【作者】 金汤；

【导师】 谢晶日；

【作者基本信息】 黑龙江中医药大学 ， 中医内科学， 2007， 硕士

【摘要】 胃食管反流病(Gastroesophageal reflux disease，GERD)是指过多胃、十二指肠内容物反流入食管产生的症状和并发症。在我国GERD的发生率约为5.77％，故为常见病、多发病之一。本病在中医学中应归属于“吐酸”、“吞酸”等范畴。本文从古今两方面探讨了中医学对胃食管反流病的病因、病机、治疗方法的认识，总结出脾虚肝郁、胃失和降、气逆于上是发生本病的关键所在，其病位在脾胃，与肝之疏泄功能密切相关。回顾了现代医学对本病发病机制、诊断和治疗的现状。确立了中医健脾疏肝，和胃降逆的治法，并探讨了组方及配伍原则，取得了良好的临床疗效。本项研究随机选择胃食管反流病门诊患者(肝胃不和型)64例分为2组，即治疗组和对照组，每组各32例，两组患者在性别、年龄、病程等方面比较无显著性差异(p＞0.05)。对照组单纯使用西药，吗丁琳10mg，一天三次，治疗组给予口服中药胃宁颗粒治疗，每次一剂，分早、中、晚三次口服。6周为一疗程，两组患者均服药一个疗程。结果表明，中药胃宁颗粒可以明显减轻胃食管反流病胃镜下病变程度，具有兴奋消化道平滑肌，增加其张力，有效抑制胃酸分泌，促进组织再生，加快粘膜修复的作用。在服药过程中，对肝肾功能及血尿常规无明显影响，是一种安全的用药途径。胃镜检查复发率极低。中药胃宁颗粒治疗胃食管反流病与纯西药相比有明显的优势和特点，不仅临床收效显著，而且可以降低纯西药治疗的副作用及复发率，为治疗胃食管反流病开辟了新的途径。更多还原

【Abstract】 Gastroesophageal reflux disease (GERD) was the symptoms and complications of contents of stomach and duodenum refluxing to the esophagus. The incidence of this disease was about 5.77%. It was a common disease in our country.This disease was belong to traditional Chinese medicine concepts, such as "acid regurgitation", "acid swallow". This thesis reviewed its etiology, pathologic mechanism, and treatment principles in TCM from ancient books and modern research. We came the conclusion that spleen deficiency and liver stagnation, failure of stomach Qi descend with abnormal flow of stomach Qi were the principal mechanism of this disease. The location of this ailment was in spleen and stomach. It was closely related to the regulation function of liver. This thesis also reviewed its pathogenesis, diagnosis and treatment according to modern science findings. The treatment principles, to strengthen spleen and soothe liver, regulate Qi and descend adverse flow of Qi were established. The principles of how to form the prescription were also been discussed.In the study we select 64 patients of Gastroesophageal reflux disease from the outpatient department were divided randomly into to groups:the treatment group and the control group. There were 32 patients in each group without significant in sex, age, symptom pattern between two group(p>0.05).The control group taking 10mg,third daily. The treatment group taking traditional Chinese herb of Weining particles, one pill daily and taking Omeprazole and Motilium. The treatment time was composed of 6 weeks.The result indicate, the traditional Chinese herb medicine Weining particles can obviously alleviate the symptoms and endsocopic manifestation of Gastroesophageal reflux disease . Weining particles can reduce reflue by increasing lower esophageal sohincter tone and enhancing esophageal acid and gastric emptying. Compared with western medicine, the traditional Chinese herb medicine Weining particles treating Gastroesophageal reflux disease have obvious superiority. Not only the curative rate of Weining particles is obvious, but also to reduce side effect and relapse rate of western medicine, opening a new way on treating reflux esophagitis.更多还原