CAJ | 학술논문

目的：观察和中健脾方治疗中虚气型逆型反流性食管炎的临床疗效。方法采用随机、平行对照的原则将符合纳入标准的患者随机分为西药组(奥美拉唑)、中药组(和中健脾方)、中西药组(和中健脾方+奥美拉唑)，每组30例，连续治疗8周。观察治疗前后患者症状群积分变化及食管胃镜下黏膜改变情况，评价临床疗效。结果治疗后，西药组、中药组、中西药组反流性食管炎食管胃镜积分与同组治疗前比较，差异均有统计学意义(Z值分别为-4.351、-4.300、-5.143，P均＜0.01)。西药组反流性食管炎症状群总有效率为83.3%(25/30)，中药组为86.7%(26/30)，中西药组为90.0%(27/30)，3组比较差异有统计学意义(χ2＝6.800，P＝0.030)。西药组、中药组、中西药组治疗后反流性食管炎症状群积分与同组治疗前比较，差异均有统计学意义(Z值分别为-5.482、-5.991、-6.120，P均＜0.01)；组间两两比较，中药组与中西药组间差异有统计学意义(Z＝-2.113，P＝0.040)。西药组、中药组、中西药组烧心(Z值分别为-3.390、-3.882、-3.666)、反酸(Z值分别为-4.850、-5.004、-5.722)、反食(Z值分别为-2.791、-3.422、-2.854)症状均较同组治疗前明显改善(P 均＜0.01)；中西药组胸骨后疼痛较治疗前未见明显改善(Z＝-0.873，P＝0.380)；中药组、中西药组咽部异物感或疼痛症状(Z值分别为-2.382、-2.724)、嗳气症状(Z值分别为-5.074、-5.061)较同组治疗前明显改善(P均＜0.05)；西药组、中西药组上腹胀(Z值分别为-2.77、-2.03)、上腹痛(Z值分别为-2.260、-2.021)较同组治疗前明显改善(P均＜0.05)。结论和中健脾方可明显改善中虚气逆型反流性食管炎患者临床症状，疗效与奥美拉唑相似，对嗳气、胸骨后疼痛等症状改善有优势。和中健脾方联合奥美拉唑的总体症状疗效优于单纯服用和中健脾方或奥美拉唑，但改善食管胃镜疗效无明显差异。目的：觀察和中健脾方治療中虛氣型逆型反流性食管炎的臨床療效。方法採用隨機、平行對照的原則將符閤納入標準的患者隨機分為西藥組(奧美拉唑)、中藥組(和中健脾方)、中西藥組(和中健脾方+奧美拉唑)，每組30例，連續治療8週。觀察治療前後患者癥狀群積分變化及食管胃鏡下黏膜改變情況，評價臨床療效。結果治療後，西藥組、中藥組、中西藥組反流性食管炎食管胃鏡積分與同組治療前比較，差異均有統計學意義(Z值分彆為-4.351、-4.300、-5.143，P均＜0.01)。西藥組反流性食管炎癥狀群總有效率為83.3%(25/30)，中藥組為86.7%(26/30)，中西藥組為90.0%(27/30)，3組比較差異有統計學意義(χ2＝6.800，P＝0.030)。西藥組、中藥組、中西藥組治療後反流性食管炎癥狀群積分與同組治療前比較，差異均有統計學意義(Z值分彆為-5.482、-5.991、-6.120，P均＜0.01)；組間兩兩比較，中藥組與中西藥組間差異有統計學意義(Z＝-2.113，P＝0.040)。西藥組、中藥組、中西藥組燒心(Z值分彆為-3.390、-3.882、-3.666)、反痠(Z值分彆為-4.850、-5.004、-5.722)、反食(Z值分彆為-2.791、-3.422、-2.854)癥狀均較同組治療前明顯改善(P 均＜0.01)；中西藥組胸骨後疼痛較治療前未見明顯改善(Z＝-0.873，P＝0.380)；中藥組、中西藥組嚥部異物感或疼痛癥狀(Z值分彆為-2.382、-2.724)、噯氣癥狀(Z值分彆為-5.074、-5.061)較同組治療前明顯改善(P均＜0.05)；西藥組、中西藥組上腹脹(Z值分彆為-2.77、-2.03)、上腹痛(Z值分彆為-2.260、-2.021)較同組治療前明顯改善(P均＜0.05)。結論和中健脾方可明顯改善中虛氣逆型反流性食管炎患者臨床癥狀，療效與奧美拉唑相似，對噯氣、胸骨後疼痛等癥狀改善有優勢。和中健脾方聯閤奧美拉唑的總體癥狀療效優于單純服用和中健脾方或奧美拉唑，但改善食管胃鏡療效無明顯差異。
목적：관찰화중건비방치료중허기형역형반류성식관염적림상료효。방법채용수궤、평행대조적원칙장부합납입표준적환자수궤분위서약조(오미랍서)、중약조(화중건비방)、중서약조(화중건비방+오미랍서)，매조30례，련속치료8주。관찰치료전후환자증상군적분변화급식관위경하점막개변정황，평개림상료효。결과치료후，서약조、중약조、중서약조반류성식관염식관위경적분여동조치료전비교，차이균유통계학의의(Z치분별위-4.351、-4.300、-5.143，P균＜0.01)。서약조반류성식관염증상군총유효솔위83.3%(25/30)，중약조위86.7%(26/30)，중서약조위90.0%(27/30)，3조비교차이유통계학의의(χ2＝6.800，P＝0.030)。서약조、중약조、중서약조치료후반류성식관염증상군적분여동조치료전비교，차이균유통계학의의(Z치분별위-5.482、-5.991、-6.120，P균＜0.01)；조간량량비교，중약조여중서약조간차이유통계학의의(Z＝-2.113，P＝0.040)。서약조、중약조、중서약조소심(Z치분별위-3.390、-3.882、-3.666)、반산(Z치분별위-4.850、-5.004、-5.722)、반식(Z치분별위-2.791、-3.422、-2.854)증상균교동조치료전명현개선(P 균＜0.01)；중서약조흉골후동통교치료전미견명현개선(Z＝-0.873，P＝0.380)；중약조、중서약조인부이물감혹동통증상(Z치분별위-2.382、-2.724)、애기증상(Z치분별위-5.074、-5.061)교동조치료전명현개선(P균＜0.05)；서약조、중서약조상복창(Z치분별위-2.77、-2.03)、상복통(Z치분별위-2.260、-2.021)교동조치료전명현개선(P균＜0.05)。결론화중건비방가명현개선중허기역형반류성식관염환자림상증상，료효여오미랍서상사，대애기、흉골후동통등증상개선유우세。화중건비방연합오미랍서적총체증상료효우우단순복용화중건비방혹오미랍서，단개선식관위경료효무명현차이。
