Clinical Observation On The Curative Effect Of Tongjiang Mixture In Treating Reflux Esophagitis Of Liver-Stomach Heat Accumulation And Its Effect On Intestinal Flora

Objective:1.To evaluate Tongjiang mixture in the treatment of reflux esophagitis of liver and stomach depression and heat,and to explore a more safe and effective drug treatment scheme.2.To observe the effect of Tongjiang mixture on intestinal flora of patients with reflux esophagitis of liver-stomach depression and heat type,and to explore the possible mechanism of action,and to provide a new way of thinking for the study of regulating intestinal microflora by traditional Chinese medicine.Methods:1.From July 2017 to June 2018,90 patients with reflux esophagitis of liver-stomach depression and heat type,Nanjing Integrated traditional Chinese and Western Medicine Hospital were collected.A randomized,parallel controlled trial was conducted and divided into three groups:traditional Chinese medicine group(n=30),western medicine group(n=30)and combined therapy group(n=30).The patients were treated with Tongjiang mixture.Esomeprazole enteric-coated tablets,Tongjiang mixture combined with Esomeprazole enteric-coated tablets for 8 weeks.Making the traditional Chinese medicine symptom quantification table and referring to the regurgitation disease questionnaire(RDQ scale)to evaluate the changes of RDQ score before and after treatment,the traditional Chinese medicine syndrome and the improvement of esophageal mucosa under endoscopy,evaluate the safety of three groups of drug therapy.After 3 months of follow-up.the long-term curative effect was evaluated.2.The feces were collected before and at the end of the course of treatment in traditional Chinese medicine group.The diversity of intestinal flora,the similarity index and the concentration of short chain fatty acids were detected by ERIC-PCR technique and gas chromatography-mass spectrometry(GC/MS).To evaluate the effect of Tongjiang mixture on intestinal floraResults:1.The total score of RDQ in the three groups decreased significantly after 8 weeks of treatment(P<0.01).The total score of RDQ in the Chinese medicine group and the western medicine group was close to that in the western medicine group(P>0.05),and the total score of RDQ in the combination group was the lowest(P<0,05).2.The total integral effect of traditional Chinese medicine syndrome in traditional Chinese medicine group was similar to that combined therapy group(P>0.05).which was better than that in western medicine group(P<0.01).The total effective rates of traditional Chinese medicine syndrome were 96.67%,76.67%and 100%in traditional Chinese medicine group,western medicine group and combined therapy group respectively.The comprehensive curative effect of traditional Chinese medicine group and combined therapy group was close to that of western medicine group(P>0.O5),which was better than that of western medicine group(P<0.01)、3.The total effective rate under endoscopy was 86.67%,90.00%,96.67%in the traditional Chinese medicine group,western medicine group and combined group,respectively.The esophageal mucosa repair was the best in the combined therapy group(P<0.O5),and the effect in the traditional Chinese medicine group was similar to that in the western medicine group(P>0.05),and the curative effect in the traditional Chinese medicine group was similar to that in the western medicine group(P>0.05).Atthe follow-up time,the total score of RDQ in the traditional Chinese medicine group and the combined therapy group remained unchanged,and the total score of RDQ in the western medicine group increased(P<0.01).5.The results of laboratory tests showed that the intestinal flora diversity and short chain fatty acid concentration in traditional Chinese medicine group before treatment were poor,and the intestinal flora diversity was restored after Tongjiangji treatment,which was similar to that of healthy adults.The concentration of short chain fatty acids increased significantly.Conclusion:1.Tongjiang mixture is safe and effective in the treatment of reflux esophagitis of liver and stomach depression and heat type.The total score of RDQ is decreased and the esophageal mucosa repair is repaired.Tongjiang mixture has the same curative effect as Esomeprazole enteric-coated tablets,but improves the traditional Chinese medicine syndrome.The effect of Tongjiang mixture was obviously better than that of Esomeprazole enteric-coated tablets.Tongjiang mixture combined with Esomeprazole enteric-coated tablets is more effective and worthy of clinical popularization.2.There may be intestinal flora disorder in patients with reflux esophagitis of liver-stomach depression-heat type.Tongjiang mixture can regulate intestinal microflora,which is worthy of further study.