目的 观察黛力新联合枫蓼肠胃康颗粒治疗胃食管反流病(GERD)重叠肠易激综合征(IBS)患者疗效及对自主神经功能、心理健康状态的影响.方法 将82例GERD重叠IBS患者随机分为观察组42例和对照组40例,对照组给予非药物(心理干预、改善生活方式等)和对症(抑酸+止泻+调节胃肠菌群)治疗,观察组在对照组治疗基础上给予黛力新联合枫蓼肠胃康颗粒治疗,疗程均为8周.比较2组临床疗效,观察2组临床症状积分、内镜检查、病情相关评分、心率变异性(HRV)和症状自评量表(SCL-90)评分变化.结果 观察组治疗总有效率显著高于对照组(P＜0.05);2组治疗后反酸、烧心、胃脘灼痛、吞咽困难、腹痛、腹胀、腹泻积分和临床症状总积分均较治疗前显著降低(P均＜0.05),观察组治疗后以上积分均显著低于对照组(P均＜0.05);2组治疗后GERD内镜检查分级均较治疗前明显好转(P均＜0.05),观察组治疗后0～Ⅰ级比例明显高于对照组(P均＜0.05);2组治疗后IBS内镜检查中肠黏膜血管异常显露、肠黏膜单处充血水肿、肠黏膜多处充血水肿、肠黏膜绒毛污浊发生率均显著降低(P均＜0.05),且观察组治疗后以上病理现象发生率均明显低于对照组(P均＜0.05).2组治疗后胃食管反流病问卷(GerdQ)、IBS症状严重程度量表(IBS-SSS)评分及SCL-90量表中躯体化、人际关系、抑郁、焦虑、精神属性、饮食与睡眠评分均显著降低(P均＜0.05),且观察组治疗后以上评分均明显低于对照组(P均＜0.05).2组治疗后HRV相关参数均显著改善(P均＜0.05),观察组改善更明显(P＜0.05).结论 黛力新联合枫蓼肠胃康颗粒治疗GERD重叠IBS疗效更好,在缓解临床症状的同时,还能改善自主神经功能,有利于心理亚健康状态的缓解.%Objective It is to observe the efficacy of Deanxit combined with Fengliao Changweikang granule in the treatment of patients with gastroesophageal reflux disease (GERD) with irritable bowel syndrome (IBS) and its influence on autonomic function and mental health status. Methods Eighty-two patients with GERD and IBS were randomly divided into observation group (42 cases) and control group (40 cases). The control group was given non-drug therapy (psychological intervention, lifestyle improvement, etc.) and symptomatic therapy (acid suppression + diarrhea + gastric regulation), and the observation group was treated with Deanxit combined with Fengliao Changweikang granule based on the control group. Both groups were treated for 8 weeks. The clinical efficacy of the two groups was compared. The changes of clinical symptom score, endoscopy, disease-related score, heart rate variability (HRV) and symptom self-rating scale (SCL-90) scores were observed. Results The total effective rate of the observation group was significantly higher than that of the control group (P＜0.05). The scores of acid regurgitation, heartburn, stomach cramps, dysphagia, abdominal pain, bloating, diarrhea and total clinical symptoms were significantly decreased in the two groups after treatment (P＜0.05), the above scores of the observation group were lower than those of the control group (P＜0.05). The GERD endoscopy scores of the two groups were significantly improved after treatment (P＜0.05), the proportion of 0-Ⅰ grade in the observation group was significantly higher than the control group (P＜0.05); the occurrence rate of intestinal mucosal vascular abnormalities, intestinal mucosa single congestion and edema, intestinal mucosa multiple congestion and edema, intestinal mucosal villus contamination in IBS endoscopic examination was significantly decreased (P＜0.05), and the incidence in the observation group was significantly lower than that in the control group (P＜0.05). The scores of GerdQ, IBS-SSS and that of somatization, interpersonal relationship, depression, anxiety, mental attributes, diet and sleep scores in the SCL-90 scale were significantly decreased (P＜0.05), and the above scores of the observation group were lower than those of the control group (P＜0.05). The HRV parameters were significantly improved after treatment in both groups (P＜0.05), and the improvement in the observation group was more significant (P＜0.05). Conclusion Deanxit combined with Fengliao Changweikang granule can significantly improve the therapeutic effect on GERD with IBS, while improving clinical symptoms, it can also improve autonomic function and is helpful for the relief of mental sub-health status.
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