柴枳平肝汤对功能性消化不良肝胃不和证患者血清5-HT、SS含量的影响

Clinical Efficacy Study on Chaizhi Pinggan Decoction in Treating Functional Dyspepsia of Liver-stomach Disharmony Type and Its Influence on 5-HT and SS

目的：探讨柴枳平肝汤治疗功能性消化不良（FD）肝胃不和证的临床疗效,并探讨其作用机制。方法选取2015年3月-2016年3月我院收治的功能性消化不良肝胃不和证患者110例,将其按照随机数字法随机分为观察组和对照组,每组55例,对照组给予多潘立酮片进行治疗,观察组给予柴枳平肝汤进行治疗,2组均治疗4周,观察治疗前后临床症状及体征的改变,并检测治疗前后血清5-羟色胺（5-HT）和生长抑素（SS）的含量;随访3月,观察2组复发情况。结果治疗后2组脘腹胀满、胁痛、脘痛、喜太息、食少纳呆、恶心、嗳气、呕吐症状积分均显著降低（P〈0.05-0.01）,但观察组降低更为明显（P〈0.05-0.01）。治疗后2组中医证候总积分均显著降低（P〈0.01）,但观察组降低更为明显（P〈0.01）。观察组上腹疼痛综合征、餐后不适综合征总有效率分别为92.8%、92.6%均显著高于对照组的72.4%、69.2%（P〈0.05）。治疗后2组血清中5-HT含量均显著上升、SS水平均显著降低（P〈0.01）,但观察组更为明显（P〈0.05）。随访3月观察组复发率为3.6%,显著低于对照组的12.7%（P〈0.05）。结论柴枳平肝汤可以显著改善功能性消化不良肝胃不和证的临床症状,临床疗效好,其作用机制可能与升高血清中的5-HT、降低血清中的SS水平有关。

OBJECTIVE To explore the clinical efficacy of using Chaizhi Pinggan decoction to treat functional dyspepsia of liver-stomach disharmony type and its mechanism.METHODS 110 patients with functional dyspepsia due to liver-stomach disharmony were selected from March,2015 to March,2016 in our hospital and randomly divided into the observation group and the control group,with 55 cases in each group.The control group was given domperidone tablets while the observation group were given Chaizhi Pinggan Decoction.After 4weeks treatment,changes in clinical symptoms and signs,serum serotonin（5HT）and somatostatin（SS）content in the two groups were detected and compared.The recurrence incidence of the two groups during the three-month follow up were observed.RESULTS Such symptoms as abdominal fullness and distention,hypochondriac pain,prone to sign,poor appetite,nausea,belching and vomiting all decreased significantly（P〈0.05~0.01）,but the observation group reduced more significantly compared with the control group（P〈0.05~0.01）.TCM syndrome total scores of both groups decreased significantly after treatment（P〈0.01）,but the observation group reduced more significantly（P〈0.01）.The total efficiency of epigastric pain syndrome and postprandial distress syndrome in the observation group were92.8% and 92.6%,which were much higher than those in the control group72.4% and 69.2%（P〈0.05）.After treatment both serum 5HT and SS in the two groups went down significantly（P〈0.01）,with more decrease in the observation group（P〈0.05）.During the three-month follow ups,the recurrence rate of the observation group was 3.6%,lower than 12.7% of the control group（P〈0.05）.CONCLUSION Chaizhi Pinggan Decoction can significantly improve clinical symptoms of patients with functional dyspepsia due to liver and stomach disharmony,whose mechanism might be related to the increase of5 HT and decrease of SS.