【摘要】 目的 观察半夏泻心汤加减联合艾司奥美拉唑镁肠溶片治疗非糜烂性胃食管反流病(NERD)肝胃郁热证的疗效及安全性。方法 选择NERD肝胃郁热证患者98例，按随机数字表法分为2组，对照组(n=49)予艾司奥美拉唑镁肠溶片，治疗组(n=49)在对照组基础上辅以半夏泻心汤加减，连续治疗8周。比较2组疗效及治疗前后中医证候总积分、食管动力[下食管括约肌静息压(LESP)、上食管括约肌静息压(UESP)]、胃肠激素[胃动素、胃泌素、胃促生长素(Ghrelin)、血管活性肠肽(VIP)]、汉密尔顿抑郁量表-17(HAMD-17)评分变化，并观察2组治疗期间不良反应发生情况。结果 治疗组总有效率为95.92%(47/49),对照组为73.47%(36/49),治疗组临床疗效优于对照组(P<0.05)。2组治疗后中医证候总积分、HAMD-17评分均较本组治疗前降低(P<0.05),且治疗组均低于对照组(P<0.05)。2组治疗后LESP均较本组治疗前升高(P<0.05),UESP均较本组治疗前降低(P<0.05);治疗后治疗组LESP高于对照组(P<0.05),UESP低于对照组(P<0.05)。2组治疗后胃动素、胃泌素、Ghrelin均较本组治疗前升高(P<0.05),VIP均较本组治疗前降低(P<0.05);治疗后治疗组胃动素、胃泌素、Ghrelin高于对照组(P<0.05),VIP低于对照组(P<0.05)。2组治疗期间均未发生不良反应。结论 半夏泻心汤加减联合艾司奥美拉唑镁肠溶片治疗NERD肝胃郁热证疗效肯定，能改善食管动力及抑郁状态，调节胃肠激素，且安全性高。更多还原

【Abstract】 Objective To analyze the efficacy and safety of modified Banxia Xiexin Decoction combined with esomeprazole magnesium enteric-coated tablets in treating non-erosive gastroesophageal reflux disease(NERD) of liver and stomach heat syndrome. Methods A total of 98 patients with NERD of liver and stomach heat syndrome divided into the control group(n=49) and the study group(n=49) according to a random number table. All patients were given esomeprazole magnesium enteric-coated tablets, and those in the study group were additionally given modified Banxia Xiexin Decoction. After 8-week of treatment, the total scores of traditional Chinese medicine(TCM) syndromes, esophageal motility(lower esophageal sphincter pressure [LESP], upper esophageal sphincter pressure[UESP]), gastrointestinal hormones(motilin, gastrin, ghrelin, vasoactive intestinal peptide [VIP]) and 17-item Hamilton Rating Scale for Depression(HAMD-17),and treatment-emergent adverse events(TEAEs) between the two groups before and after treatment were compared. Results The total effective rate of the study group was significantly higher than that of the control group(95.92% [47/49] vs 73.47% [36/49], P<0.05). After treatment, the scores TCM syndrome and HAMD-17 of the two groups were significantly lower than those before treatment(P<0.05), and the study group was significantly lower than the control group(P<0.05). After treatment, significantly increased LESP and decreased UESP in both groups were found(both P<0.05), and with significant difference between groups(both P<0.05). After treatment, significantly higher the levels of motilin, gastrin and ghrelin and lower VIP level were detected in the two groups(all P<0.05), and the improvements were more pronounced in the study group relative to the control group(P<0.05). No TEAEs was found in both groups. Conclusion The modified Banxia Xiexin Decoction combined with esomeprazole magnesium enteric-coated tablets has a definite therapeutic effect on NERD of liver and stomach heat syndrome, it can improve esophageal motility, depression, regulate motilin, gastrin, ghrelin, VIP, and it has a high safety.更多还原