. On this basis, the treatment group plus Zuo Jin Pill with Zuo Jin Pill. Xianfu Daochhe Tang he Zuo Jin Pill is an experienced prescription used by Professor Hu Yunlian for many years (its composition is 15g, 30g, 10g, 5g, 18g, 15g, 5g, 5g, 10g, 10g, 6g, respectively). 1 dose daily, half an hour after morning and evening, every time 200ml; Omeprazole capsule oral, 20 mg each time, 2 times a day, morning and evening before meals. The patients in both groups were treated with a course of treatment (8 weeks). The changes of regurgitation, heartburn, bitter mouth and other symptoms, signs and total clinical scores were observed before and after treatment, and the safety of hematuria and fecal routine, liver function, renal function, electrocardiogram and other possible adverse reactions were evaluated. After the course of treatment, statistical analysis was performed: the data were analyzed by SPSS16.0 statistical software, Ridit test was used for grade data, t test was used for measurement data, 蠂 2 test was used for counting data. Results: 1. Comparison of the clinical comprehensive efficacy of the two groups after the end of the course of treatment: the total effective rate of the treatment group was 96.666.The total effective rate was 96.666,7 cases cured, 12 cases effective, 10 cases effective, and 1 case ineffective. In the control group, the total effective rate was 76.67%, 3 cases were cured, and 8 cases were remarkable effect. 12 cases were effective and 7 cases were ineffective. The total effective rate and clinical cure rate in the treatment group were higher than those in the control group (P0.05). 2. For the symptoms of regurgitation, heartburn and pharynx, the treatment group was obviously better than the control group, and the improvement of the symptoms such as early satiety and belching was similar between the two groups. For the improvement of the total score of clinical symptoms, the treatment group was significantly better than the control group (P0.05), and the two groups of patients before and after treatment were significantly different in the total score of clinical symptoms (P0.05). Conclusion: this clinical study shows that the treatment of internal obstruction of phlegm and dampness in patients with gastroesophageal reflux disease is better than that in western medicine group, which mainly shows that the frequency of foreign body sensation in reflux, heartburn and pharynx can be significantly reduced. It can shorten the time of treatment, not only alleviate the patient's pain, but also reduce the patient's economic burden. According to the modern pharmacological theory, Xuan Fu Dai Zuo Jin Pill has the function of inhibiting gastric acid secretion, thus promoting mucosal repair and inhibiting ulcer formation. It can increase the frequency of contraction amplitude of esophagus, increase the rhythm of gastrointestinal peristalsis, accelerate the emptying of gastrointestinal tract, stimulate or regulate the immune system, adjust the function of gastrointestinal tract, and relieve spasmolysis and pain. In addition, there are significant bacteriostasis, anti-inflammatory effect. Combined therapy with related western medicine can enhance the therapeutic effect. It shows that the prescription of Xuan Fu Dai Zhe Tang and Zuo Jin Pill decoction is suitable for clinical practice and has definite curative effect in treating gastroesophageal reflux disease with phlegm dampness and internal obstruction, which is worth applying and popularizing in clinic.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R571
【參考文獻(xiàn)】
相關(guān)期刊論文 前10條
1 馬日海;糾正7-10胸椎關(guān)節(jié)錯(cuò)位治療反流性食管炎[J];按摩與導(dǎo)引;2005年04期
2 翟興紅;;趙榮萊診治反流性食管炎經(jīng)驗(yàn)擷菁[J];中華中醫(yī)藥雜志;2009年04期
3 朱海燕;金小晶;;溫通和胃法治療反流性食管炎[J];長春中醫(yī)藥大學(xué)學(xué)報(bào);2011年02期
4 王文萍;曹琦琛;高晶晶;王冬梅;;左金丸配伍意義的藥代動(dòng)力學(xué)研究[J];中國臨床藥理學(xué)雜志;2010年02期
5 楊柳;;劉華一教授治療胃食管反流病經(jīng)驗(yàn)[J];光明中醫(yī);2010年03期
6 田波;中醫(yī)辨治反流性食管炎[J];甘肅中醫(yī)學(xué)院學(xué)報(bào);2000年04期
7 劉玉成,李玉,解晨昊,張正;胃泌素對胃食管反流病患者食管壓力及pH的影響[J];河北醫(yī)科大學(xué)學(xué)報(bào);2002年06期
8 吳志光;中西醫(yī)結(jié)合治療反流性食管炎療效觀察[J];河北中醫(yī);1999年05期
9 馬銀成;清熱化濕和胃降逆法治療反流性食管炎30例[J];河北中醫(yī);2000年03期
10 賀松其;;中西醫(yī)結(jié)合治療膽胃食管反流病[J];湖北中醫(yī)雜志;2002年10期
相關(guān)博士學(xué)位論文 前1條
1 張紅兵;旋覆花總黃酮抑制血管平滑肌細(xì)胞氧化應(yīng)激和新生內(nèi)膜形成的分子機(jī)制[D];河北醫(yī)科大學(xué);2009年
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