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[1]魏仕兵,来要良.辛开苦降法对非糜烂性胃食管反流病患者食管动力及酸反流的影响[J].环球中医药,2017,10(10):1085-1089.[doi:10.3969/j.issn.1674-1749.2017.10.006]
　WEI Shibing,LAI Yaoliang..Effects of Xinkai Kujiang method on esophageal motility and acid reflux in patients with non-erosive reflux disease[J].,2017,10(10):1085-1089.[doi:10.3969/j.issn.1674-1749.2017.10.006]
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辛开苦降法对非糜烂性胃食管反流病患者食管动力及酸反流的影响()
     
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《环球中医药》[ISSN:1006-6977/CN:61-1281/TN]

卷:
第10卷
期数:
2017年10期
页码:
1085-1089
栏目:
论著
出版日期:
2017-10-06

文章信息/Info

Title:
Effects of Xinkai Kujiang method on esophageal motility and acid reflux in patients with non-erosive reflux disease
作者:
魏仕兵; 来要良
100053 北京市宣武中医医院脾胃病科
Author(s):
WEI Shibing;  LAI Yaoliang.
Xuanwu traditional Chinese medicine Hospital of Beijing,Beijing 100053,China
关键词:
辛开苦降;  非糜烂性胃食管反流病;  食管动力;  酸反流
Keywords:
Xinkai Kujiang;  Non-erosive reflux disease;  Esophageal motility;  Acid reflux
分类号:
R573.3
DOI:
10.3969/j.issn.1674-1749.2017.10.006
文献标志码:
A
摘要:
目的 观察辛开苦降法对非糜烂性胃食管反流病患者食管动力及酸反流的影响。方法 选取2015年1月～2017年1月就诊于北京市宣武中医医院门诊的非糜烂性胃食管反流病患者82例,随机分为治疗组和安慰剂组。治疗组予辛开苦降方免煎剂口服,安慰剂组予中药安慰剂口服,疗程4周。对比两组患者治疗前后高分辨食管测压指标、24小时pH监测指标及血清胃肠激素水平,评估辛开苦降法对非糜烂性胃食管反流病患者食管动力及酸反流的影响。结果(1)治疗后治疗组血清中血清胃泌紊、胃动素、P物质水平较治疗前明显升高,血管活性肠肽水平明显下降,且与安慰剂组比较有明显差异(P<0.05);(2)治疗后治疗组患者酸反流总次数、pH<4的反流时间百分比、反流时间>5分钟反流次数、最长反流时间、DeMeester评分较治疗前均有明显降低,且明显低于安慰剂组,差异有统计学意义(P<0.05);(3)治疗后治疗组患者食管上括约肌静息压、食管下括约肌静息压及远端收缩积分较治疗前明显升高,且明显高于安慰剂组,差异有统计学意义(P<0.05);(4)治疗后治疗组中医证候积分明显低于安慰剂组(P<0.05); 治疗组中医证候疗效总有效率87.8%,安慰剂组总有效率43.9%,治疗组中医证候疗效总有效率明显高于安慰剂组,差异有统计学意义(P<0.05)。结论 辛开苦降法明显改善非糜烂性胃食管反流患者反流症状,调节血清胃肠激素水平,促进食管蠕动,减少酸反流。
Abstract:
Objective To observe the effects of Xinkai Kujiang method on esophageal motility and acid reflux in patients with non-erosive reflux disease. Methods 82 cases of patients with non-erosive reflux were select from the outpatient clinic of Xuanwu TCM Hospital of Beijing from January 2015 to January 2017. The patients were randomly divided into treatment group and placebo group. The treatment group was treated with the Xinkai Kujiang prescriptions and the placebo group was treated with the Chinese medicine placebo for 4 weeks. After treatment, the high resolution esophagus pressure detection, 24 hour pH monitoring index and serum gastrointestinal hormone levels of the two groups were compared. Results(1)After treatment, the levels of gastrin, motilin and substance p in the treatment group were significantly higher than before the treatment, and also significantly higher than those in the control group, and the levels of vasoactive intestinal peptide in the treatment group was decreased, the difference was statistically significant(P<0.05).(2)After treatment, the total number of acid reflux, the percentage of reflux time(pH<4),the frequency of reflux time>5 mins, the maximum reflux time and the demeester score in the treatment group were significantly decreased than before the treatment and also significantly higher than those in the control group, the difference was statistically significant(P<0.05).(3)After treatment, the upper esophageal sphincter pressure, lower esophageal sphincter pressure, and the distal contractile integral score in the treatment group were significantly higher than before the treatment and also significantly higher than those in the control group, the difference was statistically significant(P<0.05).(4)After treatment, the traditional Chinese medicine syndrome scores of the treatment group were significantly higher than the placebo group(P<0.05). The effective rate of the treatment group(87.8%)was significantly higher than the placebo group(43.9%), the total effective rate of TCM syndrome in treatment group was significantly higher than that in placebo group(P<0.05). Conclusion The Xinkai Kujiang method can relieve the reflux symptoms, regulate serum gastrointestinal hormone levels, promote the esophageal peristalsis and reduce the acid reflux in the non-erosive reflux disease patients.

参考文献/References:

[1] 丰金香,陈朝明.非糜烂性胃食管反流病的中西医治疗进展[J].实用医学杂志,2014,30(19):3037-3039.
[2] 张颖慧,王一平.胃食管返流病与食管动力障碍研究进展[J].实用医院临床杂志,2016,13(5):212-214.
[3] 宋瑞平,朱宝.胃食管反流病的中西医诊治进展[J].实用中西医结合临床,2016,16(8):86-89.
[4] 林三仁,许国铭,胡品津,等.中国胃食管反流病共识意见[J].胃肠病学,2007,12(4):233-239.
[5] 张声生,李乾构,朱生,等.胃食管反流病中医诊疗共识意见(2009,深圳)[J].中医杂志,2010,51(9):844-847.
[6] 杜智,张成,克力木,等.高分辨率食管测压与食管24h pH监测在胃食管反流病中的应用价值[J].中华胃食管反流病电子杂志,2015,2(3):147-151.
[7] Irene Martinucci, Nicola de Bortoli, Maria Giacchino, et al. Esophageal motility abnormalities in gastroesophageal refluxdisease[J].World J Gastrointest Pharmacol Ther,2014,5(2):86-96.
[8] 陈莉丽,卜平,方晓华.脑肠肽、中医证型与胃食管反流病病程的相关性[J].世界华人消化杂志,2016,24(16):2531-2536.
[9] Quigley EM. Bugs on the brain; brain in the gut-seeking explanations for common gastrointestinal symptoms[J]. Ir J Med Sci,2013,182:1-6.
[10] 陈莉丽,卜平.不同证型胃食管反流患者脑肠肽特点[J].世界华人消化杂志,2015,23(31):5029-5034.
[11] 向旭,朱海杭.胃肠激素与糖尿病并发胃食管反流病[J].胃肠病学和肝病学杂志,2013,22(8):823-825.

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备注/Memo

备注/Memo:
基金项目: 首都临床特色应用研究(Z141107002514081)
作者简介: 魏仕兵(1987- ),硕士,住院医师。研究方向:中医药防治慢性脾胃病。E-mail:wsbsp60@126.com
通信作者: 来要良(1981- ),博士,副主任医师。研究方向:脾胃肝胆病中医药防治。E-mail:yaoliang010@163.com
更新日期/Last Update: 2017-10-06