推拿与西沙必利治疗功能性消化不良的疗效比较及其机理探讨

Comparison of Therapeutic Effect of Chinese Massage Therapy with Cisapride in Treating Functional Indigestion and Investigation of lts Mechanism

对推拿与促胃肠动力药西沙必利治疗功能性消化不良 (FD)的疗效作比较研究 ,并探讨推拿治疗的作用机制。随机将各亚型功能性消化不良患者 90例分成推拿组、服药组及安慰剂组 ,并以 3 0名健康者作对照。于治疗前后作B超胃排空及胃动力检测 ,并测定血清胃泌素、胃动素、胆囊收缩素。结果表明 ,各组FD患者治疗前的胃窦平均收缩幅度(△S)、平均收缩频率 (f)及运动指数 (Mi) ,较正常健康者显著降低 (P <0 .0 5 ,P <0 .0 1,P <0 .0 5 ) ,而半排空时间、全排空时间又显著延长 (P <0 .0 1)。FD各组餐后 2小时的胃动力指标P、f及Mi均显著低于正常组 (P <0 .0 1) ,推拿组和服药组治疗 1个月后的△S ,较治疗前无明显差别 (P >0 .0 5 ) ,f及Mi均较治疗前显著增加 (P <0 .0 5 ) ,半排空时间T50 、全排空时间T均较治疗前显著缩短。胃动力指标及症状评分均较治疗前有显著改善 (P <0 .0 1) ,而安慰剂组上述指标治疗前后均无明显差异 (P >0 .0 5 )。说明推拿与西沙必利可有效治疗功能性消化不良。消化期B超胃排空检测指标胃窦收缩幅度 (P)、f.Mi及胃动力指标可作为评估疗效的客观依据。

InthecomparativestudyofthetherapeuticeffectsbetweenChinesemassagetherapyandCisapridetopromote gastrointestinaldynamiaforfunctionalindigestion(FI)andintheinvestigationofthefunctionalmechanismofChinese massagetherapy ,90casesofvarioussubgroupfunctionalindigestionwererandomlydividedintotheChinesemassage group ,medicationgroupandplacebogroup ,togetherwiththecontrolgroupof30healthyadults .Beforeandafterthetreat ments ,Bultrasonicexaminationswereusedtodeterminegastricemptyingandgastricdynamiaandalsodetermineserum gastrin ,gastricdynamicelementandcholecystokinin .Theresultsshowedthattheaveragecontractionamplitude(△s) ,av eragecontractionfrequency(f)andmotionindex(Mi)ofgastricantruminvariousFlgroupsdecreasedremarkablythanthe normalhealthygroup(P <0 .0 5 ,P <0 .0 1,P <0 .0 5 ) ,butthehalfemptyingtimeandthetotalemptyingtimeprolonged remarkably(P <0 .0 1) .Theindexesofgastricdynamiatwohoursaftermeals ,P ,f,andMi,invariousFlgroupswerelow erremarkablythanthenormalgroup(P <0 .0 1) .Therewasnosignificantdifference(P >0 .0 5 )in△sonemonthafter thetreatmentsintheChinesemassagegroupandmedicationgroupthanbeforethetreatments .fandMiallincreasedre markablythanbeforethetreatments(allinP <0 .0 0 5 ) .Thehalf-emptyingtimeT50 andthetotalemptyingtimeTwere allshortenedthanbeforethetreatments .Theindexesofgastricdynamiaandsymptomsassaywereallremarkablyimproved (allinP <0 .0 1) .But ,therewasnosignificantdifference(P >0 .0 5 )atallintheaboveindexesintheplacebogroupbe foreandaftertreatments .Therefore ,ChinesemassagetherapyandCisapridecaneffectivelytreatfunctionalindigestion .The gastricemptyingindexesbyBultrasonicexamination ,contractionamplitudeofthegastricantrum ,f,andMiandtheindex esofthegastricdynamiacanberegardedastheobjectivefoundationtoassessmentofthetherapeuticeffect.