胃肠舒治疗肝炎后肝硬化胃肠运动异常患者30例临床观察

Clinical Observation on Weichangshu for Treatment of 30 Cases of Abnormal Gastrointestinal Motor due to Hepatocirrhosis after Hepatitis

目的:研究肝炎后肝硬化患者胃肠运动变化,探讨肝功能对患者胃肠运动的影响及胃肠舒的治疗作用。方法:符合纳入标准的肝炎后肝硬化患者90例,随机分为3组。一组单纯给予保肝等基础治疗(单纯组),另一组在基础治疗的同时口服胃肠舒(胃肠舒组),又一组在基础治疗的同时口服吗丁啉(吗丁啉组)。疗程为4周。于治疗前后进行胃窦十二指肠消化间期移行性复合运动波(MMC)检测。并与20名健康志愿者的 MMC 对照。结果:与健康志愿者比较,肝炎后肝硬化组患者 MMC 的Ⅰ相时间明显延长,Ⅲ相时间明显缩短,收缩波幅显著降低(P<0.05)。肝功能 A、B、C 三级患者 MMC Ⅲ相的持续时间及收缩波幅与肝功能受损程度呈正相关(P<0.05)。基础治疗加胃肠舒或吗丁啉治疗后 MMC 均出现Ⅲ相持续时间较治疗前明显延长、收缩波幅较治疗前明显增高(P<0.05),而单纯基础治疗后 MMC 也出现Ⅲ相持续时间较治疗前延长、收缩波幅较治疗前增高,但差异无显著性。临床观察尚发现,服用胃肠舒的患者其胃肠道症状均有不同程度的好转。结论:肝炎后肝硬化患者有明显的胃动力障碍,其程度随肝功能恶化而加重;胃肠舒对肝炎后肝硬化患者的胃动力障碍有较好的治疗作用。

Objective:To investigate changes of gastrointestinal motor and effects of hepatic function on gastrointestinal motor and therapeutic action of Weichangshu in the patient of hepatocirrhosis after hepatitis.Methods:90 cases of hepatocirrhosis after hepatitis were randomly divided into 3 groups.Group Ⅰ was treated by basic treatment for protecting liver,group Ⅱ by basic treatment plus oral administration of Weichangshu,and group Ⅲ by basic treatment plus Motolium,for 4 weeks.Antroduodenal magrating motor complex(MMC)at interdigestive period before and after treatment were detected with 20 healthy volunteers used as controls.Results:The phase Ⅰ time of MMC in the patient of hepatocirrhosis after hepatitis prolonged and the phase Ⅲ shortened,and the amplitude of contraction wave significantly decreased as compared with controls(P<0.05).The lasting time of phase Ⅲ and the amplitude of contraction wave in the patients with grades A,B,C of hepatic functions were positively correlated with degrees of hepatic injury(P<0.05).After basic treatment plus Weichangshu or plus Motolium,lasting time of phase Ⅲ prolonged significantly and the amplitude of contraction wave significantly increased as compared with those before treatment (P< 0.05),but the lasting time and the amplitude in the basic treatment group did not significantly change after treatment.Clinical observation found that gastrointestinal symptoms in the patients who took Weichangshu improved to varying degrees.Conclusion: The patient of hepatocirrhosis after hepatitis has obvious gastric motility disorder,which aggravates along with exacerbation of hepatic function;Weichangshu has a better therapeutic action on gastric motility disorder in the patient of hepatocirrhosis after hepatitis.