目的 探討逍遙丸聯(lián)合蘭索拉唑治療老年胃食道反流病的療效及對胃腸激素的影響。方法 選取2018年3月—2019年12月北京市西城區(qū)展覽路醫(yī)院收治的94例老年胃食道反流病患者作為研究對象，按照隨機數(shù)字表法將所有患者分為對照組和觀察組，每組各47例。對照組口服蘭索拉唑腸溶片，15 mg/次，1次/d。觀察組在對照組患者治療的基礎(chǔ)上口服逍遙丸，8丸/次，3次/d。兩組均連續(xù)治療4周。觀察兩組患者的臨床療效，同時比較兩組治療前后的反流性疾病問卷（RDQ）評分、酸反流次數(shù)、最長反流時間、DeMeester評分和胃腸激素水平。結(jié)果 治療后，觀察組患者總有效率為93.62%，明顯高于對照組的76.60%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組的癥狀發(fā)作頻率、癥狀發(fā)作程度均顯著降低（P<0.05）；觀察組治療后的癥狀發(fā)作頻率、癥狀發(fā)作程度顯著低于對照組（P<0.05）。兩組治療后的酸反流次數(shù)、最長反流時間、DeMeester評分顯著降低（P<0.05）；觀察組治療后的酸反流次數(shù)、最長反流時間、DeMeester評分明顯低于對照組（P<0.05）。兩組治療后的胃泌素、胃動素顯著升高，血管活性腸肽顯著降低（P<0.05）；觀察組治療后的胃泌素、胃動素顯著高于對照組，血管活性腸肽水平顯著低于對照組（P<0.05）。結(jié)論 逍遙丸聯(lián)合蘭索拉唑可提高老年胃食道反流病的療效，減輕患者的癥狀體征，調(diào)節(jié)胃腸激素的水平，具有一定的臨床研究價值。

Objective To investigate the therapeutic effect of Xiaoyao Pills combined with lansoprazole on geriatric gastroesophageal reflux disease and its effect on gastrointestinal hormones. Methods A total of 94 elderly patients with gastroesophageal reflux disease in Beijing Zhanlan Road Hospital of Xicheng District from March 2018 to December 2019 were selected as study subjects. According to the random number table method, all patients were divided into control group and observation group, with 47 patients in each group. Patients in the control group were po administered with Lansoprazole Entericcoated Tablets, 15 mg/time, once daily. Patients in the observation group were po administered with Xiaoyao Pills on the basis of control group, 8 pills/time, three times daily. Both groups were treated continuously for 4 weeks. The clinical efficacy in two groups was observed, and the RDQ scores, acid reflux times, longest reflux time, DeMeester score, and gastrointestinal hormone levels before and after treatment were compared. Results After treatment, the total effective rate of the observation group was 93.62%, significantly higher than 76.60% of the control group, and the difference between two groups was statistically significant (P<0.05). After treatment, the frequency and degree of symptom onset in two groups were significantly reduced (P<0.05). And the frequency and degree of symptom onset in the observation group were significantly lower than those in the control group (P<0.05). After treatment, the number of acid reflux, the longest reflux time and DeMeester score in two groups were significantly reduced (P<0.05). And the number of acid reflux, the longest reflux time, and DeMeester score after treatment in the observation group were significantly lower than those in the control group (P<0.05). After treatment, gastrin and motilin in two groups were significantly increased, and vasoactive intestinal peptide was significantly decreased (P<0.05). And the levels of gastrin and motilin in the observation group after treatment were significantly higher than those in the control group, and the levels of vasoactive intestinal peptide were significantly lower than those in the control group (P<0.05). Conclusion Xiaoyao Pills combined with lansoprazole can improve the efficacy of gastroesophageal reflux disease in the elderly, reduce the symptoms and signs of patients, regulate the level of gastrointestinal hormones, has certain clinical research value.

R975

北京市保健科研課題項目（京13–01號）