Clinical Observation On The Treatment Of Gastroesophageal Reflux Disease By Reversing Qiaoqi Powder And The Effect Of Drug Depression On Recurrence Rate

Gastroesophageal Reflux Disease (GERD) is a common Disease and a high morbidity-rate disease in Gastroenterology Department.GERD is the content reflux from the stomach and duodenum into the esophagus,which causes a series of clinical symptoms and pathological damage. The common clinical symptoms include acid reflux, heartburn, often accompanied by substernal burning pain, pharyngeal foreign body sensation, dysphagia, odynophagia, or extra reflux-related esophageal symptoms, such as sore throat, cough, asthma etc. The main medicines of Western medicine treatment are proton pump inhibitors(PPI) and H2 receptor antagonist (H2RA) Nevertheless, long-term use of PPI and H2RA may cause medicine dependence and adverse effect. Traditional Chinese medicine has accumulated rich experience in the treatment for gastroesophageal reflux disease, which has distinct curative effect and low relapse rate. The"Jiangni Qige decoction"is based on historical famous formula "Qige san". It conbines Professor Dong Jianhua’s theory of "dredging and subsiding".The"Jiangni Qige decoction"has been confirmed effective by the clinic for the treatment of gastroesophageal reflux disease.[Objective]:1.Evaluating objectively the Jiangni Qige decoction’s clinical curative effect in the treatment for gastroesophageal reflux disease.2.Evaluating the curative effect Comparatively between the Jiangni Qige decoction and the western medicine in the treatment of gastroesophageal reflux disease.3. Observing the curative effect and medicine resistance of half dosage of the Jiangni Qige decoction and the western medicine.4. Investigating the safety of the Jiangni Qige decoction.[Methods]:The clinical trial is a prospective study, adopting an open and randomized controlled method. The 59 patients belonging to the standard diagnosis of gastroesophageal reflux disease will be divided into Chinese medicine group and western medicine group.35 patients in Chinese medicine group will be provided with The"Jiangni Qige decoction".24 patents in the western medicine group will be provided with omeprazole and domperidone.Two groups will take prescribed dosages for 4 weeks. Then the two groups will take half dosages continually for two weeks. Two groups’patients visit the doctor once a week, fill in the case report form. We will observe the trial for 6 weeks and make safety evaluation meanwhile.[Results]:1.4 weeks after the treatment, the total effective rate of Chinese medicine group is 85.7%, the western medicine group is 79.2%. The difference is statistically significant (P< 0.05). The result shows that Chinese medicine’s curative effect is superior to western medicine group. Chinese medicine group shows similar curative effect with western medicine group in the aspect of releasing contents reflux, acid reflux, heartburn. The result shows no significant statistical difference (P> 0.05). In the aspect of improving the gastroesophageal reflux-related secondary symptoms(substernal pain, pharyngeal foreign body sensation, abdominal distension, belch, dysphagia, odynophagia, cough and asthma), Chinese medicine group’s total effective rate is 77.1% after 4 weeks of treatment, while the western medicine group is 33.3%. The result shows that the two groups have statistical significance (P< 0.05), Chinese medicine group’s curative effect is significantly better than western medicine group.2. After 2 weeks of dosage reduction, the total effective rate of Chinese medicine group rises to 94.3% comparing with the past without dosage reduction, while western medicine group’s total effective rate declines from 79.2% to 70.8%. Chinese medicine group’s effective rate is rising in the aspect of acid reflux and heartburn.However, the western medicine group’s total effective rate is decreasing. After dosage reduction, in the aspect of the treatment for gastroesophageal reflux relevant secondary symptoms, Chinese medicine group’s total effective rate is 94.3%, while the western medicine group is 45.8%, which shows that Chinese medicine group’s curative effect is still significantly better than western medicine group though dosage reduction.3. In terms of safety, the Jiangni Qige decoction is safe and reliable in the treatment for gastroesophageal reflux disease[Conclusion]:The Jiangni Qige decoction can significantly improve the symptoms of acid reflux, heartburn. It has the function of Inhibiting gastric acid and promoting Gastrointestinal dynamics which are the functions of omeprazole and domperidone. In the aspect of other gastroesophageal reflux-related symptoms, such as substernal pain, pharyngeal foreign body sensation, abdominal distension, belch, dysphagia, odynophagia, cough and asthma, the curative effect is significant, especially acid reflux accompanied with dysphagia. Chinese medicine Jiangni Qige decoction’s curative rate is rising despite half dosage reduction after 4 weeks of regular dosage treatment of gastroesophageal reflux disease.While western medicine group’s total effective rate is decreasing after dosage reduction; It is suspected that the decreasing of curative rate in western medicine group may be associated with patients’dosage dependence or medicine resistance.Chinese medicine has persistent curative effect. It is obvious that the Jiangni Qige decoction is not easy to cause dosage dependence in the treatment of gastroesophageal reflux disease. It is a reliable strategy that taking Chinese medicine "Jiangni Qige decoction" for four weeks and then taking half of the dosage in the treatment for GERD. The strategy has reliable curative effect and can reduce medicine intake and reduce the medicine expense, which is worth spreading.