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半夏泻心汤加减治疗老年反流性食管炎的效果及对食管动力和胃肠激素的影响(1)
http://www.100md.com 2020年7月15日 《中外医学研究》 202020
     【摘要】 目的:研究半夏瀉心汤加减治疗老年反流性食管炎(RE)的效果,以及对食管动力和胃肠激素的影响。方法:选取北京市石景山区中医医院内科、北京市朝阳医院京西院区消化内科2017年1月-2019年2月收治的老年RE患者156例,采用随机数字表法分为两组。对照组(78例)给予泮托拉唑肠溶胶囊和多潘立酮片治疗。观察组在对照组基础上联合半夏泻心汤加减治疗,两组连续治疗8周。检测并比较两组食管动力指标水平[食管远端收缩积分(DCI)、食管收缩波波幅(CA)、食管上括约肌压力(UESP)、食管下括约肌静息压(LESP)]、胃肠激素水平[血管活性肠肽(VIP)、胃泌素(GAS)、胃动素(MOT)、P物质(SP)]、各项中医症候评分,观察复发情况,评价中医疗效和内镜疗效。结果:治疗后,观察组DCI、CA、UESP与LESP水平高于对照组,差异有统计学意义(P<0.05);观察组血清GAS、MOT与SP水平高于对照组,血清VIP水平低于对照组,差异有统计学意义(P<0.05);观察组各项中医症候评分低于对照组,差异有统计学意义(P<0.05);观察组中医和内镜总有效率分别为96.15%、93.59%,高于对照组的80.77%、76.92%,差异有统计学意义(P<0.05);对照组复发率为18.33%,高于观察组的5.48%,差异有统计学意义(P<0.05)。结论:对老年RE患者采用半夏泻心汤加减治疗,可调节胃肠激素的分泌,并促进食管动力,改善患者症状,疗效显著,患者不良反应少,复发率低,具有临床推广价值。

    【关键词】 半夏泻心汤 反流性食管炎 泮托拉唑 多潘立酮 食管动力 胃肠激素

    doi:10.14033/j.cnki.cfmr.2020.20.001 文献标识码 A 文章编号 1674-6805(2020)20-000-04

    Therapeutic Effect of Banxia Xiexin Decoction on Elderly Patients with Reflux Esophagitis and Its Effect on Esophageal Motility and Gastrointestinal Hormones/WU Jian, LIU Shumin, ZHENG Jiyin. //Chinese and Foreign Medical Research, 2020, 18(20): -4

    [Abstract] Objective: To study the efficacy of Banxia Xiexin Decoction in the treatment of elderly patients with reflux esophagitis (RE), as well as the effects on esophageal motility and gastrointestinal hormones. Method: A total of 156 elderly RE patients in Department of Internal Medicine, Shijingshan District Hospital of Traditional Chinese Medicine and Department of Gastroenterology, Jingxi Hospital, Chaoyang Hospital from January 2017 to February 2019 were divided into two groups by random number table. The control group was treated with Pantoprazole Enteric Capsule and Domperidone Tablets. The observation group was treated with Banxia Xiexin Decoction on the basis of the control group. The two groups were treated for 8 weeks. The esophageal motility index (DCI, CA, UESP, LESP) and gastrointestinal hormone levels (VIP, GAS, MOT, substance P) and the scores of TCM symptoms were measured and compared between the two groups. Recurrence was observed. TCM efficacy and endoscopy efficacy were evaluated. Result: After treatment, the levels of DCI, CA, UESP and LESP in the observation group were higher than those in the control group (P<0.05). The levels of serum GAS, MOT and SP in the observation group were higher, and the levels of serum VIP were lower than those in the control group (P<0.05). The scores of TCM symptoms in the observation group were lower than those in the control group (P<0.05). The total effective rates of TCM and endoscopy in the observation group were 96.15% and 93.59%, respectively, which were higher than 80.77% and 76.92% in the control group (P<0.05). The recurrence rate in the control group was 18.33%, which was higher than 5.48% in the observation group (P<0.05). Conclusion: Banxia Xiexin Decoction can regulate the secretion of gastrointestinal hormones, promote esophageal motility and improve the symptoms of elderly RE patients and has obvious curative effect, fewer adverse reactions and low recurrence rate, has clinical popularization value., http://www.100md.com(吴健 刘淑敏 郑纪银)
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