Application Of Jiawei Xuandai Granules Combined With Acupoint Application In Refractory Gastroesophageal Reflux Disease Of Spleen Deficiency

Objective:The treatment of Refractory gastroesophageal reflux of spleen deficiency with Jiawei Xuandai granules combined with acupoint application was observed Patients with RGERD were evaluated by RDQ score,TCM symptom efficacy evaluation,endoscopic performance,health-related quality of life scale score of GASTROesophageal reflux disease,and the efficacy and application prospect of Jiawei Xuandai Granule combined with acupoint application in the treatment of spleen deficiency RGERD.Methods: A total of 94 patients with spleen deficiency RGERD conforming to inclusion criteria were randomly divided into group A(n = 31),group B(n= 31)and Group C(n = 32).All patients in the three groups were given oral rabeprazole sodium enteric-coated tablets.Group A was given oral moxabide citrate tablet,group B was given internal medicine plus Flavor Xuandai granule on the basis of group A,and group C was given zhuisan acupoint application on the basis of group B.After 8 weeks of treatment,RDQ symptom score,TCM symptom score,esophageal mucosal inflammation grade under gastroscope in patients with reflux esophagitis,and health-related quality of life scale score in patients with reflux esophagitis were compared between the three groups before and after treatment,so as to evaluate the clinical efficacy of Jiawei Xuandai Granule combined with acupoint application in the treatment of spleen deficiency RGERD.Results:1.During the study period,there was 1 abscission in group A,1 abscission in group B and 2 abscission in group C.The final effective cases were 30 cases in group A,30 cases in group B and 30 cases in group C.There were no statistically significant differences in gender,age and endoscopic manifestations among the three groups(P > 0.05),indicating clinical comparability.2.Comparison of RDQ symptom score and efficacy: after treatment,the total score of three groups was lower than that before treatment(P < 0.05),and RDQ symptom was improved in all three groups.After treatment,the total score of group C was lower than that of group B and group A(P < 0.05),and the total score of group B was lower than that of group A(P < 0.05).The total effective rate of group A after treatment was 80.00%.The total effective rate was 83.33% in group B and 93.33% in group C.Pairwise comparison among the three groups showed that the curative effect of group C was better than that of group B and group A(P < 0.05),and that of group B was better than that of group A(P < 0.05).3.Comparison of scores of single symptoms in TCM:(1)After treatment,comparison of single symptoms in the three groups were all P < 0.05,that is,acid reflux or water vomiting,belching or regurgitation,epigastric pain,stomach bloating,loss of appetite,fatigue and thin stools were all improved in the three groups.(2)Compared with group A,group C was superior to group A in improving the symptoms of acid reflux or water vomiting,belching or regurgitation,epigastric pain,stomach bloating,loss of appetite,fatigue and thin stool(P < 0.05).Group C was better than group B in improving the symptoms of belching or regurgitation and thin stool(P < 0.05).Group B was better than group A in improving acid reflux or water vomiting,epigastric pain,stomach bloating,loss of appetite,fatigue and thin stools.4.Comparison of TCM symptom score and efficacy: intra-group comparison of the three groups before and after treatment,P < 0.05,the difference was statistically significant,and the three groups could effectively improve TCM symptoms.After treatment,the total TCM symptom score of group C was lower than that of group B and group A(P < 0.05),and the total TCM symptom score of group B was lower than that of group A(P < 0.05).In terms of TCM symptom efficacy,the total effective rate of group A was 76.67%,group B was 90.00%,and group C was 96.67%.Pairwise comparison among the three groups showed all P < 0.05,indicating that group C had better efficacy than group B and group A,and group B had better efficacy than group A.5.Comparison of gastroscopic efficacy: The total effective rate of group A was 64.28%,group B was 75.00%,and group C was 92.30%.The total effective rate of group C and GROUP B was higher than that of group A(P <0.05),and there was no significant difference between the total effective rate of group C and group B(P > 0.05),indicating that the efficacy of group C and GROUP B was superior to group A in improving the grading of esophageal mucosal inflammation.There was no significant difference between group C and group B.6.Comparison of quality of life: After treatment,the GERD-HRQL score of patients in the three groups was lower than that before treatment(P < 0.05);After treatment,the score of GERD-HRQL scale in group C was lower than that in group B and group A(P < 0.05),and the score of GERD-HRQL scale in group B was lower than that in group A(P < 0.05),indicating that Jiawei Xuandai Granule combined with acupoint application can effectively improve the quality of life of patients with spleen deficiency RGERD.Conclusion:1.Jiawei Xuandai Granule combined with acupoint application in the treatment of RGERD of spleen deficiency can effectively improve acid reflux or water vomiting,belching or reflux,epigastric pain,stomach ruffians and fullness,loss of appetite,fatigue and thin stool symptoms.2.Compared with western medicine alone,Jiawei Xuandai Granule combined with acupoint application in the treatment of RGERD with spleen deficiency can significantly improve esophageal mucosal inflammation.3.Jiawei Xuandai Granule combined with acupoint application can significantly improve the quality of life of patients with spleen deficiency RGERD.