| Objective:The purpose of this study is to observe the clinical curative effect of chaihu banxia decoction on the treatment of Qi depression and Phlegm obstruction type of gastroesophageal reflux disease,by observing the changes of the indicators in patients before and after treatment to evaluation of the effectiveness of treatment in this study,security and the forward curative effect,discussesing the mechanism of the therapeutic scheme from the perspective of trditional chinese medicine and western medicine.Methods:1.The 60 patients who hospitalized in spleen and stomach disease specialist clinic of hubei province of traditional Chinese medicine(optical valley)from May 2016 to June 2017 had been selected,both in line with the western medicine diagnostic criteria and gastroesophageal reflux disease of traditional Chinese medicine qi depression and phlegm obstructionbsyndrome diagnostic criteria.The patients were randomly divided into treatment group and control group according to the order of treatment,with 30 patients in each group.Two groups of patients were no significant differences on age,sex,duration,clinicalsymptom integrals,anxiety depression symptoms integral before treatment(p_?0.05).Comparable.2.The treatment group gave chaihu banxia decoction(chaihu 10g,banxia 10g,zhishi 10g,baishao 10g,chaunxiong 10g,xiangfu 10g,baiji 10g,duanwalengzi 20g,daizheshi 20g,yujin 10g,jiangxiang10g,xuanshen 10g,zhebei 10g,houpo10g,jiaoshanzha 10g,gancao 6g)treatment,daily 1 agent,water decoction,divided into two times morning and evening after dinner,each 100 ml to 150 ml.In the control group,Pantolazole intestinal capsule(Producer:hangzhou sino-east China pharmaceutical co.LTD.national drug,the national drug approval number:H20010032,40mg×7 granules)was taken orally twice daily,40mg each time,befor brakefast and bed-tim.The citric acid moschalli dispersants(Producer:Chengdu Kanghong Pharmaceutical Group Co.Ltd.the national drug,the national drug approval number:H20031110,5mg×12 pills)were taken orally,3times/day,5mg/time,before meals?During the treatment,the patient was required to eat regularly,quit drinking and eat sour or sweet food,tea,coffee,chrysanthemum tea etc.And put the pillow pad up 15cm.3.With reference to Chinese traditional medicine association of spleen and stomach reached“the consensus opinion of gastroesophageal reflux disease in TCM diagnosis and treatment”in 2017 and the Chinese medicine association of Chinese and western medicine committee revised and published“the gastrointestinal diseases of traditional Chinese medicine symptom scale”in 2010at suzhou to determine the main observation of symptoms,and clinical symptoms scoring criteria,record before and after treatment in patients with pharyngeal obstruction,retrosternal discomfort,acid regurgitation,belching,difficulty swallowing,voice hoarse,choking cough in the middle of the night,and changes of modern impeded the symptom such as integral.According to“the expert consensus on the diagnosis and treatment of anxiety and depression in general hospitals”,the criteria for assessing the psychological status of patients before and after treatment and the changes after treatment were determined.The patients were followed up after 8 weeks,and the recurrence was compared between the two groups.4.For all patients involved in the study,blood routine,urine routine,fecal routine,liver and kidney function were tested and electrocardiogram examination were performed before and after treatment.In the course of treatment,the patient's symptoms of discomfort,allergic reactions or other adverse reactions were recorded in detail.5.Statistical method:All data were analyzed using SPSS23.0statistical software.The measurement data was tested by T test,the counting data was tested by X~2 test,and the grade data was tested by Rank sum test.Resluts:1.Clinical efficacy comparison:In the treatment group,there were 30 cases,9 cases were cured,13 cases were markedly improved,7 were effective and 1 was ineffective,the total effective rate was 96.67%.In the control group,there were 30 cases,4 cases were cured,10 cases were markedly improved,14 were effective,2 were ineffective,the total effective rate was 93.33%.Statistical analysis showed that the total effective rate of the two groups was not statistically significant(P>0.05).2.Clinical symptom score comparison:there was no statistical difference between the two groups before treatment (P>0.05).Clinical symptoms integral of the two groups were all decreased.The treatment group in improving the sense of pharyngeal obstruction,belching,anxiety-depression is superior to the control group,significant difference(P<0.01).However,there was no significant difference between the two groups in the improvement of poststernal discomfort,acid,dysphagia,hoarseness,and cough in the middle of the night(P>0.05).3.Anxiety and depression symptom score comparison:The two groups were no statistical difference on the anxiety and depression symptom score before treatment(P>0.05).The treatment group anxiety and depression symptom score was decreased after treatment,the control group have no obvious changes,compared two groups have significant statistical difference(P<0.01).4.The long-term efficacy comparing:after 8 weeks of withdrawal of drug,the patients with a clinical efficacy index of more than30%were followed up,and the treatment group was followed up by25 patients with a recurrence rate of 12%.Control group follow-up of 26 patients,11 cases were recurrenced,the recurrence rate was42.3%,two groups statistically difference recurrence(P<0.05).5.Safety evaluation:two groups of patients did not appear allergic reactions or other bad reflect in the process of treatment.Check the blood routine,urine routine,stool routine,liver and kidney function were in normal range and the ECG was not abnormal before and after treatment.Conclusion:Although the overall clinical efficacy of the two groups was comparable,the traditional Chinese medicine treatment group in improving symptoms at the same time,also can improve the patient's mental state,and reduce the patient's medication types and times,reduce the economic burden of the patients at the same time,and the long-term curative effect is good.The basic principles of TCM syndrome differentiation and treatment are in accordance with the principles of TCM syndrome differentiation and treatment.It's value of clinici application. |
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