Objective To observe the clinical curative effect of treating reflux esophagitis of spleen qi deficiency syndrome byHezhong-Jianpi decoction.Methods 90 patients in October 2012 to March 2014 in the standard of traditional Chinese medicine hospital of Shanghal were randomly divided into a western medicine group (omeprazole), a Chinese medicine group (Hezhong-Jianpi decoction), and a Chinese and western medicine group (Hezhong-Jianpi decoction + omeprazole), 30 cases in each group. All groups were treated for successive 8 weeks and the changes of the symptoms of integral and esophageal mucosa under gastroscope change situation were observed, and the clinical efficacy was evaluated. Results After the treatment, the esophagus gastroscope integral of the western medicine group, the Chinese medicine group and the Chinese and western medicine group were all significantly improved than those before the treatment group (Z value was respectively -4.351, -4.300, -5.143,P<0.01). Total effective rate was 83.3% (25/30) in the western medicine group, 86.7% (26/30) in the Chinese medicine group, and 90.0% (27/30) in the Chinese and western medicine group, the difference among the three groups was statistically significant (χ2=6.800,P=0.030). The difference of symptoms integral of the western medicine, Chinese medicine, and Chinese and western medicine group was statistically significant (Z values are -5.482, -5.991, -6.120, respectively, P<0.01).Comparison between two groups after treatment showed only Chinese traditional medicine group and the Chinese and western medicine group was statistically significant (Z=-2.113,P=0.040). After the treatment, symptoms as heartburn (Z value -3.390, -3.882, -3.666, respectively), the acid regurgitation (Z value -4.850, -5.004, -5.722, respectively), the food regurgitation (Z value -2.791, -3.422, -2.854, respectively) in the three groups improved significantly than those before the treatment (P<0.01); The retrosternal paln improved significantly in the Chinese and western medicine group after the treatment (Z=-0.873,P=0.380). The pharyngeal foreign body sensation or paln symptoms (Z value were -2.382 and -2.724, respectively), belching symptoms (Z value were -5.074 and -5.061, respectively) in the Chinese traditional medicine group and the Chinese and western medicine group significantly improved after the treatment(P<0.05); The abdominal distension (Z value were 2.772 and -2.032, respectively), the abdominal paln (Z value were 2.26 and 2.02, respectively) in the western medicine group and the Chinese and western medicine group were significantly improved (P<0.05). Conclusion Hezhong-Jianpi decoction can significantly improve the clinical symptoms of reflux esophagitis of spleen qi deficiency, and the curative effect is similar to omeprazole. It has advantage for relieving belch and retrosternal paln. The combined therapy was more effective than eitherHezhong-Jianpi or omeprazole, but no difference was showed in the improvement of esophageal gastroscopy.