加味枳术颗粒治疗糖尿病胃轻瘫临床疗效观察及可能机制研究

Clinical observation of modified Zhizhu granule in treating diabetic gastric paralyze and its possible mechanism

[目的]观察加味枳术颗粒对糖尿病胃轻瘫(DGP)的临床疗效及胃促生长素(Ghrelin)的影响,探讨加味枳术颗粒治疗DGP的可能机制及单方治疗DGP的可行性和有效性。[方法]将60例DGP患者采用随机数字表法分为试验组30例和对照组30例。试验组采用加味枳术颗粒内服,1剂/d,分2次早晚饭前30min温服。对照组采用枸橼酸莫沙比利片,5mg/次,3次/d,每餐前30min口服。2组疗程均为4周。记录治疗前后主要症状积分,进行治疗前后胃排空试验,检测治疗前后血清胃促生长素水平。[结果]试验组临床疗效总有效率为86.67%,对照组为70.00%,试验组优于对照组(P<0.05);治疗后试验组脘腹胀满、上腹疼痛、早饱、恶心呕吐、嗳气、反酸、排便改变症状积分及总症状积分均低于对照组(P<0.01);治疗后试验组胃排空率高于对照组(P<0.05);治疗后试验组血清胃促生长素水平高于对照组(P<0.05)。[结论]加味枳术颗粒在改善DGP患者的临床症状,促进胃排空率等方面优于枸橼酸莫沙比利片,同时加味枳术颗粒能提高DGP患者的血清Ghrelin水平,此可能为其治疗DGP的机制之一。

[Objective]To observe the clinical effection of modified Zhizhu granule in treating diabetic gastroparesis（DGP）,and to investigate its influence on Ghrelin.Be aimed to discuss its possible mechanism and feasibility and effectiveness of using single prescription to treat DGP.[Methods]Sixty patients were randomly divided into the treatment group（30 cases）and the control group（30 cases）by a random number table.Patients in the treatment group received 1 dose modified Zhizhu Granule twice daily,and in the control group received 5mg mosapride citrate tablets thrice daily 30 min before meal.All patients in both two groups received 4weeks of treatment.Before and after treatment,scores of the main symptoms were recorded,gastric emptying test was conducted and levels of Ghrelin were detected.[Results]The total efficient rate in the treatment group was 86.67%,which was superior to that of 70.00%in the control group（P〈0.05）.After treatment,scores of abdominal fullness and distention,epigastralgia,early satiety,nausea and vomiting,eructation,sour regurgitation,defecate and total symptom in the treatment group were inferior to those in the control group（P〈0.01）.After treatment,gastric emptying rate in the treatment group was higher than that in the control group（P〈0.05）.Levels of the ghrelin in the treatment group were higherthan those in the control group（P〈0.01）.[Conclusion]Modified Zhizhu granule is better than mosapride citrate on improving clinical symptoms and promoting gastric emptying in treating DGP.In the meantime,it may regulating the levels of ghrelin,this may be the one of its mechanism of treating DGP.