和肝颗粒治疗肝郁脾虚型非糜烂性反流病疗效及对5-HT,VIP的影响
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摘要
目的:观察和肝颗粒治疗肝郁脾虚型非糜烂性反流病患者的临床疗效及对患者生活质量,5-羟色胺(5-HT),血管活性肠肽(VIP)水平的影响。方法:将肝郁脾虚型非糜烂性反流病患者随机分为治疗组32例和对照组33例,治疗组采用和肝颗粒10 g/袋,每次1袋,每日2次,餐后口服。对照组采用奥美拉唑肠溶片20 mg/粒,每日2次,餐前口服。两组疗程均为8周。观察两组治疗前后中医症状总积分及SF-36健康量表评分及5-HT,VIP水平。结果:两组患者中医疗效比较,治疗组、对照组中医疗效总有效率分别为87. 5%,81. 8%,治疗组优于对照组(P <0. 05);治疗后治疗组在特殊症状、次要症状方面改善优于对照组(P <0. 05);在主要症状方面两组疗效相当;治疗后治疗组SF-36健康量表在生理职能、总体健康、活力、社会功能、情感职能、心理健康6个维度评分均较高于对照组(P <0. 05);治疗后两组患者5-HT,VIP水平均降低,治疗组低于对照组(P <0. 05)。结论:和肝颗粒治疗肝郁脾虚型非糜烂性反流病患者具有较好的临床疗效,能够改善患者的中医症状,并能提高患者的生活质量,降低食管内脏敏感性。
Objective: To observe the clinical efficacy of Hegan granule in the treatment of non-erosive reflux disease with liver stagnation and spleen deficiency syndrome and its effect on quality of life,5-hydroxytryptamine( 5-HT) and vasoactive intestinal peptide( VIP) level. Method: Patients with non-erosive reflux disease of liver stagnation and spleen deficiency were randomly divided into treatment group( 32 cases) and control group( 33 cases). The treatment group was orally given Hegan granules after meal,10 g/bag,1 bag/time,2 times/day. The control group was orally given with omeprazole enteric-coated tablets twice daily,20 mg/grain.Both groups were treated for 8 weeks. The total scores of traditional Chinese medicine( TCM) symptoms,SF-36 health scale scores,5-HT and VIP levels were observed before and after treatment. Result: The medical efficacy of the two groups was 87. 5% and 81. 8% in the treatment group and the control group,respectively. The treatment group was superior to control group( P < 0. 05). The treatment group had special symptoms and secondary symptoms after treatment,with better improvements than control group( P < 0. 05). The efficacy of the two groups was comparable in the main symptoms, after the treatment, the SF-36 health scale of treatment group in physiological function,overall health,vitality,social function,emotional function and mental health were higher than those in control group( P < 0. 05). The levels of 5-HT and VIP in two groups were lower after treatment,and treatment group was significantly lower than control group( P < 0. 05). Conclusion: Hegan granule has a good clinical efficacy in treating patients with non-erosive reflux disease and liver stagnation and spleen deficiency. It can significantly alleviate the symptoms of TCM,improve the quality of life of patients,and reduce the sensitivity of esophageal viscera.
Objective: To observe the clinical efficacy of Hegan granule in the treatment of non-erosive reflux disease with liver stagnation and spleen deficiency syndrome and its effect on quality of life,5-hydroxytryptamine( 5-HT) and vasoactive intestinal peptide( VIP) level. Method: Patients with non-erosive reflux disease of liver stagnation and spleen deficiency were randomly divided into treatment group( 32 cases) and control group( 33 cases). The treatment group was orally given Hegan granules after meal,10 g/bag,1 bag/time,2 times/day. The control group was orally given with omeprazole enteric-coated tablets twice daily,20 mg/grain.Both groups were treated for 8 weeks. The total scores of traditional Chinese medicine( TCM) symptoms,SF-36 health scale scores,5-HT and VIP levels were observed before and after treatment. Result: The medical efficacy of the two groups was 87. 5% and 81. 8% in the treatment group and the control group,respectively. The treatment group was superior to control group( P < 0. 05). The treatment group had special symptoms and secondary symptoms after treatment,with better improvements than control group( P < 0. 05). The efficacy of the two groups was comparable in the main symptoms, after the treatment, the SF-36 health scale of treatment group in physiological function,overall health,vitality,social function,emotional function and mental health were higher than those in control group( P < 0. 05). The levels of 5-HT and VIP in two groups were lower after treatment,and treatment group was significantly lower than control group( P < 0. 05). Conclusion: Hegan granule has a good clinical efficacy in treating patients with non-erosive reflux disease and liver stagnation and spleen deficiency. It can significantly alleviate the symptoms of TCM,improve the quality of life of patients,and reduce the sensitivity of esophageal viscera.
引文
[1]傅睿,李亚平.宁神清胆汤治疗胆热扰胃型非糜烂性胃食管反流病临床观察[J].新中医,2016,48(10):60-63.
[2]Fass R. Erosive esophagitis and non-erosive reflux disease(NERD):comparison of epidemiologic,physiologic,and therapeutic characteristics[J]. J Clin Gastroentero,2007,41(2):131-137.
[3]El-Serag B H,Sweet S,Winchester C C,et al. Update on the epidemiology of gastroesophageal reflux disease:a systematic review[J]. Gut,2014,63(6):871-880.
[4]Vanner S, Greenwood V, Meerveld B, et al.Fundamentals of neurogastroenterology:basic science[J]. Gastroenterology,2006,130(5):1391-1411.
