健脾消滞汤加减治疗糖尿病胃轻瘫的临床分析

Clinical Analyses of Modified Jianpi Xiaozhi Decoction in Treating Diabetic Gastric Paralyze

目的:观察健脾消滞汤加减治疗糖尿病胃轻瘫(DGP)的临床疗效及对胃动素和胃泌素影响。方法:将96例患者采用随机按数字表法分为对照组47和观察组49例。对照组采用西沙必利片,5 mg/次,3次/d,每餐前30 min口服。观察组采用健脾消滞汤加减内服,1剂/d,水煎分2次服用。两组疗程均为4周。记录治疗前后主要症状、体征评分;进行治疗前后胃排空试验;检测治疗前后血浆胃动素和胃泌素水平。结果:观察组临床疗效总有效率为91.8%,对照组为74.4%,观察组优于对照组(P<0.05);治疗后观察组胃排空时间少于对照组(P<0.01);治疗后观察组血浆胃动素和胃泌素水平低于对照组(P<0.01);治疗后观察组饱胀程度、饱胀持续时间、早饱、恶心呕吐、嗳气次数和大便情况等评分均低于对照组(P<0.01)。结论:健脾消滞汤加减治疗糖尿病胃轻瘫,能改善临床症状,促进胃排空,并能调节胃动素和胃泌素,其临床疗效优于西沙必利片。

Objective： To observe the clinical effect of modified Jianpi Xiaozhi decoction in treating diabetic gastric paralyze （DGP） , and to investigate its influence on motilin and gastrin. Method： Ninety-six patients were randomly divided into the control group （47 cases） and the observation group （49 cases） by a random number table. Patients in the control group received 5 mg cisapride tablets thrice daily 30 min before a meal. Patients in the observation received 1 dose modified Jianpi Xiaozhi decoction in twice daily. All patients in both two groups received 4 weeks of treatment. Before and after treatment, scores of the main symptoms and signs were recorded. Gastric emptying test was conducted. Levels of motilin and gastrin were detected. Result： The total efficient rate in the observation group was 91.8% , which was superior to that of 74.4% in the control group （P 〈 0.05 ）. After treatment, stomach row space in the observation group was lower than that in the control group （P 〈 0.01）. Levels of plasma motilin and gastrin in the observation group were lower than those in the control group （P 〈 0.01 ）. Scores of fullness degree, fullness, duration, early satiety, nausea and vomiting, heating amount and defecate in the observation group were inferior to those in the control group （P 〈 0.01 ）. Conclusion ： Modified Jianpi Xiaozhi decoction could improve clinical symptoms and promote gastric emptying in treating DGP. The clinical curative effect of therapy is better than that of cisapride. Its mechanism may be related to regulating the levels of motilin and gastrin.