發(fā)布時間：2018-12-14 03:59

【摘要】：目的：觀察具有疏肝清熱,和胃降逆作用的抑酸和降方聯(lián)合奧美拉唑?qū)Ψ戳餍允彻苎椎寞熜?探索中西醫(yī)結(jié)合治療該病的方法,以期進一步提高臨床療效,降低復發(fā)率。 方法：選擇符合反流性食管炎納入標準的患者60例,隨機分為治療組和對照組。對照組口服奧美拉唑,治療組在對照組基礎上加服抑酸和降方加減,服用療程同對照組,均為8周。療程結(jié)束后進行臨床癥狀改善情況的比較,并比較內(nèi)鏡效果。療程結(jié)束后16周進行隨訪,觀察復發(fā)情況。 結(jié)果：治療組中醫(yī)證候療效總有效率(93.3%)明顯優(yōu)于對照組(83.3%),具有統(tǒng)計學意義(P0.05)。兩組RDQ量表評分治療前后比較,具有統(tǒng)計學意義(P0.05),組間比較,在改善燒心、反酸、反食方面,治療組要優(yōu)于對照組(P0.05),在改善非心源性胸痛方面,兩組療效相當,差異無顯著性(P0.05)。對治療后復查胃鏡的患者進行組內(nèi)比較,兩組胃鏡分級治療前后比較有統(tǒng)計學意義(P0.05),組間比較,治療組胃鏡下食管黏膜改善情況優(yōu)于對照組(P0.01)。療程結(jié)束后16周隨訪,兩組復發(fā)率比較具有統(tǒng)計學意義(P0.05)�；颊咧委熎陂g均未發(fā)生明顯不良反應。 結(jié)論：抑酸和降方是治療反流性食管炎的有效方劑,能夠改善反流性食管炎患者的臨床癥狀,改善內(nèi)鏡下食管黏膜情況,治療效果持久,預防復發(fā)作用明顯,且無明顯不良反應,值得進一步研究和推廣。
[Abstract]:Objective: to observe the curative effect of anti-acid and omeprazole combined with omeprazole on reflux esophagitis, and to explore the method of integrated traditional Chinese and western medicine for the treatment of reflux esophagitis, in order to further improve the clinical efficacy and reduce the recurrence rate. Methods: 60 patients with reflux esophagitis were randomly divided into treatment group and control group. Omeprazole was taken orally in the control group, and the treatment group was treated for 8 weeks with the same course of treatment as that in the control group. After the course of treatment, the improvement of clinical symptoms was compared, and the effect of endoscopy was compared. The patients were followed up 16 weeks after the course of treatment and the recurrence was observed. Results: the total effective rate of TCM syndrome in the treatment group (93.3%) was significantly better than that in the control group (83.3%), with statistical significance (P0.05). Before and after treatment, the scores of RDQ scale in the two groups were statistically significant (P0.05). Compared between the two groups, the treatment group was superior to the control group in improving heartburn, acid regurgitation and food reflux (P0.05), and in improving non-cardiogenic chest pain, the treatment group was better than the control group (P0.05). There was no significant difference between the two groups (P0.05). After the treatment of patients with gastroscopy to carry out intra-group comparison, the two groups before and after gastroscope grading treatment compared with statistical significance (P0.05), the treatment group under gastroscope esophageal mucosal improvement was better than the control group (P0.01). 16 weeks after the end of the course of follow-up, the recurrence rate of the two groups was statistically significant (P0.05). No significant adverse reactions occurred during treatment. Conclusion: Yiyaohe Jiangfang is an effective prescription for the treatment of reflux esophagitis. It can improve the clinical symptoms of patients with reflux esophagitis, improve the condition of esophageal mucosa under endoscope, have a lasting effect and prevent recurrence obviously. And there is no obvious adverse reaction, which is worthy of further study and promotion.
【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R571

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