【作者】 王飞；

【导师】 李培；

【作者基本信息】 成都中医药大学 ， 中医内科学， 2015， 硕士

【摘要】 目的：通过与对照组比较,观察使用柴胡温胆汤治疗肝胃郁热型非糜烂性反流病的安全性、有效性。方法：将符合NERD(肝胃郁热型)诊断标准的60例患者随机分成观察组和对照组各30例。观察组予柴胡温胆汤加减治疗,对照组予泮托拉唑联合莫沙必利治疗,疗程8周。通过患者治疗有效率、复发率、综合疗效评价、生活质量改善等的统计学差异,比较两组治疗NERD的疗效。实验结果：两组基线(性别构成、年龄、GerdQ得分)比较,P>0.05,没有统计学差异,有可比性。观察组治疗8周后有效率为83.3%,对照组治疗8周后有效率为76.7%,P>0.05,两组治疗8周后有效率无统计学差异。观察组第16周复发率为12.0%,对照组复发率为34.8%,P>0.05,两组第16周复发率无统计学差异。观察组第24周复发率为20.0%,对照组复发率为56.5%,P<0.05,两组第24周复发率有统计学差异,观察组第24周复发率低于对照组。两组治疗第8周、第16周、第24周时GerdQ评分比较,p<0.05,有统计学差异,观察组评分低于对照组。两组治疗前后A1项(即反流症状)、C1项(即睡眠障碍)的分差经t检验,p<0.05,有统计学差异,治疗后观察组A1、C1项症状积分减少更多,表明观察组控制反流症状、改善睡眠方面优于对照组。而两组治疗前后A2(烧心症状)、B1(上腹痛症状)、B2(恶心症状)、C2(OTC用药情况)积分差无统计学差异(p>0.05)。可认为两组在控制上述症状方面疗效相当。结论：两组治疗的近期疗效无统计学差异,观察组与对照组疗效相当。观察组远期疗效优于对照组。观察组对生活质量改善优于对照组。治疗后观察组各期GerdQ评分低于对照组,可以认为观察组综合疗效优于对照组。观察组在改善反流症状、改善睡眠质量方面较西药对照组更优(p<0.05),而在控制烧心、腹痛、恶心及服用OTC药物方面两组效果相当。更多还原

【Abstract】 Objective:Observe the security and effectiveness of using Chaihuwendantang to treat the non-erosive reflux disease of liver stomach wind-cold type comparied with the control group.Methods:60 patients diagnosed with the NERD (liver stomach wind-cold type) were randomly divided into observation group and control group. The observation group were treated with Chaihuwendantang, while the control group were treated with pantoprazole and mosapride.They were treated for 8 weeks both. Through the statistical difference of efficientcy of treatment, recurrence rate, and the comprehensive therapeutic effect, life quality improvement, we can compared the two groups of curative effect for the treatment of NERD.Results:The comparison of two groups of baseline (gender, age, GerdQ scores) have no statistical differences (P> 0.05)After 8 weeks treatment, the effective rate of the observation group was 83.3%, whilethe control group was 76.7%(P> 0.05), have no statistical difference.The 16 weeks recurrence rate of the observation group was 12.0%, while the control group was 34.8%, (P> 0.05), the 16 weeks recurrence rate of the two groups have no statistical difference. The 24 weeks recurrence rate of the observation group was 20.0%, while the control group was 56.5%, (P< 0.05), the 24 weeks recurrence rate was statistically difference between in both groups, the observation group is lower than the control group.The GerdQ scores have statistically significant difference between the observation group with the control group on the 8th week、16th week and 24th week.The observation group is of lower.The integral difference between before and after treatment have statistical difference in A1 term and C1 term,(P<0.05),but have no statistical difference in A2 term、B1 term、B2 term and C2 term.Thus can we consider the observation group has better effect in improving the symptoms of reflux and sleeping quality compared with the control group (p< 0.05).The two groups have similar effect in controlling heartburn, abdominal pain, nausea and in taking OTC drugs.Conclusion:The treatment of the two groups in short-term effects have no statistical difference.The two groups have similar effect. Long curative effect in observation group is better than the control group. The better quality of life appeared in the observation group. The GerdQ scores of the observation group are lower than the control group In each period after treatment.The observation group has better effect in improving the symptoms of reflux and sleeping quality compared with the control group (p<0.05).The two groups have similar effect in controlling heartburn, abdominal pain, nausea and in taking OTC drugs.更多还原