加味异功散辅助治疗糖尿病胃轻瘫的疗效分析

Effect Analysis of Jiawei Yigong Powder in Treating of Diabetes Gastroparesis

目的:探讨加味异功散辅助治疗糖尿病胃轻瘫(DGP)的疗效及对血浆胃动素和胃泌素的影响。方法:94例患者采用随机数字表法分为对照组46例和观察组48例。对照组采用莫沙必利片,5 mg/次,3次/d,餐前30 min口服;和硫辛酸胶囊,0.6 g/次,1次/d,早餐前30 min口服。观察组在对照组治疗的基础上采用加味异功散内服,1剂/d。两组疗程均为4周。采用B超检测治疗前后胃排空情况,记录胃半排空时间(T1/2),胃排空时间(T);进行治疗前后胃轻瘫症状严重指数表(GCSI)评分;检测治疗前后血浆胃动素和胃泌素水平。结果:观察组临床总有效率为91.8%,优于对照组的74.4%(P<0.05);治疗后观察组胃半排空时间及胃排空时间均短于对照组(P<0.05);治疗后观察组餐后腹胀/早饱、恶心呕吐和腹胀评分及胃轻瘫总分均低于对照组(P<0.01);治疗后观察组胃动素和胃泌素水平低于对照组(P<0.01)。结论:加味异功散内服能减轻DGP患者的临床症状,调节胃肠激素,促进胃排空,提高临床疗效,值得进一步研究。

Objective： To discuss the curative effect of Jiawei Yigong powder in treating diabetes gastroparesis（DGP） and its influence on plasma motilin and gastrin. Method： Ninety four patients were randomly divided into control group（46 cases） and observation group（48 cases）. Patients in control group took mosapride citrate tablets,5 mg / time,3 times / day,at 30 min before meal; Sulfur acid capsules,0. 6 g / time,1time / day,at 30 min before breakfast. Besides the therapy of control group,patients in observation group were additionally treated with Jiawei Yigong powder,1 dose / day. The treatment course of both groups lasted for 4weeks. Efforts were made to detect gastric emptying by B ultrasonic before and after treatment,record gastric half emptying time（T1/2）,gastric emptying time（T）,score the symptom severity index（GCSI） of the stomach and mild paralysis,and test the levels of plasma motilin and gastrin before and after treatment. Result： Total effective rate in observation group was 91. 8%,which was superior to 74. 4% in control group（P〈0. 05）. After treatment,gastric half emptying time and gastric emptying time in observation group were shorter than these in control group（P〈0. 05）. Postprandial abdominal distension /early full,nausea and vomiting,abdominal distension score and gastroparesis total score in observation group were all lower than these data in control group（P〈0. 01）. Levels of motilin and gastrin in observation group were lower than the standards in control group（P〈0. 01）. Conclusion：Oral administration of Jiawei Yigong powder can reduce clinical symptoms of DGP patients,regulate gastrointestinal hormone,promote the gastric emptying,improve the clinical curative effect,and so is worth further studies.