Clinical Study Of Chaihu Shugan Powder Combined With Zuojin Pill In The Treatment Of Reflux Esophgitis (Stagnancy Heat Of The Liver And Stomach Syndrome)

Objective:To investigate the clinical efficacy of Chaihu Shugan Powder combined with Zuojin Pill in the treatment of reflux esophagitis(liver-stomach stagnated heat syndrome),evaluate its efficacy and safety,and explore the internal causes of Chaihu Shugan Powder combined with Zuojin Pill in the treatment of this disease,so as to provide some reference for more scientific and reasonable treatment of traditional Chinese medicine and enriching the diagnosis and treatment of reflux esophagitis with liver-stomach stagnated heat syndrome.Methods: According to the inclusion criteria,60 patients with reflux esophagitis(liver and stomach heat syndrome)collected from October2021 to October 2022 were randomly divided into treatment group and control group,30 cases in each group.The control group was given Esomeprazole Magnesium Enteric-coated Capsules(20 mg / time,2 time /day,take orally on an empty stomach in the morning and before going to bed).The treatment group was treated with Chaihu Shugan Powder and Zuojin Pills on the basis of the control group.The course of treatment was 8weeks.During the treatment,the patients in the treatment group and the control group need to adjust their lifestyles,maintain a regular daily life without staying up late,control diet,eat more fresh fruits and vegetables,avoid spicy foods and quit smoking and drinking,exercise to reduce fat,avoid sitting and lying for a long time,wear pants as loose as possible,avoid tightening the waist and abdomen,increase abdominal pressure and cause reflux,raise the head of the bed when sleeping and use the left lateral position as far as possible to reduce reflux,regulate emotions and maintain a pleasant mood.Observe and record the TCM clinical primary and secondary symptom scores,RDQ scale scores,and gastroscopy grading of the two groups of patients before and after treatment,and the changes in RDQ scale scores after 4 weeks of treatment.The data were collected and statistically analyzed using SPASS 26.Compare the clinical efficacy of TCM,the changes in RDQ scale scores,the improvement of mucosal injury grading under gastroscopy,and long-term efficacy,and evaluate the efficacy and safety of the prescription.During the treatment and follow-up period,the possible adverse reactions and side effects were closely monitored and adjusted in time.Results:(1)TCM curative effect:After 8 weeks of treatment,the total effective rate of the treatment group was 96.67%,and the effective rate of the control group was 76.67%.The difference between the two groups was statistically significant(P<0.01).The effect of Chaihu Shugan Powder and Zuojin Pill combined with esomeprazole magnesium enteric-coated capsule in the treatment of reflux esophagitis(liver and stomach heat syndrome)was significantly higher than that of single esomeprazole magnesium enteric-coated capsule.By comparing the curative effect of traditional Chinese medicine before and after treatment in the treatment group,it was found that the treatment group had a significant effect on the total score of TCM symptoms and the primary and secondary symptoms of ’ heartburn,acid reflux,post-sternal burning pain,epigastric burning pain,belching or anti-food,irritability’(P <0.01),and had a good effect on ’abdominal distention and hunger’(P <0.05).By comparing the efficacy of traditional Chinese medicine before and after treatment in the control group,it was found that the control group had a significant effect on the total score of TCM symptoms and the primary and secondary symptoms of ’heartburn,acid reflux,retrosternal burning pain,and epigastric burning pain(P <0.01),and had a good effect on ’abdominal distension,hunger,belching or anti-eating ’(P <0.05),and had no significant effect on ’irritability’.By comparing the improvement of TCM symptoms after treatment between the treatment group and the control group,it was found that the treatment group was significantly higher than the control group in terms of ’heartburn,post-sternal burning pain,epigastric burning pain,epigastric fullness,belching or anti-eating,irritability ’(P <0.01),while the advantage in improving the symptoms of ’ acid reflux ’ was relatively small(P < 0.05).There was no statistical difference between the treatment group and the control group in the treatment of difference between the treatment group and the control group(P >0.05),indicating that the treatment group and the control group had the same effect in improving the symptoms of ’hunger’.(2)RDQ efficacy : After 8 weeks of treatment,in terms of RDQ efficacy,the treatment group recovered 8 people,markedly effective 9 people,effective 13 people;in the control group,3 cases were cured,5 cases were markedly effective,18 cases were effective and 4 cases were ineffective.The effective rate of the treatment group was 100%,and the effective rate of the control group was 86.67%.After statistical test P <0.05,it can be concluded that the curative effect of the treatment group was significantly better than that of the control group.(3)gastroscopic curative effect: After 8 weeks of treatment,the patients in the treatment group and the control group were reexamined by gastroscopy.It was found that both groups could significantly improve the esophageal mucosal injury under gastroscopy.The effective rate of the treatment group was 100%,and the effective rate of the control group was 90%.Through statistical analysis,the improvement of the classification of mucosal injury under gastroscopy was compared between the two groups.It was found that P <0.05,indicating that the treatment group improved the esophageal mucosal injury under gastroscopy better than the control group.(4)Long-term efficacy : After 4 weeks of withdrawal,all patients with effective treatment were followed up with RDQ scale.The recurrence rate was 10% in the treatment group and 38.46 % in the control group.After statistical test,P <0.05,it can be seen that the treatment group has more advantages in long-term efficacy and can effectively reduce the recurrence rate.(5)Safety : During the study period,there were no toxic and side effects,adverse reactions and other safety-related problems in the two groups of patients.Chaihu Shugan Powder combined with Zuojin Pill and esomeprazole magnesium enteric-coated capsules have good safety in the treatment of reflux esophagitis with liver and stomach heat stagnation.Conclusion: Chaihu Shugan Powder combined with Zuojin Pill can effectively improve the clinical symptoms and esophageal mucosal injury of patients with reflux esophagitis of liver-stomach heat stagnation type,and the recurrence rate is low.There is no safety problem in the research process,which has clinical reference value and is worthy of learning and promotion.