健脾醒胃消滞方配合莫沙必利治疗2型糖尿病胃轻瘫所致便秘脾胃虚弱证的疗效及对自主神经功能的影响

Efficacy of Jianpi Xingwei Xiaozhi Decoction combined with mosapride on constipation due to type 2 diabetic gastroparesis of type of spleen-stomach deficiency and its influence on autonomic nerve function

目的探讨健脾醒胃消滞方配合莫沙必利治疗2型糖尿病胃轻瘫所致便秘脾胃虚弱证患者的疗效及对自主神经功能的影响。方法将2018年3月—2019年8月在南宁市红十字会医院治疗的98例2型糖尿病胃轻瘫所致便秘脾胃虚弱证患者随机分为2组,对照组49例采用2型糖尿病基础治疗+莫沙必利治疗,研究组49例在对照组治疗基础上采用健脾醒胃消滞方治疗,2组均治疗4周。比较2组治疗后临床疗效、便秘症状积分、胃排空率、胃电图指标[胃电主功率比(PDP)、胃电主频率比(PDF)]、心率变异性指标[RR间期平均值标准差(SDANN)、相邻RR间期差值的均方根(RMSSD)、全部窦性心搏RR间期的标准差(SDNN)、低频范围内功率(LF)、高频范围内功率(HF)、低频范围内功率与高频范围内功率的比值(LF/HF)]、生活质量评分及不良反应发生情况。结果研究组和对照组治疗总有效率分别为95.6%(45/49)、73.7%(36/49),研究组明显高于对照组(P<0.05)。治疗后,2组便秘症状积分及满意度、躯体不适、担心和焦虑、心理社会不适评分均明显下降(P均<0.05),胃排空率、PDP、PDF、SDANN、RMSSD、SDNN、LF、HF、LF/HF均明显上升(P均<0.05),且治疗后研究组上述指标改善情况均明显优于对照组(P均<0.05)。研究组和对照组不良反应发生率分别为6.1%(3/49)、4.1%(2/49),2组比较差异无统计学意义(P>0.05)。结论健脾醒胃消滞方配合莫沙必利治疗2型糖尿病胃轻瘫所致便秘脾胃虚弱证患者可提高临床疗效,明显改善自主神经功能,提高生活质量,且不增加不良反应。

Objective It is to explore the curative effect of Jianpi Xingwei Xiaozhi Decoction combined with mosapride on constipation due to type 2 diabetic gastroparesis of type of spleen-stomach deficiency and its influence on autonomic nerve function.Methods Ninety-eight patients with constipation caused by type 2 diabetic gastroparesis of type of spleen-stomach deficiency,treated in Nanning Red Cross Hospital from March 2018 to August 2019 were randomly divided into 2 groups,49 patients in the control group were treated with basic therapy for type 2 diabetes+mosapride,49 cases in the study group were treated with Jianpi Xingwei Xiaozhi Decoction on the basis of the control group,both groups were treated for 4 weeks.The clinical efficacy,constipation symptom scores,gastric emptying rate,gastric electrogram indexes[proportional dominant amplitude(PDP),proportional dominant frequency(PDF)],heart rate variability indexes(SDANN,RMSSD,SDNN,LF,HF,LF/HF),the scores of life quality and the occurrence of adverse reactions were compared in the two groups.Results The total effective rates in the study group and the control group were 95.6%(45/49)and 73.7%(36/49),respectively,the study group was significantly higher than the control group(P<0.05).After treatment,the scores of constipation symptoms,satisfaction,physical discomfort,worry and anxiety,and psychosocial discomfort in the two groups were significantly reduced(P<0.05),while the gastric emptying rate,PDP,PDF,SDANN,RMSSD,SDNN,LF,HF and LF/HF were significantly increased(P<0.05),and the improvement of the above indicators in the study group was significantly better than that in the control group(P<0.05).The incidence of adverse reactions in the study group and the control group were 6.1%(3/49)and 4.1%(2/49)respectively,and the difference was not significant(P>0.05).Conclusion Jianpi Xingwei Xiaozhi Decoction combined with mosapride can significantly improve the clinical efficacy,significantly improve autonomic nerve function and the quality of life without increasing adverse reactions in the treatment of constipation due to type 2 diabetic gastroparesis of type of spleen-stomach deficiency.