Observation On The Clinical Curative Effect Of Jiawei Chaihu Guizhiganjiang Decoction In The Treatment Of Gastroesophageal Reflux Disease Of Liver Vigour And Spleen Deficiency

Objective:Based on the summary of Professor Li Zhenhua’s previous experience in treating GERD,and on the basis of the combination of disease differentiation and syndrome differentiation,the modified Chaihu Guizhi Ganjiang Decoction was used to treat GERD.To observe the efficacy of the modified Chaihu Guizhi Ganjiang Decoction in treating the main symptoms and overall symptoms of GERD and the improvement of the quality of life of GERD patients.Methods:In this study,a prospective cohort design was used,and using the case itself as a research method.The patients with GERD of liver and spleen deficiency who met the inclusion criteria and did not meet the exclusion criteria were treated with the modified Chaihu Guizhi Ganjiang Decoction(Bupleurum,Guizhi,dried ginger,trichosanthin,Scutellaria baicalensis,calcined oyster,roasted licorice,etc.).Professionals recorded general information,GERD Q scale,secondary symptoms scale and quality of life scale(GERD-HRQL),observed the changes of scores before,2 weeks after,4 weeks after and 2 weeks after withdrawal,and recorded the adverse situation during the medication.The data of the above four observation nodes are input into Excel and the database is established.Import SPSS20.0 software for statistical analysis.Results:65 patients with GERD were enrolled,of which one was discontinued because of the change of syndrome type and was converted to routine clinical treatment.Sixty-four patients with GERD were actually enrolled.(1)General data:The majority of GERD patients were middle-aged and elderly,with no significant gender difference;The main risk factors were eating spicy,greasy,meat and sweets,but the dietary habits of the target population were still based on time and quantity;Emotionally irritable,nervous and anxious;bad habits of life are mainly tobacco and alcohol,staying up late and other bad habits.(2)Efficacy index:The scores of TCM syndrome total score before treatment,2 weeks after treatment and 4 weeks after treatment were 17.39±5.16,10.56±4.22,5.31±4.29,respectively,and the difference before and after treatment was statistically significant(P<0.01);The scores of the main symptom total scores before treatment,2 weeks after treatment and 4 weeks after treatment were 4.42±1.28,2.73±1.39,1.19±1.23,respectively,and the changes of the three-stage integral were statistically significant(P<0.05);The scores of the secondary symptoms were 12.97±4.69,7.81±3.63,and 3.77±3.23,respectively,before treatment,2 weeks after treatment,and 4 weeks after treatment.The changes of the three-stage integral were statistically significant(P<0.05).For secondary symptoms such as dry mouth and bitterness,anorexia,thin stools(or no formation),stomach pain,chills and other symptoms,as well as a better quality of life.(3)Effectiveness:The effective rate of TCM syndrome is 89.06%,and the total effective rate of main symptom is 95.30%.62 patients with heartburn symptoms were cured in 4 cases,markedly effective in 31 cases,effective in 24 cases and ineffective in 3 cases after taking medicine for 4 weeks,and the total effective rate was 95.16%;63 patients with reflux symptoms were cured in 11 cases,markedly effective in 32 cases,effective in 14 cases and ineffective in 6 cases,and the total effective rate was 90.47%;the total effective rate of secondary symptoms was 85.94%.Recurrence rate:2 weeks after drug withdrawal,1 case lost follow-up.In 56 cases of effective follow-up,7 cases recurred,46 cases did not recur,the recurrence rate was 12.50%.Conclusions:The modified Chaihu Guizhi Ganjiang Decoction had obvious curative effect on treating liver-flourishing and spleen-deficiency type of GERD,which could effectively improve reflux(reflux acid),heartburn,epigastric pain,stomach distention,poor appetite,dry mouth,bitter throat,pharyngeal foreign body sensation,loose stool(or not formed)and other symptoms,and improve the quality of life of patients.Among the effectively improved cases,there were fewer recurrent people and fewer side effects.In the cases with effective improvement,the relapsing population was less and the side effects were low,which indicated that the modified Chaihu Guizhi Ganjiang Decoction could treat GERD patients as a whole,cure diseases and prevent recurrence,which was worthy of further study.