旋覆代赭汤加减联合系统生活方式干预治疗胃气上逆型胃食管反流性咳嗽临床观察

目的观察旋覆代赭汤加减联合系统生活方式干预治疗胃气上逆型胃食管反流性咳嗽的临床疗效。方法将100例胃气上逆型胃食管反流性咳嗽患者按照随机数字表法分为2组,对照组50例予西医常规治疗,治疗组50例予旋覆代赭汤加减联合系统生活方式干预治疗。2组均治疗4周为1个疗程,治疗3个疗程后统计胃镜疗效及临床疗效,比较2组治疗前、治疗后及治疗后3个月咳嗽评分、莱塞斯特咳嗽生命质量问卷(LCQ)评分及反流性疾病问卷(ROQ)评分变化情况,比较2组治疗后3个月疾病复发情况。结果治疗组胃镜疗效总有效率80.0%(40/50),临床疗效总有效率84.0%(42/50),治疗后3个月复发率16.0%(8/50),对照组胃镜疗效总有效率72.0%(36/50),临床疗效总有效率74.0%(37/50),治疗后3个月复发率30.0%(15/50),治疗组胃镜疗效及临床疗效均高于对照组(P<0.05),复发率低于对照组(P<0.05)。2组治疗后及治疗后3个月与本组治疗前比较,咳嗽评分及RDQ评分均明显降低(P<0.05),LCQ评分均明显升高(P<0.05),且治疗组治疗后及治疗后3个月各项评分改善均优于对照组同期(P<0.05)。结论旋覆代赭汤加减联合系统生活方式干预治疗胃气上逆型胃食管反流性咳嗽疗效确切,可有效改善患者咳嗽症状,缓解胃食管反流症状,促进食管黏膜修复,提高生活质量,且远期疗效稳定,复发率低。

Clinical observation of Modified Xuanfu Daizhe Decoction combined with systematic lifestyle intervention in the treatment of gastroseophageal reflux cough with adverse rising type of gastric qi

Objective To observe the clinical observation on modified Xuanfu Daizhe Decoction combined with systematic lifestyle intervention in the treatment of of gastroesophageal reflux cough(GERC)with adverse rising type of gastric qi.Methods A total of 100 cases of GERC with adverse rising type of gastric qi were randomly and equally divided into two groups,the control group(n=50)were treated with conventional western medicine,while the treatment group(n=50)with Xuanfu Daizhe Decoction combined with systemic lifestyle intervention.Four weeks for a course of treatment and a total of 3 courses of treatment,the efficacy of gastroscopy and clinical efficacy were statistically analyzed,the cough score,lester cough quality of life questionnaire(LCQ)score,reflux disease questionnaire(RDQ)score,as well as disease recurrence were compared between the two groups before and after treatment.Results The total response rates of gastroscopy in treatment group and control group were 80.0%(40/50)vs 72.0%(36/50),respectively,and the curative effect being better in treatment group than control group(P<0.05).The total effective rate of clinical curative effect in treatment group and control group were 84.0%(42/50)vs 74.0%(37/50),respectively.The recurrence rate of 3 months after treatment in treatment group and control group were 16.0%(8/50)vs 30.0%(15/50),respectively,and the recurrence rate of 3 months after treament being lower in treatment group than control group(P<0.05).Compared between after initial treatment and 3 months after treatment and before treatment in the two groups,the cough score and RDQ score were significantly decreased(P<0.05),and the LCQ score was significantly increased(P<0.05),and the improvement of each score in the treatment group was better than that in the control group(P<0.05).Conclusion It is definite effect,that modified Xuanfu Daizhe Decoction combined with systematic lifestyle intervention in the treatment of GERC with adverse rising type of gastric qi.This method can effectively relieved the symptoms of patients cough and GERC,it can promote gastric mucosal repair and improve the patients'life quality,the long-term efficacy is stable and the recurrence rate is lower.