四逆散配合七味白术散加味治疗肝郁脾虚型功能性消化不良的临床效果观察

Effect of Sini powder and scattered seven Atractylodes in the treatment of functionaldyspepsia with hepatic stagnation and spleen deficiency syndrome

目的探讨四逆散配合七味白术散加味治疗肝郁脾虚型功能性消化不良的临床疗效。方法选取衢州市中医医院门诊收治的100例肝郁脾虚型功能性消化不良患者为研究对象，采用信封分组法分为西药组和中药组，各50例，西药组于三餐前口服莫沙必利片，5 mg/次，中药组口服四逆散和七味白术散加味汤剂，150 mL/次，每天2次，疗程4周，比较两组疗效评估、腹胀评分和药物不良反应。结果中药组明显好转40例，好转8例，无效2例，临床总有效率96.0%；西药组明显好转30例，好转12例，无效8例，临床总有效率80.4%，中药组总有效率高于西药组，差异有统计学意义（χ2＝8.239，P＝0.041）。两组治疗后的腹胀评分均比治疗前有所降低，但中药组（2.4±2.7）分，治疗后的腹胀评分显著低于西药组的（2.9±2.2）分，中药组治疗效果高于西药组（t＝3.794，P＝0.006）。两组均未发现严重不良反应。结论四逆散配合七味白术散加味能够有效改善肝郁脾虚型功能性消化不良患者的临床症状，并且无明显不良反应。

ObjectiveTo discuss the clinical efficacy of Sini powder and scattered seven Atractylodes in the treatment of functional dyspepsia with hepatic stagnation and spleen deficiency syndrome.MethodsA total of 100 cases of functional dyspepsia with hepatic stagnation and spleen deficiency syndrome in our hospital were selected and randomly divided into the western medicine group and Chinese medicine group by envelope grouping method.The patients in western medicine group were treated with mosapride tablets, 5mg each time, and the patients in Chinese medicine group were treated with Sini powder and scattered seven Atractylodes, 150mL each time, two times a day for 4 weeks.The efficacy, abdominal distension scores and adverse drug reactions were compared between the two groups.ResultsIn the Chinese medicine group, 40 cases were obviously improved, 8 cases were improved, 2 cases were invalid, and the total clinical effective rate was 96.0%.In the western medicine group, 30 cases were obviously improved, 12 cases were improved and 8 cases were invalid.The total clinical effective rate was 80.4%.The total effective rate of the Chinese medicine group was higher than that of the western medicine group, the difference was statistically significant（χ2=8.239, P=0.041）. The abdominal distension scores of the two groups after treatment was lower than those before treatment, but the abdominal distension score of the Chinese medicine group[（2.4±2.7）points]was significantly lower than that of the western medicine group[（2.9±2.2）points], the clinical efficacy of the traditional Chinese medicine group was better than that of the Western medicine group（t=3.794, P=0.006）. No serious adverse reactions were found in the two groups.ConclusionSini powder and scattered seven Atractylodes can effectively improve the clinical symptoms of liver stagnation and spleen deficiency in patients with functional dyspepsia, and has no obvious adverse reactions.