香砂六君子汤加减方对功能性消化不良的影响及作用机制研究

Observation of the effects and action mechanism of modified Xiangsha- liujunzi decoction on the treatment of functional dyspepsia

目的观察香砂六君子汤加减方对功能性消化不良(FD)的影响,并探讨其作用机制。方法将120例FD患者随机分为2组,治疗组60例予香砂六君子汤治疗,对照组60例予多潘立酮联合奥美拉唑肠溶胶囊治疗。2个月后评定疗效,并检测胃肠激素、血浆P物质、胃排空率,以尼平消化不良指数(NDI)评价治疗前后胃肠功能变化。结果治疗组总有效率86.7%,高于对照组(68.3%,P<0.05)。2组治疗后及停药后随访时症状指数(NDSI)及生活质量指数(NDLQI)评分均明显改善(P<0.05),且治疗组改善情况明显优于对照组(P<0.05)。2组治疗后血清胃动素(MTL)、生长抑素(SS)、血浆P物质测定及胃排空率均明显改善(P<0.05),且治疗组改善情况明显优于对照组(P<0.05)。结论香砂六君子汤加减治疗FD临床疗效确切,其发挥作用的机制可能与降低内脏高敏感,提高胃肠道动力有关。

Objective To observe the effects of modified Xiangsha- liujunzi decoction on the treatment of functional dyspepsia（ FD）,and to investigate the action mechanism. Methods 120 FD patients were randomly divided into two groups,60 cases in each group. The treatment group received modified Xiangsha- liujunzi decoction,and the control group received domperidone combined with omeprazole enteric- coated capsules. The curative effect was evaluated after two months. The levels of gastrointestinal hormone,plasma substance p,the gastric emptying rate were measured in two groups. The gastrointestinal function before and after treatment was evaluated by Nepean dyspepsia index（ NDI） in two groups. Results The total effective rate in treatment group（ 86. 7%） was superior to that in control group（ 68. 3%,P 〈 0. 05）. The Nepean dyspepsia symptom index（ NDSI） and life quality index（ NDLQL） after treatment and drugs withdrawal were obviously improved in two groups（ P 〈 0. 05）,and the improvement in treatment group was superior to that in control group（ P 〈 0. 05）. The serum motilin,somatostatin,plasma substance p and the gastric emptying rate after treatment were significantly improved in two groups（ P 〈 0. 05）,and the improvement in treatment group was superior to that in control group（ P 〈 0. 05）. Conclusion Modified Xiangsha- liujunzi decoction has exact clinical effects on FD,its mechanism may relate to the decrease of visceral hypersensitivity and the increase of gastrointestinal motility.