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刘婉琪,舒磊,刘凡,刘嵩,张书,郭洁,时昭红.半夏调中颗粒治疗寒热错杂型非糜烂性反流病的临床疗效观察[J].湖南中医药大学学报,2023,43(7):1273-1277[点击复制] |
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| 半夏调中颗粒治疗寒热错杂型非糜烂性反流病的临床疗效观察 |
| 刘婉琪,舒磊,刘凡,刘嵩,张书,郭洁,时昭红 |
| (湖北中医药大学, 湖北 武汉 430065;武汉市中西医结合医院消化内科, 湖北 武汉 420020) |
| 摘要: |
| 目的 观察半夏调中颗粒在寒热错杂型非糜烂性反流病（non-erosive reflux disease，NERD）治疗中的临床疗效及其对高分辨率食管测压相关指标的改善情况。方法 选取2021年1月至2022年5月在武汉市中西医结合医院就诊的寒热错杂型NERD患者80例，随机分为治疗组（半夏调中颗粒）及对照组（奥美拉唑联合伊托必利），治疗4周后，比较两组患者治疗前后中医症状积分、临床疗效及高分辨率食管测压相关数据[包括食管下括约肌长度（lower esophageal sphincter length，LESL）、下食管括约肌静息压（lower esophageal sphincter pressure，LESP）、上食管括约肌静息压（upper esophageal sphincter pressure，UESP）、远端收缩延迟时间（distal latency，DL）、收缩前沿速度（contractile front velocity，CFV）和远端收缩积分（distal contractile integral，DCI）]的变化差异。结果 治疗后，治疗组中主症胸骨后烧灼、反酸和次症食欲不振、神疲乏力、手足不温的中医症状积分较治疗前降低（P<0.05），对照组中主症反酸、次症食欲不振的中医症状积分较治疗前降低（P<0.05），但两组各项中医症状积分比较差异无统计学意义（P>0.05）。治疗组的总有效率与对照组比较，差异无统计学意义（P>0.05）。治疗组治疗后高分辨率食管测压指标LESP、DCI、CFV较治疗前升高，差异有统计学意义（P<0.05）；对照组治疗后LESP、DCI较治疗前升高，差异有统计学意义（P<0.05）；两组治疗前组间比较差异无统计学意义（P>0.05），治疗后组间比较显示，治疗组的CFV较对照组明显升高，差异有统计学意义（P<0.05）。结论 半夏调中颗粒在寒热错杂型NERD治疗中可有效改善患者的临床症状，同时调节食管体部运动功能，且安全性高，无明显不良反应。 |
| 关键词: 半夏调中颗粒 非糜烂性反流病 寒热错杂证 高分辨率食管测压 食管动力 食管体部运动 |
| DOI：10.3969/j.issn.1674-070X.2023.07.019 |
| 投稿时间：2023-02-15 |
| 基金项目:国家重点研发计划中医药现代化研究专项（2019YFC1709604）；武汉市卫生健康委员会科研项目（WZ20C03）。 |
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| Clinical efficacy observation of Banxia Tiaozhong Granule in treating non-erosive reflux disease with cold-heat complex pattern |
| LIU Wanqi,SHU lei,LIU Fan,LIU Song,ZHANG Shu,GUO Jie,SHI Zhaohong |
| (Hubei University of Chinese Medicine, Wuhan, Hubei 430065, China;Department of Gastroenterology, Wuhan Hospital of Integrated Chinese and Western Medicine, Wuhan, Hubei 420020, China) |
| Abstract: |
| Objective To observe the clinical efficacy of Banxia Tiaozhong Granule (BXTZG) in treating non-erosive reflux disease (NERD) with cold-heat complex pattern and its improvement of related indexes of high-resolution esophageal manometry. Methods A total of 80 patients of NERD with cold-heat complex pattern in Wuhan Hospital of Integrated Chinese and Western Medicine from January 2021 to May 2022 were selected and randomly divided into treatment group (treated with BXTZG) and control group (treated with Omeprazole combined with Itopride). After 4 weeks of treatment, the changes of TCM symptom scores, clinical efficacy and high-resolution esophageal manometry data[including lower esophageal sphincter length (LESL), lower esophageal sphincter pressure (LESP), upper esophageal sphincter pressure (UESP), distal latency (DL), contractile front velocity (CFV), and distal contractile integral (DCI)] before and after treatment were compared between two groups. Results For treatment group, TCM symptom scores of the primary symptoms (poststernal burning and acid reflux) and the secondary symptoms (loss of appetite, fatigue, and lack of warmth in the extremeties) after treatment were lower than those before treatment (P<0.05). For control group, TCM symptom scores of the primary symptom (acid reflux) and the secondary symptom (loss of appetite) after treatment were lower than those before treatment (P<0.05). There was no significant difference in TCM symptom scores between treatment group and control group (P>0.05). Moreover, no significant difference was found in the total effective rate between two groups (P>0.05). For treatment group, the post-treatment high-resolution esophageal manometry indexes of LESP, DCI, and CFV were significantly higher than those before treatment (P<0.05); for control group, LESP and DCI after treatment were significantly higher than those before treatment (P<0.05). The difference in these indexes between two groups before treatment was not statistically significant (P>0.05); however, the comparison of them between groups after treatment showed that CFV of treatment group was significantly higher than that of control group (P<0.05). Conclusion BXTZG can effectively alleviate the clinical symptoms of patients with non-erosive esophageal reflux disease with cold-heat complex pattern and regulate the motor function of the esophageal body, with high safety and no obvious adverse reactions. |
| Key words: Banxia Tiaozhong Granule non-erosive reflux disease cold-heat complex pattern high-resolution esophageal manometry esophageal power esophageal body movement |
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