柴胡疏肝散加减治疗肝胃不和型反流性咽炎

42 CHINA MEDICINE AND PHARMACY Vol.9 No.5 March

2019

2019年3月第9卷第5期

·中医研究·

柴胡疏肝散加减治疗肝胃不和型反流性咽炎

陈学华 陈 舒 陈俊曦 钟艳萍广东省佛山市中医院，广东佛山 528000

[摘要] 目的 观察柴胡疏肝散加减治疗肝胃不和型反流性咽炎的疗效。 方法 将153例临床诊断为肝胃不和型反流性咽炎患者随机分为三组，各51例，治疗组给予柴胡疏肝散加减治疗，观察组给予柴胡疏肝散+奥美拉唑治疗，对照组给予奥美拉唑治疗，疗程为8周，比较三组的临床疗效。 结果 治疗前后比较：三组的反流症状指数量表（RSI）、反流体征量表（RSF）评分均有改善；治疗组与对照组比较，差异无统计学意义（P ＞0.05），观察组与治疗组，差异有统计学意义（P ＜0.05）。治疗1周时咽异物感的缓解率：治疗组87.76%（43/49），观察组91.67%（44/48），对照组70.83%（34/48），与对照组比较，治疗组及观察组的缓解率更高，差异有统计学意义（P ＜0.05）。 结论 柴胡疏肝散加减对肝胃不和型反流性咽炎有较好的疗效,单用可以达到与奥美拉唑相似的效果，奥美拉唑联用柴胡疏肝散可以进一步提高疗效，特别是在缓解咽异物感症状上具有一定优势。

[关键词] 柴胡疏肝散；反流性咽炎；质子泵抑制剂

[中图分类号] R276.1 [文献标识码] A [文章编号] 2095-0616（2019）05-42-03

Modified Chaihushugan powder in the treatment of reflux

pharyngitis of liver stomach disharmony type

CHEN Xuehua CHEN Shu CHEN Junxi ZHONG Yanping

Department of Otorhinolaryngology,Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,China

[Abstract] Objective To study the clinical efficacy of modified Chaihushugan powder in the treatment of Reflux Pharyngitis of Liver Stomach Disharmony Type. Methods A total of 153 cases with reflux pharyngitis of liver stomach disharmony type were divided into treatment group,observation group and control group,with 51 cases in each group.The treatment group was treated with ChaihuShugan Powder,the observation group was treated with ChaihuShugan Powder plus proton pump inhibitor(PPI) Omeprazole,while the control group was treated with PPI only.The course of treatment was 8 weeks,and the clinical effects of the three groups were compared. Results Comparison before and after treatment:RSI and RSF scores of the three groups were parison between groups:there was no significant difference between the treatment group and the control group (P ＞0.05),there were statistically significant differences between the observation group and the treatment group(P ＜0.05).The remission rate of pharyngeal foreign body sensation at 1 week after treatment:87.76% (43/49) in the treatment group,91.67% (44/48) in the observation group,and 70.83% (34/48) in the control pared with the control group,the remission rate of the treatment group and the observation group was higher,and the difference was statistically significant (P ＜0.05). Conclusion Chaihushugan powder has better curative effect on disharmony regurgitation pharyngitis of liver and stomach,which can achieve similar effect with omeprazole alone,and omeprazole combined with chaihushugan powder can further improve the curative effect,especially in alleviating symptoms of foreign body sensation in pharynx.

[Key words] Chaihushugan powder;Reflux Pharyngitis;Proton pump inhibitor

[基金项目] 广东省中医药局科研课题（20161243）。

慢性咽炎（梅核气）是耳鼻喉科门诊常见疾病，研究表明在慢性咽炎的患者中，患有胃食管反流病患者达34.6%[1]，该病在很长时间内被误诊为普通的慢性咽喉炎[2]。该病主要表现为咽部异物感、咽干、声音嘶哑、痰多、慢性咳嗽等症状，可伴见烧心、反酸、呃逆等症状，甚至引起喉部黏膜角化、狭窄、息肉增生、癌变等严重后果。在人们生活节奏变快、饮食习惯发生改变等诸多因素的综合作用下，反流

性咽炎的发病率也逐年提高。目前临床上主要运用质子泵抑制剂（PPI）抑酸治疗，并从临床症状、体征、及动态胃酸监测结果证实了其疗效，但患者往往需较长明间服药（1～3个月，甚至半年），容易导致消化不良，且停药后容易复发。我科参考《中医耳鼻咽喉科临床研究》中喉痹、喉喑、梅核气等的分型标准[3]，将反流性咽炎分为肝胃不和型、痰瘀互结型、气阴两虚型，发现大部分患者属于肝胃不和型[4]。本研究以柴胡疏肝散加减治疗肝胃不和型反