乌梅丸治疗糖尿病胃轻瘫寒热错杂型的临床疗效观察

Therapeutic Effect of Wumei Wan for Diabetic Gastroparesis with Syndrome of Cold-Heat Mixture

【目的】探讨乌梅丸治疗糖尿病胃轻瘫寒热错杂型的临床疗效。【方法】将68例糖尿病胃轻瘫属于寒热错杂型患者,随机分为治疗组和对照组各34例。在常规控制血糖水平的同时,治疗组用乌梅丸治疗,对照组用口服西沙比利治疗。治疗1个月后评价疗效,并观察2组治疗前后胃肠道症状、胃排空功能及餐后2 h血糖(2h PG)、糖化血红蛋白(Hb A1c)、空腹血糖(FPG)水平的变化情况。【结果】(1)治疗组总有效率为88.24%,优于对照组的67.65%(P<0.05)。(2)治疗后,治疗组恶心呕吐、胃脘痞闷、厌食、嗳气泛酸、胃腹疼痛、腹泻、便秘等各项胃肠道症状积分均较治疗前显著改善(P<0.05或P<0.01),而对照组仅恶心呕吐、厌食、腹泻等症状有改善(P<0.05);治疗组在改善恶心呕吐、胃腹疼痛、腹泻、便秘等症状方面优于对照组(P<0.05或P<0.01)。(3)治疗后,2组2h PG、FPG、Hb A1c水平均较治疗前显著降低(均P<0.05),且治疗组在改善2h PG、FPG、Hb A1c水平方面优于对照组(P<0.05)。(4)治疗后,2组胃半排空时间、胃全排空时间、胃窦收缩幅度等各项胃排空功能指标均较治疗前显著改善(均P<0.05),且治疗组在改善胃排空功能方面优于对照组,差异均有统计学意义(P<0.05)。【结论】乌梅丸治疗糖尿病胃轻瘫的临床疗效明显优于西药西沙比利,值得临床推广应用。

Objective To investigate the clinical efficacy of Wumei Wan（Fructus Mume Pills） for diabetic gastroparesis with the syndrome of cold-heat mixture. Methods Sixty-eight diabetic gastroparesis patients with the syndrome of cold-heat mixture were evenly randomized into treatment group and control group. On the basis of treatment for controlling the blood glucose level,the treatment group was given oral use of Wumei Wan and the control group was given oral use of Cisapride. After treatment for one month,the therapeutic effect of both groups was evaluated, and the changes of gastrointestinal symptoms, gastric emptying, 2-hour postprandial glucose（2h PG）,glycosylated hemoglobin（Hb A1c）,and fasting plasma glucose（FPG） in both groups were also observed. Results（1）The total effective rate of the treatment group was 88.24%,and that of the control group was 67.65%,the difference being significant（P〈0.05）.（ 2）After treatment, the scores of gastrointestinal symptoms of nausea and vomiting,gastric fullness,anorexia,belching and acid regurgitation,abdominal and gastric pain,diarrhea,and constipation in the treatment group were markedly improved（P〈0.05 or P〈0. 01 compared with those before treatment）. In the control group, symptom relief was shown in nausea and vomiting,anorexia,and diarrhea（P〈0.05）. The treatment group had better effect on relieving nausea and vomiting,abdominal and gastric pain, diarrhea,and constipation than the control group（P〈0.05 or P〈0.01）.（3）After treatment,2h PG, FPG and Hb A1 c levels were obviously decreased in both groups（P0.05 compared with those before treatment）,and the decrease in the treatment group was superior to that in the control group（P〈0.05）.（4）After treatment,half gastric emptying time,full gastric emptying time,and the contraction of gastric antrum were improved in both groups（P〈0.05）,and the improvement of gastric emptying in the treatment group was superior to that in the control group（P〈0.05）. Conclusion Wumei Wan has better effect for the treatment of diabetic gastroparesis than western medicine Cisapride.