Clinical Observation On The Treatment Of Refractory Gastroesophageal Reflux Disease(Blood Stasis And Heat Accumulation Type) With The Method Of "Xin Kai Ku Jiang,Huo Xue Xie Re"

Objective:In this study,xinkaikujiang,activating blood circulation and purging heat were used to treat refractory gastroesophageal reflux disease with blood stasis and heat.By evaluating its effectiveness and safety,we can further explore the understanding and treatment scheme of TCM on the mechanism of this disease,so as to lay a foundation for better clinical guidance.Methods:In this study,70 cases of refractory gastroesophageal reflux disease with blood stasis and heat were randomly divided into treatment group and control group.35 cases in the treatment group were decocted with "Lianzhi Qinglong Decoction" and 35 cases in the control group were treated with "rabeprazole sodium enteric coated tablets".The changes of gerdq score,TCM syndrome score,TCM syndrome efficacy index and Los Angeles(LA)score of endoscopic mucosal changes before and after treatment were statistically analyzed.Results:1.A total of 70 cases were included in this study,including 2 cases in the treatment group and 3 cases in the control group.Finally,a total of 65 people completed the observation of this study,including 33 cases in the treatment group and 32 cases in the control group.The shedding rate was 7.1%.2.Comparative analysis of all subjects showed that there was no significant difference in gender distribution,age distribution and etiology distribution between the two groups(P >0.05).3.After treatment,there was significant difference in gerdq score of clinical symptoms between the two groups(P < 0.05).There was significant difference between the two groups before and after treatment(P < 0.05).There was significant difference between the two groups before and after treatment(P < 0.05).There was significant difference between the two groups(P < 0.05).4.There was significant difference in the total score of TCM syndromes between the two groups after treatment(P < 0.05).There was significant difference between the two groups before and after treatment(P < 0.05).There was significant difference between the two groups before and after treatment(P < 0.05).According to the analysis of individual TCM syndrome scores,the individual scores in the group before and after treatment,except for "irritability",were lower than those before treatment,and the difference was statistically significant(P < 0.05).After treatment,the scores of single syndrome in the two groups were significantly different in heartburn,chest tightness,abdominal distension,belching or regurgitation(P < 0.05);There was no significant difference in acid reflux,retrosternal tingling or burning pain,epigastric burning pain,back pain,irritability,lack of appetite,fatigue and hunger(P > 0.05).There was significant difference in the total score of TCM syndromes between the two groups after treatment(P < 0.05).5.There was significant difference in esophageal mucosal score between the two groups before and after treatment(P < 0.05).There was no significant difference in esophageal mucosal score between the two groups after treatment(P > 0.05).There was no significant difference between the two groups after treatment(P > 0.05).6.During the treatment,there were no serious adverse reactions in both groups.Conclusions:1."Lianzhi Qinglong Decoction" can improve the clinical symptoms and TCM Syndromes of patients with refractory gastroesophageal reflux disease of "blood stasis and heat combination",and the therapeutic effect is better than "rabeprazole sodium enteric coated tablets",and there are no obvious toxic and side effects.2.Combined with the clinical efficacy of "Lianzhi Qinglong Decoction",we can know that the weakness of the spleen and stomach,the stagnation of heat in the liver and stomach,the formation of blood stasis after a long illness,and the combination of blood stasis and heat are one of the possible mechanisms of refractory gastroesophageal reflux disease.