| Objective:By observing the improvement of clinical symptoms,changes of esophageal mucosa under gastroscopy,anxiety scale score and the changes before and after treatment of gastroesophageal reflux disease with spleen deficiency dampness obstruction by Siping wube Powder plus or minus prescription,the optimal treatment of gastroesophageal reflux disease was explored,and the clinical experience of treating gastroesophageal reflux disease with spleen deficiency dampness obstruction by traditional Chinese medicine and traditional Chinese medicine was further summarized.Methods: By collecting 120 patients with gastroesophageal reflux disease from February 2019 to January 2020 in the outpatient and ward of digestive department,according to the random digital table method,they were randomly divided into Chinese medicine group,integrated Chinese and western medicine group and western medicine group,each group was 40 cases.The traditional Chinese medicine group was given Siping wube Powder plus or minus prescription,the traditional Chinese medicine group was given Siping wube Powder plus or minus prescription combined with rabeprazole,and the western medicine group was given rabeprazole for 8 weeks,followed up for 4 weeks.To observe and record the score of esophageal and mucosal endoscopic curative effect before and after treatment,the self-rating scale of Zung anxiety(SAS),the score of main and secondary symptoms of clinical Chinese medicine and the score of 8th,Comparison of clinical combined efficacy at 12 weeks(follow-up).Using Excel to make statistics and establish database,using statistical software SPSS22.0 analyze clinical data and evaluate clinical efficacy.Result:3.1 General data: Among 120 patients with gastroesophageal reflux disease,the ratio of male to female was 1:1.07;the onset age was mainly 28?59 years old,with the highest number of 30?40 years old,and in this age group the number of men smoking was more.baseline indicators such as age,sex,course of disease,smoking and clinical symptoms before treatment in the three groups were statistically analyzed(P>0.05)and comparable.3.2 Effect of gastroscopy:(1)Compared with the western medicine group,the Chinese medicine group and the integrated Chinese and western medicine group were different in terms of total symptom score and SAS score(P<0.05).(2)The curative effect of gastroscopy: There was no difference between the three groups after treatment(P>0.05),suggesting that the curative effect was equal in the three groups.(3)The total effective rate was 95.00%,87.50% and 77.50% respectively,compared with the western medicine group,there was no difference(P>0.05),there was a significant difference between the integrated Chinese and western medicine group(P<0.05),which indicated that the Chinese medicine group and the western medicine group had the same curative effect at 8 weeks of treatment,while the integrated Chinese and western medicine group had more advantages than the western medicine group.The total effective rate of the three groups was 95.00%,90.00% and 72.50%respectively.Compared with the western medicine group,the Chinese medicine group and the integrated Chinese and western medicine group had obvious difference(P<0.05).Compared with the traditional Chinese medicine group,the integrated Chinese and western medicine group had no difference(P>0.05).In the western medicine group.(5)Compared with the western medicine group,the Chinese medicine group had no difference in the score of acid regurgitation and heartburn symptom(P>0.05),and there were differences in the score of epigastric distending pain,fatigue,loose stools and eating symptoms(P<0.05).3.3 Experience summary: The clinical experience of Director Zhou in treating GERD is summarized.Zhou believes that GERD onset of spleen deficiency dampness obstruction as the basis,often due to spleen and stomach weakness,transport weak,water valley fine can not irrigate the four sides,gather into wet,anti-tempered not rising,stomach failure,rise and fall contrary,stomach qi adverse and hair for vomiting acid,but also with liver loss of catharsis,lung loss,dampness block three coke and other factors closely related.Treatment should be holistic syndrome differentiation,using spleen dryness and dampness,regulating qi and reducing adverse effects,soothing liver and relieving depression,clearing heat and removing dampness,Xuan Tong San Jiao treatment,for patients with refractory gastroesophageal reflux disease,the choice of water culvert wood to clear heat,fire to return to the original Antiacid and other methods,flexibility and efficiency.At the same time pay attention to the combination of endoscopic microscopic syndrome differentiation,Shenxi,the endoscopic findings of acid water,mucous membrane and cardia closed state comprehensive consideration,flexible syndrome differentiation,comprehensive grasp of the disease to guide clinical,successful effect.Conclusion:4.1 Siping Wubei Powder plus or minus prescription has a good effect in improving the symptoms of acid regurgitation,heartburn,epigastric distending pain,fatigue,loose stools,lack of appetite and other symptoms,anxiety and other bad emotions,reducing recurrence,improving the quality of life.4.2 Siping Wubei Powder plus or minus prescription combined with rabeprazole combined with traditional Chinese and western medicine is more effective in treating patients with gastroesophageal reflux disease with spleen deficiency and dampness obstruction.None of the three groups had adverse reactions in the experiment,and the safety was good.4.3 Integrated Chinese and Western medicine group and traditional Chinese medicine group in its long-term efficacy is significantly better than the western medicine group,worthy of clinical promotion and use. |
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