| Objective: To observe the clinical effect of puling Lianxia formula combined with rabeprazole enteric coated capsule and mosapride citrate tablets in the treatment of refractory reflux esophagitis(RRE),so as to provide new ideas and new methods for the clinical effective treatment of the disease.Methods: Ninty patients with refractory reflux esophagitis were divided into three groups: Chinese medicine group,western medicine group and combined group.The traditional Chinese medicine group was given puling Lianxia decoction,the western medicine group was given rabeprazole enteric coated capsules and mosapride citrate tablets,the combined group was given puling Lianxia decoction,rabeprazole enteric coated capsules and mosapride citrate tablets.The course of treatment was 8 weeks.After treatment,the gerdq score,gerd-hrql score,TCM syndrome score,TCM syndrome efficacy,gastroscopy esophageal mucosa score and 24 h esophageal impedance p H monitoring results were analyzed.After 6months follow-up,the recurrence rate of the three groups was observed.Among them,TCM syndrome integral table was recorded 5times,respectively before treatment,2W,4W,8W and 6months after treatment.Result:1.Gerd Q score changesComparison within the group: After treatment,the scores of the three groups were lower than before treatment,the difference was statistically significant(P<0.05).Comparison among groups: Compared with the western medicine group,the traditional Chinese medicine group and the combined group decreased more significantly,the difference was statistically significant(P<0.05),but there was no significant difference between the traditional Chinese medicine group and the combined group(P>0.05).2.GERD-HRQL score changesComparison within the group: After treatment,the scores of the three groups were lower than before treatment,the difference was statistically significant(P<0.05).Comparison among groups: Compared with the western medicine group,the scores of the traditional Chinese medicine group and the combined group were significantly lower,the difference was statistically significant(P < 0.05),but there was no significant difference between the traditional Chinese medicine group and the combined group(P>0.05).3.Changes of TCM syndrome integralComparison within the group: After treatment,the scores of TCM syndromes in TCM group and combined group were lower than those before treatment,the difference was statistically significant(P<0.05),In the western medicine group,the scores of acid regurgitation or panting,burning or heartburn after sternum,dry mouth and bitter mouth,and epigastral discomfort were significantly lower than those before treatment(P<0.05),There was no significant difference in the scores of anti food,belching,mental fatigue,anorexia,poor sleep and loose stools before treatment(P>0.05).Comparison among groups: Points of acid regurgitation or panting water,poststernal burning pain or heartburn syndrome,acid regurgitation or panting water,poststernal burning pain or heartburn syndrome,there was no significant difference among the three groups(P>0.05),Syndrome points of anti food,belching,epigastral discomfort,dry mouth and bitter mouth,mental fatigue,anorexia,poor sleep and loose stool,compared with the western medicine group,the traditional Chinese medicine group and the combined group decreased significantly,the difference was statistically significant(P<0.05),but the traditional Chinese medicine group and the combined group had no statistical significance(P>0.05).4.Comparison of esophageal mucosa score under gastroscopeComparison within the group: after treatment,the scores of the three groups were lower than before treatment,the difference was statistically significant(P<0.05).Comparison among groups: compared with the traditional Chinese medicine group and the western medicine group,the combined group decreased more significantly,the difference was statistically significant(P<0.05),the difference between the traditional Chinese medicine group and the western medicine group was not statistically significant(P>0.05).5.Comparison of 24-hour esophageal impedance p H monitoring resultsComparison within the group: After treatment,the scores of the three groups were lower than before treatment,the difference was statistically significant(P<0.05).Comparison among groups: Compared with the western medicine group,the total number of reflux,demeester score,acid reflux(p H<4)times,non acid reflux times,and the longest reflux time in the traditional Chinese medicine group and the combined Chinese medicine group were significantly lower,and the difference was statistically significant(P<0.05).Compared with the combined Chinese medicine group,the difference was not statistically significant(P>0.05);acid reflux times,weak acid reflux times,acid reflux(p H<4),there was no significant difference in time between the three groups(P>0.05).6.Curative effect of TCM SyndromeAfter treatment,compared with the western medicine group,the effective rate of the traditional Chinese medicine group and the combined group was higher,the difference was statistically significant(P<0.05),and there was no statistical significance between the traditional Chinese medicine group and the combined group(P>0.05).7.Recurrence rate comparisonAt the end of 6 months follow-up,compared with the traditional Chinese medicine group and the western medicine group,the combined group was lower,the difference was statistically significant(P<0.05),the difference between the traditional Chinese medicine group and the western medicine group was not statistically significant(P>0.05).Conclusion:1.Puling Lianxia formula combined with rabeprazole sodium enteric coated capsule and mosapride citrate tablets can effectively alleviate the clinical symptoms and TCM Syndromes of patients.2.Puling Lianxia formula combined with rabeprazole sodium enteric coated capsule and mosapride citrate tablets can effectively improve the performance of esophageal mucosa under gastroscope.3.Puling Lianxia formula combined with rabeprazole sodium enteric coated capsule and mosapride citrate tablets are safe and can effectively improve the quality of life of patients.4.Puling Lianxia formula combined with rabeprazole sodium enteric coated capsule and mosapride citrate tablets have significant long-term effect and can effectively reduce the recurrence rate. |
