Impacts of modified Zuojin pill combined with ear acupoint therapy on symptom improvement and the levels of GAS and MTL in patients with gastroesophageal reflux disease
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摘要: 目的 分析左金丸加味联合耳穴疗法对胃食管反流病患者症状改善以及胃泌素(gastrin，GAS)和胃动素(motilin，MTL)水平的影响。方法 选取2021年11月—2022年10月收治的80例患者为研究对象，按照SAS分析系统随机程序将其分为试验组和西药组，每组各40例；西药组给予艾司奥美拉唑镁肠溶片治疗，试验组给予自拟左金丸加味+耳穴疗法治疗；治疗8周后，观察记录两组的临床疗效、不良反应发生情况和复发率，比较两组的中医证候积分、胃食管反流病问卷(gastroesophageal reflux disease diagnostic questionnaire，GerdQ)和焦虑自评量表(self-rating anxiety scale，SAS)评分、GAS和MTL水平。结果 试验组临床总有效率为90.00%，高于西药组的72.50%(P < 0.05)；治疗后，两组患者的中医证候积分均显著下降(P < 0.05)，且试验组低于西药组(P < 0.05)；治疗后，两组患者的GerdQ和SAS评分显著低于治疗前(P < 0.05)，且试验组低于西药组(P < 0.05)；治疗后，两组患者的GAS、MTL水平显著高于治疗前(P < 0.05)，且试验组高于西药组(P < 0.05)；两组患者的口干、腹泻、恶心、便秘、头晕等不良反应发生率比较差异无统计学意义(P>0.05)；治疗后试验组的复发率显著低于西药组(P < 0.05)。结论 左金丸加味联合耳穴疗法能够提高对胃食管反流病患者的疗效，降低复发率，提高患者的GAS、MTL水平及生活质量。Abstract: Objective To analyze the impacts of modified Zuojin pill combined with ear acupoint therapy on symptom improvement and the levels of gastrin(GAS) and motilin(MTL) in patients with gastroesophageal reflux disease.Methods Eighty outpatient and inpatient patients from our hospital from November 2021 to October 2022 were collected as the research subjects. They were randomly separated into an experimental group and a western medicine group according to the statistical analysis system(SAS) random program, with 40 patients in each group; the western medicine group was treated with esomeprazole magnesium enteric coated tablets, while the experimental group was treated with self-designed modified Zuojin pill and ear acupoint therapy; after 8 weeks of treatment, the clinical efficacy, incidence of adverse reactions, and recurrence rate of both groups were observed and recorded, the Traditional Chinese Medicine(TCM) scores, gastroesophageal reflux disease diagnostic questionnaire(GerdQ) and self-rating anxiety scale(SAS) scores, the levels of GAS and MTL were compared between the two groups.Results The total clinical effective rate in the experimental group was 90.00%, which was higher than 72.50% in the western medicine group(P < 0.05); after treatment, the TCM syndrome score of both groups obviously decreased(P < 0.05), and the experimental group was lower than the western medicine group(P < 0.05); after treatment, the GerdQ and SAS scores in both groups were obviously lower than before treatment(P < 0.05), and the experimental group were lower than the western medicine group(P < 0.05); after treatment, the levels of GAS and MTL in both groups were obviously higher than before treatment(P < 0.05), and the experimental group were higher than the western medicine group(P < 0.05); there was no difference in the incidence of adverse reactions such as dry mouth, diarrhea, nausea, constipation, and dizziness between the two groups(P>0.05); after treatment, the recurrence rate in the experimental group was obviously lower than that in the western medicine group(P < 0.05).Conclusion The combination of modified Zuojin pill and ear acupoint therapy can improve the treatment efficiency of patients with gastroesophageal reflux disease, reduce the recurrence rate, and improve the levels of GAS, MTL, and quality of life of the patients.
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Key words:
- modified Zuojin pill /
- ear acupoint therapy /
- gastroesophageal reflux disease /
- gastrin /
- motilin
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表 1 两组患者的临床资料比较
X±S, 例(%) 临床资料 试验组
(n=40)西药组
(n=40)χ2/t P 年龄/岁 48.34±8.69 49.72±8.50 0.718 0.475 性别 0.053 0.818 男 24(60.00) 25(62.50) 女 16(40.00) 15(37.50) BMI 24.16±2.87 24.33±2.65 0.275 0.784 病程/年 5.08±2.43 4.91±2.56 0.305 0.761 合并症 高血压 13(32.50) 11(27.50) 0.238 0.626 高血脂 9(22.50) 10(25.00) 0.069 0.793 糖尿病 10(25.00) 7(17.50) 0.672 0.412 
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表 2 两组患者的临床疗效比较
例(%) 组别 例数 治愈 显效 有效 无效 总有效 试验组 40 17(42.50) 12(30.00) 7(17.50) 4(10.00) 36(90.00) 西药组 40 13(32.50) 11(27.50) 5(12.50) 11(27.50) 29(72.50) χ2 4.021 P 0.045
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表 3 两组患者的中医证候积分比较
分，X±S 组别 例数 治疗前 治疗后 t P 试验组 40 26.48±5.91 19.60±4.27 14.564 < 0.001 西药组 40 27.03±5.86 23.36±4.52 7.803 < 0.001 t 0.418 3.824 P 0.677 < 0.001
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表 4 两组患者的GerdQ和SAS评分比较
分，X±S 组别 例数 GerdQ评分 SAS评分 治疗前 治疗后 治疗前 治疗后 试验组 40 11.48±3.79 7.80±2.111) 67.49±11.63 48.37±5.421) 西药组 40 11.75±3.62 9.24±2.171) 65.84±12.06 51.65±5.911) t 0.326 3.009 0.623 2.587 P 0.745 0.004 0.535 0.012 与治疗前比较，1)P < 0.05。
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表 5 两组患者的GAS、MTL水平比较
ng/L，X±S 组别 例数 GAS MTL 治疗前 治疗后 治疗前 治疗后 试验组 40 24.81±7.25 47.05±14.661) 145.11±42.28 225.37±69.131) 西药组 40 25.03±8.11 40.12±12.901) 137.92±44.51 189.41±60.771) t 0.128 2.244 0.741 2.471 P 0.899 0.028 0.461 0.016 与治疗前比较，1)P < 0.05。
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表 6 两组患者的不良反应、复发情况比较
例(%) 组别 例数 口干 腹泻 恶心 便秘 头晕 总发生 复发 试验组 40 1(2.50) 0 0 1(2.50) 0 2(5.00) 2(5.00) 西药组 40 3(7.50) 1(2.50) 2(5.00) 0 1(2.50) 7(17.50) 9(22.50) χ2 2.003 5.165 P 0.157 0.023
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