[5]李建生. 2013美国GERD诊治指南介绍[J].胃肠病学和肝病学杂志,2013,22(5):471-472.
[6]于丽媛,龚晓健,王永庆.长期使用质子泵抑制剂致骨质疏松的研究进展[J].药学与临床研究,2017,25(3):237-242.
[7]吴玲玲,林征,林琳,等.经皮神经电刺激内关、足三里对胃食管反流病患者临床症状及生活质量的影响[J].中国针灸,2017,37(2):139-142.
[8]权红,解晓静.和肝汤治疗胃食管反流病40例[J].中国中西医结合消化杂志,2009,17(4):266-267.
[9]中华医学会消化病学分会.中国胃食管反流病专家共识意见(2014年)[J].胃肠病学,2015,20(3):155-168.
[10]中华人民共和国卫生部.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:124-129.
[11]王婷.益气舒膈汤治疗非糜烂性反流病肝郁脾虚证临床疗效观察[D].北京:中国中医科学院,2012.
[12]李鲁,王红妹,沈毅,等. SF-36健康调查量表中文版的研制及其性能测试[J].中华预防医学杂志,2002,36(2):109-113.
[13]陆会飞,牛小平.神经肽参与NERD内脏高敏感外周机制的研究进展[J].胃肠病学和肝病学杂志,2016,25(9):1071-1074.
[14]张秀莲,程艳梅,朱生樑.中西医改善非糜烂性胃食管反流病患者生活质量概况[J].中国中医急症,2015,24(4):657-659.
[15]中华中医药学会脾胃病分会.胃食管反流病中医诊疗专家共识意见(2017)[J].中国中西医结合消化杂志,2017,25(5):321-326.
[16]李军祥,王允亮.胃食管反流病的中医药疗效评价[J].中医杂志,2016,57(3):212-215.
[17]贺秀玲,张继荣.质子泵抑制药的药理作用及临床应用分析[J].世界最新医学信息文摘,2018,18(77):117-129.
[18]周海新.和胃降逆汤加减治疗胃食管反流病64例[J].中国实验方剂学杂志,2014,20(18):204-207.
[19]郭一,李军祥,毛堂友,等.和胃降逆方对非糜烂性胃食管反流病大鼠5-羟色胺及其受体表达的影响(一)[J].中医药导报,2017,23(21):17-21.
[20]陈莉丽,卜平.脑-肠肽与胃食管反流病关系的研究进展[J].医学综述,2015,21(3):456-458.
[2]Fass R. Erosive esophagitis and non-erosive reflux disease(NERD):comparison of epidemiologic,physiologic,and therapeutic characteristics[J]. J Clin Gastroentero,2007,41(2):131-137.
[3]El-Serag B H,Sweet S,Winchester C C,et al. Update on the epidemiology of gastroesophageal reflux disease:a systematic review[J]. Gut,2014,63(6):871-880.
[4]Vanner S, Greenwood V, Meerveld B, et al.Fundamentals of neurogastroenterology:basic science[J]. Gastroenterology,2006,130(5):1391-1411.
[5]李建生. 2013美国GERD诊治指南介绍[J].胃肠病学和肝病学杂志,2013,22(5):471-472.
[6]于丽媛,龚晓健,王永庆.长期使用质子泵抑制剂致骨质疏松的研究进展[J].药学与临床研究,2017,25(3):237-242.
[7]吴玲玲,林征,林琳,等.经皮神经电刺激内关、足三里对胃食管反流病患者临床症状及生活质量的影响[J].中国针灸,2017,37(2):139-142.
[8]权红,解晓静.和肝汤治疗胃食管反流病40例[J].中国中西医结合消化杂志,2009,17(4):266-267.
[9]中华医学会消化病学分会.中国胃食管反流病专家共识意见(2014年)[J].胃肠病学,2015,20(3):155-168.
[10]中华人民共和国卫生部.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:124-129.
[11]王婷.益气舒膈汤治疗非糜烂性反流病肝郁脾虚证临床疗效观察[D].北京:中国中医科学院,2012.
[12]李鲁,王红妹,沈毅,等. SF-36健康调查量表中文版的研制及其性能测试[J].中华预防医学杂志,2002,36(2):109-113.
[13]陆会飞,牛小平.神经肽参与NERD内脏高敏感外周机制的研究进展[J].胃肠病学和肝病学杂志,2016,25(9):1071-1074.
[14]张秀莲,程艳梅,朱生樑.中西医改善非糜烂性胃食管反流病患者生活质量概况[J].中国中医急症,2015,24(4):657-659.
[15]中华中医药学会脾胃病分会.胃食管反流病中医诊疗专家共识意见(2017)[J].中国中西医结合消化杂志,2017,25(5):321-326.
[16]李军祥,王允亮.胃食管反流病的中医药疗效评价[J].中医杂志,2016,57(3):212-215.
[17]贺秀玲,张继荣.质子泵抑制药的药理作用及临床应用分析[J].世界最新医学信息文摘,2018,18(77):117-129.
[18]周海新.和胃降逆汤加减治疗胃食管反流病64例[J].中国实验方剂学杂志,2014,20(18):204-207.
[19]郭一,李军祥,毛堂友,等.和胃降逆方对非糜烂性胃食管反流病大鼠5-羟色胺及其受体表达的影响(一)[J].中医药导报,2017,23(21):17-21.
[20]陈莉丽,卜平.脑-肠肽与胃食管反流病关系的研究进展[J].医学综述,2015,21(3):456-458.
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