| 摘要: |
| 目的:观察活血通降方治疗瘀血阻络证反流性食管炎(RE) 对胃电图的影响，从电生理角度探讨该方药的作用机制。方法:筛选瘀血阻络证RE 患者60 例，随机分为两组予以治疗，西药组30 例:奥美拉唑+ 多潘立酮+ 铝碳酸镁，中西药组30 例:奥美拉唑+ 活血通降方，对患者治疗前及治疗后4 周及8 周后症状学积分、胃镜表现及胃电图进行比较分析。结果:西药组:西医症状学积分:治疗前(20.59±4.25) 分，治疗4 周(16.21±3.02) 分，治疗8 周(9.32±2.08) 分，差异有统计学意义(P ＜ 0.05)；中医症状学积分:治疗前(43.28±8.09) 分，治疗4 周(35.06±5.03) 分，治疗8 周(18.23±4.09) 分，差异有统计学意义(P ＜ 0.05)；胃镜分级:治疗前A 级8 例，B 级16 例，C 级6 例，治疗8 周后14 例恢复正常，A 级10 例，B 级5 例，C 级1 例；中西药组:西医症状学积分:治疗前(19.38±3.05) 分，治疗4 周(15.23±2.12 分)，治疗8 周(7.23±3.12)分，差异有统计学意义；中医症状学积分:治疗前(45.41±7.12) 分，治疗4 周(35.34±4.11) 分，治疗8 周(15.12±5.21) 分，差异有统计学意义(P ＜ 0.05)；胃镜分级:治疗前A 级7 例，B 级15 例，C 级8 例，治疗8 周后16 例恢复正常，A 级9 例，B 级5 例，C 级0 例；与西药组比较，中西药组治疗后症状学及内镜改善更明显，胃电图主要表现为主频下降，慢波百分比区趋于正常，胃动过速、胃动过缓及节律紊乱百分比减低。结论:活血通降方可缓解瘀血阻络证RE 患者临床症状及情志，改善胃镜下黏膜表现，具有黏膜保护、动力调节的作用，其机制可能是通过调节胃食管肌电活动及电节律紊乱而发挥作用的。 |
| 关键词: 活血通降方 反流性食管炎 瘀血阻络 胃电图 |
| DOI：10.3969/j.issn.1007-6948.2020.03.018 |
| 投稿时间：2019-04-08 |
| 基金项目:国家自然科学基金面上项目(81573737) |
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| Effect of Huoxue Tongjiang Formula on Electrogastrogram in Patients with Reflux Esophagitis of Static Blood Blocking Collaterals Syndrome |
| GONG Yan-xia,TANG Yan-ping,LI Shu-hong |
| Department of Gastroenterology, Tianjin Nankai Hospital, Tianjin 300100, China |
| Abstract: |
| Objective To observe the effect of Huoxue Tongjiang Formula on Electrogastrogram (EGG) in reflux esophagitis (RE) with syndrome of static blood blocking collaterals and to explore the mechanism of action of Huoxue Tongjiang Formula by electrophysiology. Methods 60 RE patients with static blood blocking collaterals syndrome were selected and randomly divided into two groups. Western medicine group (30 cases):Omeprazole + Domperidone + Hydrotalcite; Chinese and Western medicine group (30 cases): Omeprazole +Huoxue Tongjiang Formula. The symptomatic scores, gastroscopic manifestations and Electrogastrogram were compared before and after treatment for 4 and 8 weeks. Results Western medicine group: Western medicine symptomatology score: before treatment (20.59±4.25), 4 weeks after treatment (16.21±3.02), 8 weeks after treatment (9.32±2.08), the difference was statistically significant; Chinese medicine symptomatology score:before treatment (43.28±8.09), 4 weeks after treatment (35.06±5.03), 8 weeks after treatment (18.23±4.09),the difference was statistically significant; gastroscope grading: before treatment: 8 cases of A, 16 cases of B, 6 cases of C; 8 weeks after treatment: 14 cases returned to normal, 10 cases of grade A, 5 cases of grade B and 1 case of grade C. Chinese and Western medicine group: Western medicine symptomatology score: before treatment (19.38±3.05), 4 weeks after treatment (15.23±2.12), 8 weeks after treatment (7.23±3.12),the difference was statistically significant; Chinese medicine symptomatology score: before treatment(45.41±7.12), 4 weeks after treatment (35.34±4.11), 8 weeks after treatment (15.12±5.21), the difference was statistically signi?cant. Gastroscope grading: before treatment: there were 7 cases of A, 15 cases of B, 8 cases of C, 8 cases of C; 8 weeks after treatment: 16 cases returned to normal, 9 cases in grade A, 5 cases in grade B and 0 in grade C. Compared with the western medicine group, the improvement of symptoms and endoscopy in the Chinese and Western medicine group had more advantages. The main manifestations of electrogastrogram were the decline of main frequency, normalization trend of slow wave percentage, and the decrease of the percentage of gastric tachycardia, slow gastric motility and rhythm disorder. Conclusion Huoxue Tongjiang Formula can alleviate the clinical symptoms and emotions, improve the performance of the mucosal manifestations in gastroscope for RE patients with static blood blocking collaterals syndrome, which had the function of mucosal protection and dynamic regulation. Its mechanism may be effected through regulating gastroesophageal myoelectric activity and electrical rhythm disorder. |
| Key words: Huoxue Tongjiang Formula re?ux esophagitis (RE) static blood blocking collaterals syndrome electrogastrogram |
