调胃汤治疗功能性消化不良的临床及实验研究

Clinical and experimental study on Tiaowei decoction in treatment of functional dyspepsia

[目的]通过实验和临床研究探讨中药复方调胃汤治疗功能性消化不良(FD)的作用机制。[方法]予大白鼠分别灌服调胃汤及其双倍剂量调胃汤、西沙必利溶液、蒸馏水,再灌服葡聚糖蓝2000,然后处死动物取胃肠,以分光光度计λ620 nm测定胃内葡聚糖蓝2000残留量,并计算自幽门括约肌至色素最前端及至盲肠距离百分比为小肠推进比。FD患者95例,随机分成治疗组67例,予调胃汤加减治疗;对照组28例,予多潘立酮治疗,4周为1个疗程,观察治疗前后疗效。[结果]调胃汤组胃内色素残留率小于空白组和西沙比利组(P<0.01,<0.05),平均小肠推进率大于对照组(P<0.01),与西沙比利组相似(P>0.05)。治疗组改善主要症状作用优于对照组(P<0.05),总疗效作用相似(P>0.05),但显效率明显高于对照组。[结论]调胃汤有较好的促进胃肠运动的作用,是治疗FD的有效方剂,值得进一步研究。

[Objective] To discuss the mechanism of Tiaowei decoction （TWD） in the treatment of functional dyspepsia（FD）, [Methods] The rats were perfused with TWI）, cloubledose of TWD, cisapride solutions, distilled water respectively and then 2 % Blue Dxtran 2000. Stomach and small intestine were taken out after that. The gastric contents Abs was assayed with spectrophotometer with X620nm and the length from sphincter of pylorus to the anterior extremity of Blue Dxtran 2000 and to cecum was mearsured respectively to calculate average intestinal driving ratio. Ninety-five patients were randomly divided into TWD group （n=67） and domperidone con trol group （n= 28）. The TWD group was treated with TWD and the control group was given domperidone. [Results] The Abs of TWD group was smaller than that o（ the blank group and cisapride group （P〈0. 01,〈0.05）. The average intestinal driving ratio of TWD was higher than that of the blank group（P〈0.01） and similar to that of cisapride group （P〉0. 05）. Compared with the control group, TWD group was superior in improving the main symptoms （P〈0. 05） and similar in total effective rate （P〉0. 05）, while its excellent effective rate was much better. [Conclusion]TWD has good effect on FD patients in promoting gastrointestinal motility.