健脾导滞交通汤对糖尿病性胃轻瘫胃动力及胃排空功能的影响

Effect of Jianpi Daozhu Jiaotong Decoction on Gastric Motility and Gastric Emptying Function of Diabetic Gastroparesis

目的:观察健脾导滞交通汤联合甲钴胺注射液对糖尿病性胃轻瘫胃动力及胃排空功能的影响。方法:128例糖尿病性胃轻瘫患者按照随机数字对照表分为对照组和观察组。两组均给予常规糖尿病治疗方案,包括饮食控制,口服降低血糖药、注射胰岛素、体育锻炼、心理疏导等。对照组给予甲钴胺注射液0.5 mg肌肉注射,每日1次;多潘立酮片10 mg,口服,每日3次;枸橼酸莫沙必利5 mg,饭前口服,每日3次。观察组在对照组治疗基础上给予健脾导滞交通汤。两组均以两周为1个疗程,两个疗程后比较两组患者临床疗效及胃动力作用。结果:两组患者临床疗效比较:对照组临床治愈17例,显效20例,有效19例,无效8例,有效率为87.50%;观察组临床治愈33例,显效21例,有效8例,无效2例,有效率为96.88%;两组有效率比较,差异有统计学意义(P<0.05)。两组患者治疗前后中医证候积分比较:对照组治疗后恶心、腹胀、厌食、早饱等证候积分与治疗前比较,差异均有统计学意义(P<0.05);观察组治疗后全部中医证候积分与治疗前比较,差异有统计学意义(P<0.05);观察组优于对照组(P<0.05)。两组患者中医证候疗效比较:对照组治愈14例,显效24例,有效16例,无效10例,有效率为84.38%;观察组治愈29例,显效19例,有效12例,无效4例,有效率为93.75%;两组有效率比较,差异有统计学意义(P<0.05)。两组患者治疗前后血浆胃动素水平比较:两组患者治疗后胃动素水平与治疗前比较,差异有统计学意义(P<0.05);观察组治疗后与对照组比较,差异有统计学意义(P<0.05)。两组患者治疗前后胃排空功能比较:两组患者治疗后固性胃排空时间和液性胃排空时间与治疗前比较,差异有统计学意义(P<0.05);观察组治疗后与对照组比较,差异有统计学意义(P<0.05)。结论:健脾导滞交通汤联合甲钴胺注射液治疗糖尿病性胃轻瘫疗效显著,可明显减轻患者临床症状,增强胃动力,促进胃排空。

Objective：To observe the effect of Jianpi Daozhu Jiaotong decoction combined with methylcobalamin injection on gastric motility and gastric emptying function of diabetic gastroparesis. Methods ：128 patients with diabetic gastroparesis were randomly divided into the control group and the observation group. The two groups of patients were treated with routine diabetes treatment, including diet control, oral bypoglycemie drugs, insulin injection, physical exercise, psychological counseling, and so on. The control group was given intramuscular injection of mecobalamin injection 0.5 mg once a day ; domperidone 10rag, orally administration,three times a day;mosapride citrate 5 rag, before meals,three times a day. The observation group was treated with Jianpi Daozhu Jiaotong decoction on the basis of the control group. The two groups were treated for 2 weeks. After two courses of treatment, the clinical efficacy and gastric motility were compared between the two groups. Results ： Clinical effect comparison ： 17 cases of pa- tients were clinical cured in the control group,20 cases were markedly effective, 19 cases were effective, and 8 cases were invalid, the effective rate was 87.50% ;33 cases were clinical cured in the observation group ,21 cases markedly effective ,8 cases were ef- fective, and 2 cases were invalid, and the effective rate was 96.88% ; the difference between the two groups was statistically signifi- cant （ P 〈 0.05 ）. The TCM syndrome scores such as nausea, abdominal distension, anorexia and early satiety in the control group were significantly different from those before treatment （P 〈 0.05 ）, but belching score had no significant difference （ P 〉 0.05 ）. The scores of all TCM syndromes after treatment in the observation group were significantly different from those before treatment （ P 〈 0.05 ）, and the observation group was superior to the control group （P 〈 0.05 ）. Comparison of TCM syndromes efficacy between the two groups：in the control group, 14 cases were cured,24 cases were markedly effective, 16 cases were effective, 10 cases were ineffective,the effective rate was 84.38% ;in the observation group,29 cases were cured, 19 cases were markedly effective, 12 cases were effective,4 cases were ineffective, the effective rate was 93.75%, and the difference was statistically significant （ P 〈 0.05 ）. There was significant difference in motilin levels of the two groups after treatment （ P 〈 0.05 ） and the difterence between the observation group and the control group was statistically significant （P 〈 0.05 ）. The time of solid gastric emptying and liquid gastric emptying after treatment was significantly different of the two groups （P 〈 0.05 ）, and the difference between the observation group and the control group was statistically significant （ P 〈 0.05 ）. Conclusion ： Jianpi Daozhu Jiaotong decoction combined with methylcobalamin injection has significant effect in the treatment of diabetic gastroparesis, which can obviously relieve the clinical symptoms of the patients, enhance gastric motility and promote gastric emptying.