匀气汤对返流性食管炎患者食管粘膜形态及食管动力学的影响

目的 :观察匀气汤对返流性食管炎患者食管粘膜形态及食管动力学的影响。方法 :42例返流性食管炎患者 ,按照中医辨证分为肝胃不和 (D组 )、脾胃虚寒 (DC组 )和肝郁化热 (H组 ) 3个证型组。分别以匀气汤Ⅰ、Ⅱ、Ⅲ号进行 4周治疗。治疗前后计算症状积分 ,检查胃镜并测定食管动力学变化。结果 :(1 )症状缓解率 81 1 % ,其中D组症状缓解率低于I组和H组 (P <0 0 1 ) ;(2 )食管粘膜治愈率 61 1 % ,有效率 90 5 % ,无效率 9 5 % ,治愈率 3组间比较无显著性差异 (P >0 0 5 ) ;(3 )食管动力学的变化 :Ⅰ组的食管下端括约肌压力 (LESP)、平均蠕动压 (APP)明显提高 (P <0 0 5 ) ;D组的LESP、胃 -食管屏障压 (GEBP)、蠕动传导速度 (PCS)明显提高 (P <0 0 5 ) ,H组的GEBP显著改善 (P <0 0 5 )。结论 :匀气汤治疗返流性食管炎可改善临床症状 ,促进粘膜修复并可改善食管动力功能。

Effects of Yunqitang on Both Esophageal Mucosal Morphology and Esophageal Motility in Reflux Esophagitis Patients

OBJECTIVE: To observe the effects of Yunqitang (YQT) on both esophageal mucosal morphology and esophageal motility in patients with reflux esophagitis (RE). METHODS: According to Syndrome Differentiation of TCM, 42 RE patients were divided into three groups: Disharmony of Liver and Stomach (D) group, Deficiency-Cold of Spleen and Stomach (DC) group, Heat Syndrome caused by depression of Liver Qi (H) group. No. I, II, III of YQT were taken respectively for 4 weeks. Before and after treatment scores of typical symptoms were collected, gastroscope and esophageal motility were measured. RESULTS: (1) The symptom remission rate was 81.1%, there were significant differences between the group DC with group D and Group H (P < 0.01). (2) The esophageal mucosal healing rate was 61.9%, the effective rate was 90.5%, and the ineffective rate 9.5%. There weren't significant difference of effective rates among the three groups (P < 0.05). (3) The changes of esophageal motility: lower esophageal sphictor pressure (LESP), average peristaltic pressure (APP) of group D were higher (P < 0.05), LESP, gastro-esophageal barrier pressure (GEBP) and peristaltic conduct speed (PCS) of group DC were remarkably higher (P < 0.05), GEBP of group H was improved (P < 0.05). CONCLUSIONS: YQT has a good therapeutical effect, it's not only resolving reflux symptoms, healing esophageal mucosa, but also improving esophageal motile function.