Clinical Study On Treatment Of Gastroesophageal Reflux Disease By TCM Syndrome Differentiation

ObjectiveTraditional Chinese medicine(TCM)is the wisdom crystallization of the working people in our country who have been fighting against diseases for a long time.It is an empirical summary of clinical efficacy and safety of diseases based on a large number of long-term observation and analysis under real world conditions.This article compares and observes the clinical efficacy of treating gastroesophageal reflux disease based on syndrome differentiation and treatment of traditional Chinese medicine through non-random selection of treatment measures according to the actual condition of patients and their willingness to accept treatment of traditional Chinese medicine or western medicine.According to the two most common clinical syndromes of gastroesophageal reflux disease,liver-stomach disharmony and spleen-stomach qi deficiency,this paper adopts two therapeutic principles of soothing the liver and harmonizing the stomach and invigorating the spleen and regulating qi,respectively,and makes a comparative study with the conventional treatment of western medicine.At the same time,it further explores the application rules of traditional Chinese medicine in the treatment of gastroesophageal reflux disease.MethodsThe source of the cases was 60 patients with gastroesophageal reflux disease who met the diagnostic criteria in the Outpatient Department of Spleen and Stomach Disease of the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from June 2018 to February 2019.According to the patient's actual condition and his/her willingness to accept treatment by traditional Chinese medicine or western medicine,20 cases were included in the group of soothing liver and harmonizing stomach,20 cases in the group of invigorating spleen and regulating qi,and 20 cases in the proton pump inhibitors control group.The TCM treatment group was treated with Sini Powder plus Xiangsha Liujunzi Decoction according to syndrome differentiation,while the western control group was treated with Esomeprazole Magnesium Enteric-coated Tablets 20mg bid,30 minutes before breakfast and dinner.Observe and record the symptom score and syndrome curative effect of the study object before treatment and 2 weeks,4 weeks,6 weeks,8 weeks after treatment and 4 weeks after drug withdrawal.Through statistical analysis,evaluate and summarize the clinical therapeutic effect of the treatment group.Results1.Therapeutic effect:?Symptom integral:After2?4?6 and 8 weeks of treatment,the symptom score of each group after treatment was significantly lower than that before treatment(P<0.05).The symptom improvement score of Shugan Hewei group was significantly higher than that of Jianpi Liqi group and western medicine control group after 4,6 and 8 weeks of treatment(P<0.05),and which was no significant difference in the improvement of clinical symptoms campared with Jianpi Liqi group and PPI control group after 2 weets of treatment.There was no significant difference in clinical symptom improvement effect between spleen and stomach qi deficiency group and western medicine control group after 2?4?6 and 8 weeks of treatment(P>0.05).?Syndrome curative effect:After 8 weeks of treatment,the clinical effect of Shugan Hewei group after treatment was significantly higher than that of Jianpi Liqi group(P<0.05).There was no significant difference between Shugan Hewei group and western medicine control group(P>0.05),and there was no significant difference between spleen and stomach qi deficiency group and western medicine control group after treatment(P>0.05).2.Recurrence rate:After 8 weeks of treatment and 4 weeks of drug withdrawal in each group,19 cases in the Shugan Hewei group were treated effectively,of which 2 cases recurred,with a recurrence rate of 10.5%.15 cases in Jianpi Liqi group were treated effectively,of which 2 cases recurred with a recurrence rate of 13.3%.In the proton pump inhibitors control group,18 cases were treated effectively,of which 5 cases recurred,with a recurrence rate of 27.8%.From the above data,we can see that the recurrence rates of the groups of soothing liver and harmonizing stomach and invigorating spleen and regulating qi in the TCM treatment group were lower than those in the proton pump inhibitors control group,but there is no significant difference between the recurrence rates of each group(P>0.05).Whether the recurrence rate is caused by too few samples still needs further discussion.Conclusion1.The Chinese medicine treatment group and the proton pump inhibitors control group are both effective in treatment,but the treatment effect of Shugan Hewei group is more remarkable,which also shows that the treatment of deficiency syndrome is more difficult than the treatment of excess syndrome.2.The recurrence rates of the groups of soothing liver and harmonizing stomach and invigorating spleen and regulating qi in the TCM treatment group were lower than those in the proton pump inhibitors control group,but there is no significant difference between the recurrence rates of each group(P>0.05).Whether the recurrence rate is caused by too few samples still needs further discussion.3.The basic pathogenesis of gastroesophageal reflux disease is stomach disharmony and stomach-qi ascending and descending.For sthenia syndrome,it is mostly caused by liver depression and stagnation of Qi,which is contrary to stomach.The treatment method should be to soothe the liver and harmonize the stomach.The Prescriptions is Sini Powder added.For deficient syndrome,it is mostly caused by the weakness of the spleen and stomach and the loss of the middle coke.The treatment of deficiency is to invigorate the spleen and regulate qi.The prescription is flavored with Xiangsha Liujunzi Decoction.From the short-term effect,the treatment of traditional Chinese medicine has certain advantages,which deserves further study.