溫膽湯加味治療氣郁痰阻型非糜爛性反流病的臨床研究
發(fā)布時間：2019-02-12 09:06
【摘要】：1目的本研究在于觀察溫膽湯加味治療氣郁痰阻型非糜爛性反流病(NERD)的臨床療效,及其對患者生活質量的影響,并通過隨訪來評估溫膽湯加味治療本病的遠期療效。2方法將具備納入條件的60例患者隨機分為兩組,治療組和對照組各30例。治療組予溫膽湯加味口服,對照組予雷貝拉唑聯(lián)合莫沙必利口服,療程共8周。采用問卷調查的方式,記錄并分析治療各期患者的臨床癥狀、中醫(yī)證候及生活質量積分,以進行療效評定;療程結束3月后進行隨訪,記錄癥狀積分以觀察遠期療效。3結果3.1反流癥狀問卷(RDQ)評價3.1.1組內各項癥狀積分比較治療第4周末、第8周末及隨訪期,兩組的各項癥狀積分較治療前降低,差異有統(tǒng)計學意義(P0.01或P0.05)。3.1.2治療組與對照組癥狀積分比較治療第4周末,治療組的燒心、反酸、反食積分低于對照組,有統(tǒng)計學差異(P0.05),胸痛積分比較,無統(tǒng)計學差別(P0.05);第8周末,治療組各項癥狀積分均低于對照組(P0.01或P0.05)。3.1.3兩組癥狀總積分、有效率及復發(fā)率比較治療第4周末、第8周末及隨訪期,治療組癥狀總積分均低于對照組,差異有統(tǒng)計學意義(P0.01);治療后治療組總顯效率(90%)高于對照組總顯效率(66.67%)(P0.05)。隨訪期,治療組復發(fā)率(6.7%)低于對照組復發(fā)率(26.27%)(P0.05)。3.2中醫(yī)證候評價3.2.1組內各項癥候積分比較治療第4周末,治療組各項癥候積分明顯低于治療前(P0.01);對照組的反流、半夜嗆咳、急躁易怒、便溏、納呆、噯氣積分低于治療前(P0.01或P0.05),余癥候積分比較無差異(P0.05);第8周末,兩組患者各項積分均顯著低于治療前(P0.01)。3.2.2治療組與對照組癥候積分比較治療第4周末,治療組咽喉不利、反流、半夜嗆咳、急躁易怒積分低于對照組(P0.01或P0.05),余癥候積分比較無統(tǒng)計學差異(P0.05);治療8周末,治療組咽喉不利、反流、半夜嗆咳、噯氣、急躁易怒積分低于對照組(P0.01或P0.05),余癥候積分比較,無明顯差異(P0.05)。3.2.3兩組癥候總積分、有效率比較治療第4周末、第8周末及隨訪期,治療組癥狀總積分均低于對照組(P0.01或P0.05);治療后治療組顯效率(93.3%)高于對照組(66.67%)(P0.05)。3.3 SF-36量表評價治療第8周末,治療組生理職能(RP)、情感職能(RE)、社會功能(SF)、等維度積分高于對照組(P0.01或P0.05),精神健康(MH)、生理機能(PF)積分比較,差異無統(tǒng)計學意義(P0.05)。隨訪期,治療組軀體疼痛(BP)、一般健康(GH)、精力(VT)等維度積分高于對照組(P0.01或P0.05),生理機能、生理職能積分無統(tǒng)計學差異(P0.05)。4研究結論溫膽湯加味可明顯緩解非糜爛性反流病患者的不適癥狀,并在改善患者生活質量方面具有顯著的優(yōu)勢,且復發(fā)率低,具有較為理想的遠期療效。
[Abstract]:Objective to observe the clinical effect of Wendan decoction on non-erosive reflux disease (NERD) caused by Qi stagnation and phlegm obstruction and its effect on the quality of life of the patients. Methods 60 patients with Wentan decoction were randomly divided into two groups: treatment group (n = 30) and control group (n = 30). The treatment group was treated with Wendan decoction and the control group with rabeprazole and mosapride for 8 weeks. Questionnaire survey was used to record and analyze the clinical symptoms, TCM syndromes and quality of life scores of patients in each stage to evaluate the curative effect. Three months after the course of treatment were followed up, symptom scores were recorded to observe the long-term curative effect. 3 results 3.1Reflux symptom questionnaire (RDQ) was used to evaluate the comparison of symptom scores in group 3.1.1 at the end of the 4th week, the 8th week and the follow-up period. The scores of symptoms in the two groups were significantly lower than those before treatment (P0.01 or P0.05). 3.1.2 the symptom scores of the treatment group were compared with those of the control group at the end of the 4th week of treatment, the heart burning and regurgitation of the treatment group, and the difference between the two groups were significant (P0.01 or P0.05). The score of backeating was lower than that of the control group (P0.05), but the score of chest pain had no statistical difference (P0.05). At the end of the 8th week, the symptom scores in the treatment group were lower than those in the control group (P0.01 or P0.05). 3.1.3 the total symptom score, the effective rate and the recurrence rate of the two groups were compared at the end of the 4th week, the 8th weekend and the follow-up period. The total symptom score in the treatment group was lower than that in the control group (P0.01). The total effective rate of the treatment group (90%) was higher than that of the control group (66.67%) (P0.05). During the follow-up period, the recurrence rate in the treatment group (6.7%) was lower than that in the control group (26.27%) (P0.05). The scores of symptoms in the treatment group were significantly lower than those before treatment (P0.01). In the control group, the score of regurgitation, cough, irritability, loose stools, belching and belching was lower than that before treatment (P0.01 or P0.05), but there was no difference in the scores of other symptoms (P0.05). At the end of the 8th week, the scores of the two groups were significantly lower than those before the treatment (P0.01). 3.2.2 the symptom score of the treatment group and the control group were compared at the end of the 4th week of treatment, the treatment group had adverse throat, reflux, and cough in the middle of the night. The score of irritability and irritability was lower than that of the control group (P0.01 or P0.05), but there was no statistical difference in the score of other symptoms (P0.05). At the end of 8 weeks, the scores of pharynx, reflux, cough, belching, irritability and irritability in the treatment group were lower than those in the control group (P0.01 or P0.05). There was no significant difference between the two groups (P0.05). 3.2.3 the total score of symptoms in the treatment group was lower than that in the control group (P0.01 or P0.05) at the end of the 4th weekend, the 8th weekend and the follow-up period. The effective rate in the treatment group (93.3%) was higher than that in the control group (66.67%) (P0.05). 3.3 SF-36 scale was used to evaluate the end of the 8th week of treatment. The physiological function, (RP), emotional function, (RE), social function (SF), in the treatment group were evaluated. The equal dimension score was higher than the control group (P0.01 or P0.05), the mental health (MH), physiological function (PF) score comparison, the difference was not statistically significant (P0.05). During the follow-up period, the scores of (BP), (GH), energy, (VT) and so on in the treatment group were higher than those in the control group (P0.01 or P0.05). There was no significant difference in physiological function score (P0.05). 4 conclusion Wendan decoction can significantly relieve the discomfort of patients with non-erosive reflux disease, and has significant advantages in improving the quality of life of patients, and the recurrence rate is low. It has ideal long-term effect.
