The Clinical Study Of Chaihu Shugan Pouder Combined With Zuojin Pill To Add And Subtract In The Treatment Of Chest Pain Induced By Gastroesophageal Reflux Disease

Objective: This study is aimed to observe the clinical efficacy of Chaihu Shugan powder combined with Zuojin Pill addition and subtraction in the treatment of liver and stomach gloomy heat type of gastroesophageal reflux disease of chest pain, evaluate thesafety, effectiveness and long-term effect of Chaihu Shugan powder of Zuojin Pill, and explore its mechanism to treatment of gastroesophageal reflux disease of chest pain based on traditional Chinese medicine and modern medicine theory.Methods: 1. We selected 76 patients with diagnosis of gastroesophageal reflux disease associated chest pain during April 2014- June 2015 in Hubei Province Hospital of traditional Chinese medicine, TCM for patients with liver and stomach gloomy heat type. According to the sequence of treatment, the patients were completely randomized 2 groups, 38 cases in the treatment group, 38 cases in the control group. There was no significant difference between the two groups in gender, age, course of disease and treatment before clinical symptoms total score(P>0.05), so they are comparable.2. The treatment group was received oral administration of Chaihu Shugan powder Zuojin Pill addition and subtraction, the drug Shuijianbi, 1agent/day, 2 times/day,150ml-200ml/times,after meals. The control group was given oral omeprazole enteric coated capsules, 20mg/times, 2 times/day, orally before the early dinner. Domperidone Tablets, 10mg/ times, 2 times / day, take orally before breakfast and dinner. The treatment group and the control group were treated for 8 weeks, visited 1 times every 2 weeks, and the changes of symptoms and signs was recorded. Before and after the treatment, we took the examination to the patientsof 1 time gastroscopy, 1 safety observation index. During treatment, we enjoined patients: light diet, nospicy, greasy, tea, coffee, alcoholic drinks and tobacco control, should not eat before going to bed, not immediately bed after eating, bedside adjustable high 10-15 cm, regulating emotion. Avoid taking other drugs associated with this disease. 3. In the light of "gastrointestinal disease TCM symptom score table" and "gastroesophageal reflux disease in Chinese medical consensus(2009, Shenzhen)", we determined the main clinical symptoms and quantitative grading standard for evaluation. We recordedclinical symptomsintegralof each patient before and after treatment(pain, acid regurgitation, heartburn or heartburn sternum after, abdominal distention, dry mouth, mouth pain, belching, gastral cavity ministry noisy easy hunger, mood disorders). After 8 weeks of treatment,we checked the patients by gastroscopy and esophageal mucosa situation. Follow up for 6 months after the end of treatment, we sawthe recurrence of the disease. 4.Statistical analyses: all data were analyzed by statistical software SPSS17.0. Count data using ?2 test, measurement data using t test, rank data using Ridit analysis.Results: 1.The comparison of total score of clinical symptoms: Before treatment, there was no significant difference between the two groups in clinical symptom scores(P>0.05). After treatment and 6 months follow-up,the clinical symptom score of the two groups lower than before treatment; the improvement of clinical symptoms in the treatment group was significantly better than that in the control group(P<0.01) after 6 months. Compared the individual clinical symptoms,the treatment group in the retrosternal pain, acid regurgitation, heart burn or burning sensation, abdominal fullness, belching, emotional abnormal curative effect is better than that of the control group(P<0.05), dry mouth, mouth pain, epigastric noisy easy hunger without significant difference(P>0.05). 2.The comparison of clinical curative effect :The treatment group: 11 cases were cured, 17 cases were markedly effective, 6 cases wereeffective,4 cases were ineffective, efficiency rate was 89.4%; control group: 10 cases were cured, 14 case swere markedly effective, 9 cases were effective, 5 cases were ineffective, efficiency rate was 86.8%.Compared the clinical symptoms of the two groups,there was insignificant difference(P>0.05),treatment group is equal to the control group. 3.Endoscopic examination showed that the treatment group 7 cases were cured, 17 cases were markedly effective, 8 cases were effective, 5 cases were invalid, efficiency was 86.5%; control group 9 cases were cured, 16 cases were markedly effective, 9 cases were effective, 3 cases were invalid, efficiency was 91.9%. There were insignificant differences between two groups(P>0.05), the result showed that the healing of mucosa in the treatment group was equivalent to that of the control group. 4.After 6 months of follow-up, the recurrence rate of treatment group was 2.9%, the recurrence rate of control group was 21.2%, there were significant differences between two groups(P<0.05), the long-term curative effect of treatment group is better than that of control group.Conclusion: The curative effect of Chaihu Shugan powder Zuojin Pill Decoction for the treatment of gastroesophageal reflux disease of chest pain is equal to the control group,it can effectively improve the clinical symptoms. In improving some of the clinical symptoms, improve the quality of life of patients, alleviate anxiety / depression and long term efficacy were better than control group.It is a relatively safe, reasonable price, practical traditional Chinese prescription.It is worth of clinical application.