【摘要】 目的 探讨雷贝拉唑联合不同用药时长荜铃胃痛颗粒治疗胃食管反流病（GERD）的临床效果。方法 回顾性队列研究分析，收集2022年6月至2024年6月就诊的150例GERD患者病例资料，根据治疗方案分为A(n=56)、B(n=50)、C(n=44)3组。A组单用雷贝拉唑治疗，共治疗8周；在此基础上B组联合应用4周的荜铃胃痛颗粒治疗，C组联合应用8周的荜铃胃痛颗粒治疗。观察3组临床疗效、不良反应以及短期（1个月）复发率，比较治疗前后中医证候积分、胃食管反流病问卷（GERDQ）评分、食管黏膜损伤程度以及血清胃蛋白酶Ⅰ/Ⅱ水平。结果 3组治疗后中医证候积分和GERDQ评分均较治疗前降低，其中C组上述指标低于A组和B组，B组低于A组（P<0.05）。B组和C组治疗后食管黏膜损伤程度较A组轻（P<0.05）,B组与C组比较无统计学差异（P>0.05）。3组治疗后血清胃蛋白酶Ⅰ/Ⅱ水平均较治疗前降低，其中C组上述指标低于A组和B组，B组低于A组（P<0.05）。C组和B组临床总有效率高于A组，且C组高于B组（P<0.05）。3组不良反应总发生率无统计学差异（P>0.05）。C组和B组1个月短期复发率均低于A组（P<0.05）。结论 雷贝拉唑联合荜铃胃痛颗粒能更有效地缓解患者的症状、降低GERDQ评分、减少复发率，且不会增加不良反应发生率，长期联合使用效果更佳。更多还原

【Abstract】 Objective To explore clinical response effect of Rabeprazole and Biling Weitong granules administered at different time points on gastroesophageal reflux disease(GERD). Methods In this retrospective cohort study, case data were collected from 150 patients with GERD between June 2022 and June 2024. According to different treatment methods, patients were divided into group A(n=56, Rabeprazole treatment alone for 8 weeks), group B(n=50, treatment with Biling Weitong granules for 4 weeks on the basis of group A) and group C(n=44, treatment with Biling Weitong granules for 8 weeks on the basis of group A). The clinical response effect, adverse reactions, and short-term(1-month) recurrence rate in the three groups was observed, and the scores of TCM syndromes and gastroesophageal reflux disease questionnaire(GERDQ), severity of esophageal mucosa injury, and the levels of serum pepsin Ⅰ/Ⅱ were compared among the three groups before and after treatment. Results After treatment, scores of TCM syndromes and GERDQ were lower in the three groups than those before treatment, which was the lowest in group C, followed by group B and group A(P<0.05). After treatment, severity of esophageal mucosa injury in groups B and C was milder than that in group A(P<0.05), while there was no significant difference between group B and group C(P>0.05). After treatment, levels of serum pepsinⅠ/Ⅱ were decreased in the three groups, which was the lowest in group C, followed by group B and group A(P<0.05). The total clinical response rate was the highest in group C, followed by group B and group A(P<0.05). There was no significant difference in total incidence of adverse reactions among the three groups(P>0.05). The short-term(1 month) recurrence rate in group C and group B was lower than that in group A(P<0.05). Conclusion Rabeprazole combined with Biling Weitong granule can more effectively relieve symptoms, and reduce GERDQ scores and recurrence rate, which will not increase the incidence of adverse reactions, and long-term combined medication has better effects.更多还原