Zhang Yu-Jing, Wu Shen-Ping
Department of Oncology, Beijing Integrated Traditional Chinese and Western Medicine Hospital, Beijing 100039, China.
World J Clin Cases. 2024 May 6;12(13):2194-2200. doi: 10.12998/wjcc.v12.i13.2194.
Gastroesophageal reflux disease (GERD) is a common complication of esophageal cancer surgery that can affect quality of life and increase the risk of esophageal stricture and anastomotic leakage. Wendan Decoction (WDD) is a traditional Chinese herbal formula used to treat various gastrointestinal disorders, such as gastritis, functional dyspepsia, and irritable bowel syndrome. Mosapride, a prokinetic agent, functions as a selective 5-hydroxytryptamine 4 agonist, enhancing gastrointestinal motility.
To evaluate the therapeutic effects of WDD combined with mosapride on GERD after esophageal cancer surgery.
Eighty patients with GERD were randomly divided into treatment (receiving WDD combined with mosapride) and control (receiving mosapride alone) groups. The treatment was conducted from January 2021 to January 2023. The primary outcome was improved GERD symptoms as measured using the reflux disease questionnaire (RDQ). The secondary outcomes were improved esophageal motility (measured using esophageal manometry), gastric emptying (measured using gastric scintigraphy), and quality of life [measured the Short Form-36 (SF-36) Health Survey].
The treatment group showed a notably reduced RDQ score and improved esophageal motility parameters, such as lower esophageal sphincter pressure, peristaltic amplitude, and peristaltic velocity compared to the control group. The treatment group showed significantly higher gastric emptying rates and SF-36 scores (in both physical and mental domains) compared to the control group. No serious adverse effects were observed in either group.
WDD combined with mosapride is an effective and safe therapy for GERD after esophageal cancer surgery. It can improve GERD symptoms, esophageal motility, gastric emptying, and the quality of life of patients. Further studies with larger sample sizes and longer follow-up periods are required to confirm these findings.
胃食管反流病(GERD)是食管癌手术的常见并发症,可影响生活质量,并增加食管狭窄和吻合口漏的风险。温胆汤(WDD)是一种用于治疗各种胃肠道疾病的传统中药方剂,如胃炎、功能性消化不良和肠易激综合征。莫沙必利是一种促动力剂,作为选择性5-羟色胺4激动剂发挥作用,增强胃肠动力。
评估温胆汤联合莫沙必利对食管癌手术后胃食管反流病的治疗效果。
80例胃食管反流病患者随机分为治疗组(接受温胆汤联合莫沙必利治疗)和对照组(仅接受莫沙必利治疗)。治疗时间为2021年1月至2023年1月。主要结局是使用反流疾病问卷(RDQ)测量的胃食管反流病症状改善情况。次要结局是食管动力改善(使用食管测压法测量)、胃排空(使用胃闪烁扫描法测量)和生活质量[使用简短36项健康调查(SF-36)测量]。
与对照组相比,治疗组的RDQ评分显著降低,食管动力参数如食管下括约肌压力、蠕动幅度和蠕动速度得到改善。与对照组相比,治疗组的胃排空率和SF-36评分(身体和心理领域)显著更高。两组均未观察到严重不良反应。
温胆汤联合莫沙必利是治疗食管癌手术后胃食管反流病的一种有效且安全的疗法。它可以改善胃食管反流病症状、食管动力、胃排空以及患者的生活质量。需要进行更大样本量和更长随访期的进一步研究来证实这些发现。