Clinical Observation Of Shugan Hewei Recipe Combined With PPI In The Treatment Of Refractory Gastroesophageal Reflux

Objective: To observe the clinical and recurrence of Shugan Hewei Recipe combined with PPI in the treatment of refractory gastroesophageal reflux disease(liver-stomach stagnation type),the mechanism of action was discussed,which provided a new idea for the treatment of refractory gastroesophageal reflux disease(rGERD)with integrated traditional Chinese and western medicine.Methods: Included in the period from January 2020 to October 2020,those who were diagnosed with refractory gastroesophageal reflux disease and were diagnosed as intractable gastroesophageal reflux disease and were diagnosed with stagnant heat of the liver and stomach.Of the 73 patients,they were randomly divided into a treatment group of 37 cases and a control group of 36 cases according to the order of visits.The treatment group was given Shugan Hewei Recipe combined with PPI(rabeprazole)orally,and the control group was given PPI(rabeprazole)orally for 8weeks.The reflux disease questionnaire(RDQ)scores,TCM syndrome efficacy,TCM individual symptom scores,SAS,SDS scores,and endoscopic results were compared between the two groups before and after treatment,and SPSS25.0software was used for statistical analysis.At the same time,the safety indicators of the two groups of patients before and after treatment were observed,and the two groups of patients were followed up and observed to judge the recurrence after 3months of stopping the treatment.Results: A total of 73 cases were enrolled.During the study period,2 cases were dropped from the control group due to loss of follow-up visits,and 3 cases in the treatment group were eliminated due to poor compliance and self-interruption of medication.Finally,there were 34 cases in the effective treatment group and 34 cases in the control group,and the observational study was completed.3.1 Impact on symptom scores and total curative effect of Chinese and Western medicineIn terms of Western medicine symptom scores,the RDQ scores of the two groups were compared before and after treatment,and the score of the treatment group was significantly reduced(P<0.05);the total effective rate was 91.2% in the treatment group and 64.7% in the control group.The treatment group was higher than the control group.Group(P<0.05),the difference is statistically significant.In terms of TCM syndrome scores,the reduction in scores before and after the treatment group was greater than that of the control group(P<0.05);in terms of total effective rate,the treatment group(91.2%)was significantly better than the control group(61.7%),P<0.01;On the one hand,Shugan Hewei Recipe improved the symptoms of patients with acid reflux,retrosternal burning,regurgitation,belching,flank and gastric pain,mood disorders,dry mouth,loose stools or dryness,and other symptoms were better than those of the control group(P<0.05),especially in the aspect of mood disorders,Shugan Hewei Recipe has a significant improvement effect(P<0.01).3.2 The impact on the mental and psychological aspectsThe SAS and SDS scores before and after the two groups decreased(P<0.05),and the SAS and SDS scores of patients in the Shugan Hewei Recipe treatment group decreased significantly(P<0.01).3.3 Effect on the healing of gastric mucosaBefore treatment,both groups of patients underwent endoscopy,and the number of cases in each of NERD,RE,and BE were counted.The RE patients were selected for gastroscopic re-examination after the end of the treatment course to observe the changes of mucosal under endoscopy.The treatment group had 17 cases of RE before treatment,and 16 cases were effective after treatment,with an effective rate of 94.1%;the control group had 14 cases before treatment and 12 cases after treatment.The effective rate was 85.7%,P<0.05 after comparison,the mucosal healing of RE patients in the treatment group was better than that in the control group.3.4 Impact on recurrenceFollow-up 3 months after drug withdrawal,4 cases in the treatment group relapsed,with a recurrence rate of 11.7%;11 cases in the control group recurred,with a recurrence rate of 32.4%,P<0.05,indicating that the recurrence of the treatment group was lower than that of the control group.3.5 Safety evaluationFrom before the treatment to the end of the follow-up,any safety incident occurred,and there were no obvious abnormalities in the medication safety-related indicators,so the safety of this clinical trial can be evaluated as good.Conclusion:Shugan Hewei Recipe combined with PPI(rabeprazole)can effectively treat rGERD of liver and stomach stagnation heat,and can reduce the recurrence rate,has good safety,and has broad application prospects.