Study On The Literature And Clinical Application Of Reflux Esophagitis

Reflux esophagitis (RE) is a common esophageal function disorder in digestive department. Its incidence is rising,and easy to relapse,can cause serious complications, seriously affected the quality of people’s lives. Modern medicine thinks it is a decrease in the anti reflux defense mechanism and reflux content to esophageal mucosa attack combined action result, who has obtained the certain curative effect on treatment and results, but the clinical efficacy of poor durability and easy to relapse after drug withdrawal. While traditional Chinese medicine (TCM) in the treatment of RE reflect a certain superiority. But since the syndromes have not unified, and the diversity of clinical medicine, led to the research results hardly to promote.Based on many years of clinical and basic research work about Synopsis Golden Chamber, my tutor think that RE has complicated etiology and pathogenesis,and simple treatment is difficult to work. My tutor recommended use harmonizing method to treat RE. Treatment shall follow the pathogenesis, therapeutic principle and prescription is reasonable also need to test in clinical practice. So this study refer to the related literature, analyze the theory of harmonizing method and progress of Chinese and western medicine treatment of RE. And analyze the clinical commonly used prescription of my tutor, and combine theory with practice, to provide new ideas for clinical treatment of RE.Objective:(1)This study mainly explored the theoretical significance of harmonizing method in treatment of reflux esophagitis.(2)Based on observation of clinical trials, we try to find the influence of harmonizing method on RE patients’ Clinical symptoms and endoscopic manifestations and the recurrence rate, in the part of clinical research.Methods:This research mainly divided into theoretical research and clinical research.(1) The theoretical research part discussed the theoretical research of harmonizing method, summarized the development changes of harmonizing method in TCM history, emphatically discussed the inheritance and development of harmonizing method in past dynasties doctor, and the principle and the concrete application of harmonizing method. (2)The clinical research part:we choose 100 RE patients, who saw a doctoc in our digestive internal medicine clinic in January 2013-December 2014, and conform to the requirements of standard case, as the research objects, and they are randomly divided into traditional Chinese medicine group and western medicine group, each group consists of 50 cases. The traditional Chinese medicine group was given the Ban Xia Xie Xin decoction: Rhizoma Pinelliae 9g, Scutellaria Baicalensis 10g, Coptis Chinensis 6g, Dried Ginger lOg, Dangshen 15g, Main licorice 6g, Jujube 9g, Poria Cocos 15g, calcined concha Arcae 30g, Acid-insoluble ash 10g, Evodia Rutaecarpa 6g. The decoction were taken 2 times a day for 8 weeks. The western medicine group took the prescription of Rabeprazole Sodium, which was taken 2 times a day for 8 weeks and 10mg for once. We respectively scored the symptom, syndrome and endoscopic characteristics of the two groups before and after treatment,used the SPSS20.0 statistical software to statistical analysis, compared the Syndrome effect and Mucosal effect of these two groups. We also respectively followed up the two groups patients to observe the recurrence rate for 3 months.Results:(1) The formation and development of harmonizing method through a long process, by the exploration and summary of the past dynasties doctors. Later doctors according to their academic opinions and clinical experience put forward different theories and views, enriches and expands the application scope of harmonizing method, and finally to make formation and law have specific properties and the range of treatment. To evil in Shaoyang or Moyuan half exterior and half interior, Ying and Wei exterior and interior,can use harmonizing method to" make human body harmony within, make human body external liberated ". To disorder of fire and water, Yin and Yang of the viscera, Qi and blood to the human body, use harmonizing method to harmonize the human body. And treatment of harmonizing method focus on regulate the cardinal, make the inside out, lifting up and down, Qi and blood, fire and water and viscera to harmonious. There are some reasons between RE and diet, moods, and the attacks of Liu yin, mainly relates to spleen and stomach, liver spleen function is impaired, do not fall stomach qi, qi push up and cause this disease. The disease based on spleen and stomach weak, mainly displays in qi do not down. The disease locat in the esophagus, controled by the stomach, and the spleen and liver and gallbladder are closely linked. And qi stagnation, hot and humid, phlegm turbidity and blood stasis are mainly pathologic factors. There are many complex and varied clinical methods of treatment, while always focus on harmonizing method such as reconcile the zang-fu organs, regulate qi and blood.The purpose is to cure disease does not hurt the human body, helps the body not to help disease. (2) The clinical research part:① The study included 100 patients, equally divided into the traditional Chinese medicine group and western medicine group.23 cases were males,27 cases were females in the traditional Chinese medicine group; 26 cases were males,24cases were females in the western medicine group. In the traditional Chinese medicine group,6 cases were aged from 18 to 29 years old,8 cases were aged from 30 to 39 years old,12 cases were aged from 40 to 49 years old,15 cases were aged from 50 to 59 years old,9 cases were aged from 60 to 65 years old. In the western medicine group,4 cases were aged from 18 to 29 years old,9 cases were aged from 30 to 39 years old,14 cases were aged from 40 to 49 years old,14 cases were aged from 50 to 59 years old,9 cases were aged from 60 to 65 years old. ②In the aspect of single symptom, each symptom of the traditional Chinese medicine group was improved, and all the P values were less than 0.05, which means there were statistically significant. While, in the western medicine group, the P values of 3 symptoms, mental fatigue, coolness of extremities and loose stool, were more than 0.05,that means the 3 symptoms improved significantly after that western medicine treatment.③In the aspect of clinical comprehensive therapeutic effect, the total integral, before and after treatment, of the two groups were significantly different, illustrating that the two treatments were effective. The total efficiency of the traditional Chinese medicine group was 88%; and the total efficiency of the western medicine group was 78%. The traditional Chinese medicine group’s total efficiency was more than that of the western medicine group’s, and there were statistically significant.④In the aspect of gastroscopic effect, the gastroscope integral, before and after treatment, of the two groups were significantly different, illustrating that the two treatments were effective. The total efficiency of the traditional Chinese medicine group was 80%; and the total efficiency of the western medicine group was 70%. The traditional Chinese medicine group’s total efficiency was more than that of the western medicine group’s, but there were no statistically significant. ⑤In the aspect of the recurrence rate, The traditional Chinese medicine group’s was 29.55%,and the western medicine group’s was 51.28%. The traditional Chinese medicine group’s recurrence rate was less than that of the western medicine group’s, and there were statistically significant.Conclusion:There are certain theoretical basis about the treatment of RE by harmonizing method in TCM use, and has the certain superiority in the clinical treatment. But it is lack of evidence of evidence-based medicine, still need to further improve the specific research methods. Overall speaking, harmonizing method was more effective than Rabeprazole Sodium triazole in the single symptom effect and syndrome effect; was no difference with Rabeprazole Sodium triazole in curative effect of endoscopic mucosa; and was more effective than Rabeprazole Sodium triazole in recurrence control.