Curative effect observation of modified Huatan Xiaoyu decoction on treatment of gastroesophageal reflux disease with chronic atrophic gastritis
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摘要: 目的:观察化痰消瘀方加味治疗胃食管反流病(GERD)伴慢性萎缩性胃炎(CAG)的疗效。方法:选取反流性食管炎(RE)或非糜烂性反流病(NERD)同时伴有CAG的70例患者为研究对象。按随机数字表法分为2组,每组各35例。对照组采用西医抑酸、促胃动力治疗,治疗组在对照组治疗基础上加用化痰消瘀方加味。治疗后观察比较2组患者的中医证候疗效、萎缩治疗总有效率、GERD治疗总有效率、汉密尔顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分、匹兹堡睡眠质量指数(PSQI)评分。结果:疗程结束后,治疗组中医证候各项积分明显低于对照组(P<0.05);2组胃黏膜萎缩治疗总有效率分别为88.57%、65.71%,治疗组明显高于对照组(P<0.05);2组GERD治疗总有效率分别为82.86%、68.57%,治疗组明显高于对照组(P<0.05);2组HAMD、HAMA、PSQI评分较治疗前均降低(P<0.05),且治疗组积分明显低于对照组(P<0.05)。结论:化痰消瘀方加味治疗GERD伴CAG的疗效优于单纯使用常规西医治疗,值得临床推广。Abstract: Objective: To observe the curative effect of modified Huatan Xiaoyu decoction in the treatment of gastroesophageal reflux disease(GERD) with chronic atrophic gastritis(CAG).Methods: Seventy cases either in the form of reflux esophagitis(RE) or non-erosive reflux disease(NERD), which were accompanied with CAG, were selected and randomly divided into 2 groups, each with 35 patients. In the control group, only western medicines were administered to suppress acid and promote gastric motility. In the treatment group, the same western medicine treatment was administered in combination with modified Huatan Xiaoyu decoction. After treatment, the traditional Chinese medicine(TCM) syndrome efficacy,total effective rate of atrophy treatment, total effective rate of anti-gastroesophageal reflux treatment, and scores as indicated in the Hamilton depression scale(HAMD), Hamilton anxiety scale(HAMA) and Pittsburgh sleep quality index(PSQI) were observed and compared between the groups.Results: After treatment, the itemized scores of TCM syndrome in the treatment group were significantly lower than that in the control group(P<0.05).The total effective rate of gastric mucosa atrophy in the two groups was 88.57% and 65.71%,respectively(P<0.05); the total effective rate of anti-gastroesophageal reflux treatment in the two groups was 82.86% and 68.57%, respectively(P<0.05). HAMD, HAMA and PSQI scores in both groups were lower than before treatment(P<0.05) while these scores in the treatment group were significantly lower than those in the control group, and the difference was statistically significant(P<0.05).Conclusion: In the treatment of GERD with CAG, the introduction of modified Huatan Xiaoyu decoction is more effective than conventional western medicine alone. It is worthy of clinical application and further investigation.
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