加味枳实消痞汤治疗糖尿病胃轻瘫的疗效及作用机制

Clinical Effect and Action Mechanism of Jiawei Zhishixiaopi Decoction in Treatment of Diabetic Gastroparesis(DGP)

目的:探讨加味枳实消痞汤治疗糖尿病胃轻瘫(DGP)的疗效及作用机制。方法:选择惠州市第一妇女儿童医院2013年3月至2015年9月收治的156例DGP患者,随机分为观察组和对照组各78例。观察组予以加味枳实消痞汤治疗,对照组予以多潘立酮片治疗。同时招募70例健康志愿者为参照,观察两组DGP患者的疗效及治疗前后胃排空率。结果:观察组的总有效率及胃排空率均明显优于对照组;治疗前后,两组患者的胃泌素(GAS)、血中胃动素(MOT)与健康志愿者相比差异无统计学意义(P>0.05);治疗后,对照组患者的瘦素(LEP)、血管活性肠肽(VIP)、生长抑素(SS)与健康志愿者差异具有统计学意义(P<0.05)。结论:加味枳实消痞汤对治疗DGP有着确切疗效,通过降低患者血清中SS、VIP及LEP激素水平来实现胃排空。

Objective To probe into and analyze the clinical effects and its mechanism of action of Jiawei Zhishixiaopi Decoction in treatment of diabetic gastroparesis（DGP）. Methods 156 cases of DGP suffered from the hypostatic pneumonia and accepted treatments in our hospital from March, 2013 to September, 2015 were divided into the observation group（n=78） and the control group（n=78） randomly. In the observation group, they were received the Jiawei Zhishixiaopi Decoction treatment while in the control group, they were received the Domperidone Tablets, and at the same time, 70 healthy volunteers were recruited as the reference. Then the clinical effect of two groups of DGP patients and gastric emptying rate were observed before and after treatment. Results The total effective rate and gastric emptying rate in the observation group were significantly better than those in the control group; Before and after the treatment, the gastrin（GAS）, plasma motilin（MOT） of two groups of patients were compared with healthy volunteers had no obvious difference; After treatment, the SS, VIP and LEP of patients in the control group were significantly different than those of the healthy volunteers（P〈0.05）. Conclusion The Jiawei Zhishixiaopi Decoction in treatment of DGP has a definite clinical effect, which it is mainly by lowering the serum LEP, VIP, SS hormone levels to achieve the gastric emptying.