基于辛开苦降理论探讨半夏泻心汤治疗肺心病胃肠道功能障碍的研究

Discussion on the Research of Banxia Xiexin Decoction in the Treatment of Gastrointestinal Dysfunction of Pulmonary Heart Disease Based on the Theory of Pungent Drugs for Dispersion and Bitter Drugs for Purgation

目的探讨半夏泻心汤对肺心病急性加重期合并胃肠道功能障碍的临床效果。方法采用前瞻性随机对照研究方法,选择福建中医药大学附属人民医院肺病科2016年1月—2017年7月符合肺心病合并胃肠功能障碍患者60例,采用中心分层区组随机化方法分为治疗组与对照组各30例,2组均采用肺心病标准治疗,对照组在标准治疗上加用胃肠道功能障碍治疗药物,治疗组在标准治疗基础上给予半夏泻心汤治疗,疗程10 d,在治疗第1、7、10天,采用胃肠道症状评分及监测血浆胃动素(MTL)、生长抑素(Somatostatin,SS),血浆二胺氧化酶(DAO)活性评价半夏泻心汤的疗效。结果与对照组相比:(1)治疗组在饮食减少、反酸嗳气、便次异常、胃脘部及脘腹部胀闷不适、胃脘部疼痛、恶心呕吐等症状积分明显减少(P<0.05)。(2)治疗第7天:治疗组在MTL及DAO活性方面优于对照组(P<0.05)。(3)治疗第10天,治疗组在MTL、SS及DAO活性方面改善程度均优于对照组(P<0.05)。结论半夏泻心汤在改善肺心病患者胃肠功能障碍不仅可改善临床症状,还调节胃肠动力,改善患者的胃肠屏障功能。

Objective To study the clinical effect of Banxia Xiexin decoction in acute exacerbation of chronic pulmonary heart disease with gastrointestinal dysfunction. Methods By taking the foreseeing stochastic comparative method, a total of 60 patients with acute exacerbation of chronic pulmonary heart disease with gastrointestinal dysfunction from January 2016 to July 2017 in our hospital were selected as the study objects. According to the multi-center stratified block randomization, all the patients were randomly divided into observation group of 30 cases and control group of 30 cases. The standard treatment of corpulmonale was used in the two groups. The control group was treated with normal treatment combined with the standard treatment of gastrointestinal dysfunction. Th observation group was treated with normal treatment combined with Banxia Xiexin decoction. The total course of treatment is 10 days. By using GSRS, MIL, Somatostatin, DAO, the clinical effect of Banxia Xiexin decoction were evaluated at the 1st, 7th, and 10th day. Results The observation group improved in terms of low food intake acid regurgitation, gastralgia, abnormal stoold, istention and fullness, which was compared with the control group. The difference was statistieallysignificant （P〈0.05） . In 7th day, the observation group increased the activities of MTL and DAO, which was compared with the control group. The difference was statistieally significant （P〈0.05） . Inl0th day, the observation group improved the levels of improvement of MTL, SS and DAO, which was compared with the control group. The difference was statistieally significant （P〈0.05） . Conclusion Banxia Xiexin decoction can not only improved the clinical symptoms, but also regulated the gastrointestinal motility and improved the gastrointestinal barrier function in patients in acute exacerbation of chronic pulmonary heart disease with gastrointestinal dysfunction.