Evaluation Of The Efficacy Of Tongjiang Mixture In The Treatment Of Hepatic And Stagnation-type Reflux Esophagitis And Its Mechanism Based On "Brain-gut Axis"

Objective:To observe the clinical efficacy of Tongjiang Mixture in the treatment of hepatic and stagnation type reflux esophagitis.and to explore the possible mechanism of Tongqiao Mixture based on "brain-gut axis" treat:ment of this disease.Methods:1.A total of 75 patients who were diagnosed with reflux esophagitis and TCM syndrome differentiation for liver and stomach stagnation syndrome were randomly divided into Chinese medicine group,western medicine group and Chinese and Western medicine combination group,with 25 cases in each group.Another 25 healthy volunteers were recruited.The Chinese medicine group was treated with Tongjiang mixture,the western medicine group was treated with Esmeprazole magnesium enteric-coated tablets,and the Chinese and Western medicine combined group was treated with Tongjiang mixture combined with Esomeprazole magnesium enteric-coated tablets.The course of treatment was 8 weeks.Three groups of RDQ scores,clinical efficacy,endoscopic efficacy and symptom improvement were observed.2.Blood samples were collected from patients in the traditional Chinese medicine group before treatment and 8 weeks after treatment,and compared with healthy volunteers.The levels of serum neurotransmitters(5-HT,DA,NE)and gastrointestinal hormones(SP,VIP,GAS)were measured and compared.Results:1.Before treatment,there were no significant differences in gender,age,endoscopic distribution,RDQ scores,and TCM symptom scores among the three groups(P>0.05).2.In terms of RDQ scores,there were significant statistical differences between the three groups of RDQ before and after the total scores(P<0.01).The etficacy of the Chinese medicine group was similar to that of the western medicine group(P>0.05).The effect of the Chinese and Western medicine group was significantly better than that of the Chinese medicine group and the western medicine group(P<0.01).3.In terms of TCM symptoms,there were significant statistical differences between the three groups of TCM syndromes before and after the total score(P<0.01).The effective rates of the Chinese medicine group,western medicine group and integrated Chinese and Western medicine group were 92%,88%and 100%,respectively.The curative effect of Chinese medicine group was better than that of western medicine group(P<0.05).The curative effect of Chinese and Western medicine combined group was significantly better than that of traditional Chinese medicine group and western medicine group(P<0.01).The Chinese medicine group and the combination of traditional Chinese and western medicine can effectively improve the burning of stomach cramps,abdominal distension,suffocation,emotional dysfunction,hunger,dry mouth and bitterness,constipation symptoms(P<0.01).Western medicine group could not effectively improve the symptoms of abdominal distension,emotional discomfort and constipation(P>0.05).In the improvement of acid reflux,heartburn,post-sternal pain,and stomach cramps,the Chinese medicine group and the western medicine group were equivalent(P>0.05).and the Chinese and Western medicine group was better than the Chinese medicine group and the western medicine group(P<0.05).In the improvement of abdominal distension,dry nouth and bitterness,and emotional discomfort,the efficacy of traditional Chinese medicine group and integrated Chinese and Western medicine group was significantly better than that of western medicine group(P<0.01).The efficacy of the Chinese medicine group was similar to that of the integrated Chinese and Western medicine group(P>0.05).In the improvement of hernia and constipation,the efficacy of the Chinese medicine group and the integrated Chinese and Western medicine group was better than that of the western medicine group(P<0.05).The efficacy of the Chinese medicine group was similar to that of the integrated Chinese and Western medicine group(P>0.05).In the improvement of hunger and hunger,the three groups were equally effective(P>0.05).4.In terms of endoscopic efficacy,the Chinese and Western medicine group in the treatment of esophageal mucosal injury was the best,and the Chinese medicine group was equivalent to the western medicine group(P>0.05).5.Serum neurotransmitter detection:the levels of serum 5-HT and NE in the Chinese medicine group before treatment were lower than those in the healthy control group(P<0.01),serum DA levels were higher than healthy controls(P<0.01);after 8 weeks of treatment,serum 5-FHT and NE levels in the Chinese medicine group were higher than those before treatment(P<0.01),and serum DA levels were lower than before treatment(P<0.01).6.Serum gastrointestinal hormone test:the serum SP and GAS levels in the Chinese medicine group before treatment were lower than those in the healthy control group(P<0.01),and the serum VIP level was higher than the healthy control group(P<0.01);after 8 weeks of treatment,serum SP and GAS levels in the Chinese medicine group were higher than those before treatment(P<0.01),and serum VIP levels were lower than before treatment(P<0.01).Conclusion:l.Tongjiang Mixture has a good clinical effect in the treatment of liver and stomach stagnation type RE,which can effectively improve the clinical symptoms of patients,and promote the healing of esophageal mucosal injury.The treatment is safe and effective,and it is worthy of clinical promotion.2.Tongjiang Mixture has a significant regulatory effect on serum gastrointestinal hormones and neurotransmitters,not only can significantly increase serum 5-HT,NE levels,reduce serum DA levels,improve mental state and reduce esophageal sensitivity to some extent;but also can increase serum SP and GAS levels,reduce VIP levels,and effectively improve esophageal and gastrointestinal motility.It may be one of the potential mechanisms for the efficacy of Tongjiang mixture based on the "brain-gut" axis.