【學位授予單位】：安徽中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R259
[Abstract]:Objective to observe the clinical effect of Wendan decoction on non-erosive reflux disease (NERD) caused by Qi stagnation and phlegm obstruction and its effect on the quality of life of the patients. Methods 60 patients with Wentan decoction were randomly divided into two groups: treatment group (n = 30) and control group (n = 30). The treatment group was treated with Wendan decoction and the control group with rabeprazole and mosapride for 8 weeks. Questionnaire survey was used to record and analyze the clinical symptoms, TCM syndromes and quality of life scores of patients in each stage to evaluate the curative effect. Three months after the course of treatment were followed up, symptom scores were recorded to observe the long-term curative effect. 3 results 3.1Reflux symptom questionnaire (RDQ) was used to evaluate the comparison of symptom scores in group 3.1.1 at the end of the 4th week, the 8th week and the follow-up period. The scores of symptoms in the two groups were significantly lower than those before treatment (P0.01 or P0.05). 3.1.2 the symptom scores of the treatment group were compared with those of the control group at the end of the 4th week of treatment, the heart burning and regurgitation of the treatment group, and the difference between the two groups were significant (P0.01 or P0.05). The score of backeating was lower than that of the control group (P0.05), but the score of chest pain had no statistical difference (P0.05). At the end of the 8th week, the symptom scores in the treatment group were lower than those in the control group (P0.01 or P0.05). 3.1.3 the total symptom score, the effective rate and the recurrence rate of the two groups were compared at the end of the 4th week, the 8th weekend and the follow-up period. The total symptom score in the treatment group was lower than that in the control group (P0.01). The total effective rate of the treatment group (90%) was higher than that of the control group (66.67%) (P0.05). During the follow-up period, the recurrence rate in the treatment group (6.7%) was lower than that in the control group (26.27%) (P0.05). The scores of symptoms in the treatment group were significantly lower than those before treatment (P0.01). In the control group, the score of regurgitation, cough, irritability, loose stools, belching and belching was lower than that before treatment (P0.01 or P0.05), but there was no difference in the scores of other symptoms (P0.05). At the end of the 8th week, the scores of the two groups were significantly lower than those before the treatment (P0.01). 3.2.2 the symptom score of the treatment group and the control group were compared at the end of the 4th week of treatment, the treatment group had adverse throat, reflux, and cough in the middle of the night. The score of irritability and irritability was lower than that of the control group (P0.01 or P0.05), but there was no statistical difference in the score of other symptoms (P0.05). At the end of 8 weeks, the scores of pharynx, reflux, cough, belching, irritability and irritability in the treatment group were lower than those in the control group (P0.01 or P0.05). There was no significant difference between the two groups (P0.05). 3.2.3 the total score of symptoms in the treatment group was lower than that in the control group (P0.01 or P0.05) at the end of the 4th weekend, the 8th weekend and the follow-up period. The effective rate in the treatment group (93.3%) was higher than that in the control group (66.67%) (P0.05). 3.3 SF-36 scale was used to evaluate the end of the 8th week of treatment. The physiological function, (RP), emotional function, (RE), social function (SF), in the treatment group were evaluated. The equal dimension score was higher than the control group (P0.01 or P0.05), the mental health (MH), physiological function (PF) score comparison, the difference was not statistically significant (P0.05). During the follow-up period, the scores of (BP), (GH), energy, (VT) and so on in the treatment group were higher than those in the control group (P0.01 or P0.05). There was no significant difference in physiological function score (P0.05). 4 conclusion Wendan decoction can significantly relieve the discomfort of patients with non-erosive reflux disease, and has significant advantages in improving the quality of life of patients, and the recurrence rate is low. It has ideal long-term effect.
【學位授予單位】：安徽中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R259
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