目的 探讨逍遥丸联合兰索拉唑治疗老年胃食道反流病的疗效及对胃肠激素的影响。方法 选取2018年3月—2019年12月北京市西城区展览路医院收治的94例老年胃食道反流病患者作为研究对象，按照随机数字表法将所有患者分为对照组和观察组，每组各47例。对照组口服兰索拉唑肠溶片，15 mg/次，1次/d。观察组在对照组患者治疗的基础上口服逍遥丸，8丸/次，3次/d。两组均连续治疗4周。观察两组患者的临床疗效，同时比较两组治疗前后的反流性疾病问卷（RDQ）评分、酸反流次数、最长反流时间、DeMeester评分和胃肠激素水平。结果 治疗后，观察组患者总有效率为93.62%，明显高于对照组的76.60%，两组比较差异有统计学意义（P<0.05）。治疗后，两组的症状发作频率、症状发作程度均显著降低（P<0.05）；观察组治疗后的症状发作频率、症状发作程度显著低于对照组（P<0.05）。两组治疗后的酸反流次数、最长反流时间、DeMeester评分显著降低（P<0.05）；观察组治疗后的酸反流次数、最长反流时间、DeMeester评分明显低于对照组（P<0.05）。两组治疗后的胃泌素、胃动素显著升高，血管活性肠肽显著降低（P<0.05）；观察组治疗后的胃泌素、胃动素显著高于对照组，血管活性肠肽水平显著低于对照组（P<0.05）。结论 逍遥丸联合兰索拉唑可提高老年胃食道反流病的疗效，减轻患者的症状体征，调节胃肠激素的水平，具有一定的临床研究价值。

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

北京市保健科研课题项目（京13–01号）