Clinical Observation On The Effect Of Banxia Xiexin Decoction Combined With Diaphragm Biofeedback Training In The Treatment Of GERD With Cold And Heat Mixed Type

ObjectivesTo evaluate the clinical efficacy and mechanism of Banxia Xiexin Decoction combined with diaphragm biofeedback training in the treatment of GERD with cold and heat mixed type.by Randomly assigned.MethodsAll patients were from March 2016 to March 2017,Guangdong Province,Chinese medicine hospital digestive specialist outpatient,Who are Was diagnosed GERD with cold and heat mixed type.They are between 18 and 65 years old.All patients must be discontinued for one week before they are examined and treated.According to the random number table,the patients were randomly divided into PPI group,Banxia Xiexin Decoction combined with diaphragm biofeedback training group,PPI combined with Banxia Xiexin Decoction combined with diaphragm biology feedback training group.All the patients must finish the GED-Q score table,the Gastroesophageal Reflex Disease Symptom Table,the Health-related Quality of Life Scale(SF-6),and the 24-hour esophageal dynamic gastric acid monitoring and esophageal manometry.After 8 weeks Treatment,all of them review the subjective indicators before treatment and gastrointestinal dynamics objective indicators.PPI group given rabeprazole sodium enteric-coated tablets 10mg(2 times/day);Banxia Xiexin Decoction+ Diaphragmatic biofeedback training group in the application of traditional Chinese medicine treatment(Banxia Xiexin Decoction 150ml/times,2 times/day)At the same time for diaphragm biometric feedback training(20minutes/time,2 times/day),Participating in the training of patients once a week to the hospital under the guidance of a doctor for feedback training,the rest of the time at home to train themselves,every time takes 20 minutes.PPI + Banxia Xiexin Decoction + Diaphragm Biofeedback Training Group is the first two groups of treatment methods together.ResultsThere was no significant difference in age,sex,condition and BMI between the three groups(P>0.05),and the baseline was comparable.(1)Effect on clinical symptoms of GERD patientsIn the main symptoms(heartburn,chest pain,mouth acid/bitter taste,of patients after treatment compared with before treatment points were significantly decreased(P<0.05),the changes have Statistical significance.There are no significant difference between the three groups(P>0.05).Indicating that the three groups in the main symptoms of GERD efficacy is not significant.In terms of secondary symptoms:There was no significant difference between the three groups before the treatment(P>0.05).The baseline stage was comparable.Three groups before and after treatment changes:PPI Group(11.70± 3.21,9.40 ± 2.18);Banxia Xiexin Decoction+Diaphragmatic Biofeedback Training Group(11.85± 2.68,6.10± 2.17);PPI+Banxia Xiexin Decoction+Diaphragmatic Biofeedback Training Group(12.10 ± 3.02,6.25 ±1.68),Three groups after treatment were lower than before treatment,(P<0.05)The difference was statistically significant.After treatment,Banxia Xiexin Decoction+diaphragm feedback group and PPI+Banxia Xiexin Decoction +diaphragm feedback group decreased more Obvious than the PPI group,(P<0.05)The difference was statistically significant.(2)On the quality of life of patients with GERDIn terms of quality of life,Three groups after treatment compared wit h before treatment,all the dimensions were improved(P<0.05),the diff erence was statistically significant.After 8 weeks of treatment,Between the three groups,There was no significant difference between the three g roups at the physiological function(RP),Body pain(BP),general health(G H),vitality(VT),social function(SF),emotional function(RE),mental hea 1th(MH)7 dimensions,(P>0.05)it was not statistically significant.But in the physiological function(PF)of this dimension:Banxia Xiexin Decoction+Diaphragmatic Biofeedback Group and PPI+Banxia Xiexin Decoction+ Diaphra gmatic Biofeedback Training Group were significantly improved compared wi th PPI group after treatment,(P<0.05)The Differences were statistically significant.(3)On the effect of LESP and Dia-Ao on GERD patientsIn terms of LESP:There was no significant difference between the three groups before and after treatment,(P>0.05);There was no significant difference between the three groups after treatment,(P>0.05);Indicating that PPI,diaphragm biofeedback training and Banxia Xiexin Decoction had little effect on LESP.On the effect of Dia-Ao:In the three groups,there was no significant difference between the PPI group and the former group before treatment,(P>0.05).While the Banxia Xiexin Decoction + diaphragm biofeedback group and PPI+ Banxia Xiexin Decoction + diaphragm biofeedback group,After r8 weeks,the Tension of crural diaphragm at resting increased from(14.20±2.21),(14.40± 2.41)mmHg to(22.75 ± 2.24),(23.9 ± 1.80)mmHg,Compared with before treatment,the difference was statistically significant,(P<0.01),But there was no significant difference between the two groups after treatment,(P>0.05)?(4)Effects on gastric acid reflux:In the acid reflux:After 8 weeks of treatment,the three groups of gastric acid reflux(Demeester score,reflux more than 5min times,Ph<4 time percentage,etc.)all have decreased,PPI group,Banxia Xiexin Decoction +diaphragm biofeedback group and PPI + Banxia Xiexin Decoction + diaphragm biofeedback group at The Demeester score changes from(34.14± 14.95)to(10.27±2.20)in the PPI group;changing from(39.96± 15.06)to(22.71 ±12.96)in the Banxia Xiexin Decoction + diaphragm biofeedback group;changing from(33.92±21.09)to(10.32±1.99)in the PPI + Banxia Xiexin Decoction + diaphragm biofeedback group.There were statistically significant differences between the three groups before and after treatment,(P<0.05)?After 8 weeks of treatment,PPI group and PPI + Banxia Xiexin Decoction + Diaphragmatic Biofeedback Training Group declined more obvious than those of Banxia Xiexin Decoction and Diaphragmatic Biofeedback Training Group,The difference was statistically significant(P<0.05),But there was no significant difference between the two groups after treatment,(P>0.05)?(5)Impact on Gerd-Q Score:There was no significant difference between the three groups before treatment(P>0.05).PPI group,Banxia Xiexin Decoction+ Diaphragmatic biofeedback group and PPI +Banxia Xiexin Decoction + Diaphragmatic biofeedback group After treatment their changes as follows:PPI group(10.75±2.48,7.00±1.65)?Banxia Xiexin Decoction + Diaphragmatic biofeedback group(11.15±2.41,6.45±1.46)?PPI + Banxia Xiexin Decoction + Diaphragmatic biofeedback group(11.60±1.66,6.15±1.49),Before and after the group were statistically significant,(P<0.05),There was no statistically significant difference between the two groups after treatment(P>0.05).Conclusion1.Banxia Xiexin Decoction combined with diaphragm biofeedback training is the effective treatment of "cold and heat" type of gastroesophageal reflux disease effective program.2.Banxia Xiexin Decoction combined with diaphragm biometric feedback training can improve the quality of life of patients by improving the mechanism of resting the diaphragmatic foot tension,enhancing the anti-reflux mechanism,reducing the esophageal acid exposure time,improving the patient's symptoms and improving the quality of life.