摘要
目的:观察活血通降方治疗瘀血阻络型反流性食管炎(RE)的临床疗效及对胃排空的影响,从胃动力角度探讨该方药的作用机制。方法:选取2017年1月—2017年12月就诊于我院瘀血阻络型RE患者89例,随机分为三组,A组(西药治疗组):予雷贝拉唑+伊托必利;B组(中药治疗组):活血通降方;C组(中西医结合组):西药+活血通降方。三组疗程均为8周。比较治疗前后三组患者的消化道症状学积分(RDQ问卷)、中医证候积分、胃镜分级(LA)及胃排空(固体半排空)时间。结果:三组患者治疗后消化道症状评分、中医证候评分较治疗前均有明显改善,差异有统计学意义(P<0.05);治疗后消化道症状评分改善:C组优于A组和B组(P<0.05),A组和B组无明显差异(P>0.05);治疗后三组中医证候评分改善程度C组优于B组,B组优于A组(P<0.05)。胃镜下LA分级治疗后三组较治疗前均有不同程度好转,A组和C组较治疗前明显改善(P<0.05),改善程度C组优于B组(P<0.05),其他两两相比无显著差异(P>0.05)。三组胃排空指标治疗后较治疗前均有明显改善(P<0.05),改善程度C组优于A、B组(P<0.05),而A组和B组无明显差异(P>0.05)。结论:活血通降方可改善瘀血阻络型RE患者临床症状及胃镜下黏膜表现,调节胃排空及胃动力可能是其治疗RE的机制之一。
Objective To observe the clinical efficacy of Huo Xue Tong Jiang Fang in treating Reflux esophagitis(RE)with blood stasis and obstruction of collaterals and its effect on gastric emptying,and to explore the mechanism of action of Huo Xue Tong Jiang Fang from the perspective of gastric motility.Methods 89 RE patients with blood stasis and obstruction of collaterals from January 2017 to December 2017 were randomly divided into three groups.Group A(western medicine treatment group):rabeprazole+ITO ratio.Group B(traditional Chinese medicine treatment group):Huo Xue Tong Jiang Fang.Group C(integrated Chinese and Western medicine group):Western medicine+Huo Xue Tong Jiang Fang.The course of treatment in the three groups was 8 weeks.Before and after treatment,digestive tract symptom score(RDQ questionnaire),TCM syndrome score,gastroscopic grading(LA)and gastric emptying(solid half emptying time)were compared and analyzed.Results After treatment,digestive tract symptom score and TCM syndrome score of the three groups were significantly improved compared with those before treatment,and the difference was statistically significant(P<0.05).The improvements of digestive tract symptom score after treatment were as follows:Group C was better than group A and group B(P<0.05).There was no significant difference between group A and group B(P>0.05).After treatment,the improvement degree of TCM syndrome score in group C was better than that in group B and group B was better than A.There was statistical difference between the two groups(P<0.05).After LA grading treatment under gastroscope,the three groups improved in different degrees compared with those before treatment.The improvement of group A and group C was better than that of group B(P<0.05),but there was no significant difference between the other two groups(P>0.05).The indexes of gastric emptying in three groups were significantly improved after treatment(P<0.05).The improvement degree of group C was better than that of group A and group B(P<0.05),but there was no significant difference between group A and group B(P>0.05).Conclusion Huo Xue Tong Jiang Fang can improve the clinical symptoms and gastroscopic mucosal manifestations of RE patients with blood stasis and obstruction of collaterals.Regulating gastric emptying and gastric motility maybe one of the mechanisms of treating RE.
作者
康丽丽
唐艳萍
杨莉
郝旭雯
KANG Li-li;TANG Yan-ping;YANG Li(Department of Gastroenterology,Tianjin Nankai Hospital,Tianjin(300100),China)
出处
《中国中西医结合外科杂志》
CAS
2020年第4期635-640,共6页
Chinese Journal of Surgery of Integrated Traditional and Western Medicine
基金
国家自然科学基金面上项目(81573737)。
关键词
活血通降方
瘀血阻络型
反流性食管炎
胃排空
Huo Xue Tong Jiang Fang
blood stasis obstructing collaterals
reflux esophagitis
gastric emptying
