肝胃百合汤联合氟西汀片治疗围绝经期功能性消化不良肝气犯胃证临床研究

Clinical Study on Ganwei Baihe Decoction Combined with Fluoxetine Tablet on Menopausal Patients with Functional Dyspepsia with Liver-qi Infracting Stomach

目的观察肝胃百合汤联合氟西汀片治疗围绝经期功能性消化不良(MPFD)的临床疗效。方法采用随机数字表法将60例MPFD患者分为观察组和对照组各30例。观察组予肝胃百合汤,每日1剂,分2次口服;氟西汀片20 mg/次,1次/d。对照组予莫沙必利片5 mg/次、3次/d,氟西汀片20 mg/次、1次/d,口服。2组均连续治疗4周。观察2组治疗前后尼平消化不良症状指数(NDSI)评分、尼平消化不良生活质量指数(NDLQI)评分、汉密顿焦虑量表(HAMA)评分及汉密顿抑郁量表(HAMD)评分,检测血清胃泌素(GAS)、胃动素(MTL)水平,评价中医临床疗效。结果观察组总有效率为93.33%(28/30),对照组为80.00%(24/30),观察组明显优于对照组(P<0.05)。与本组治疗前比较,2组治疗后中医症状积分、NDSI评分、HAMA评分及HAMD评分明显下降(P<0.05,P<0.01),NDLQI评分明显升高(P<0.05);2组治疗后比较,观察组上述评分改善较对照组明显(P<0.05)。与本组治疗前比较,2组治疗后血清GAS、MTL水平明显升高(P<0.05);2组治疗后比较,观察组治疗后血清GAS、MTL水平明显高于对照组(P<0.05)。结论肝胃百合汤联合氟西汀片治疗MPFD疗效显著,可缓解患者临床症状,改善其精神状态,升高血清GAS、MTL水平。

Objective To explore clinical efficacy of Ganwei Baihe Decoction combined with fluoxetine tablet on menopausal patients with functional dyspepsia (MPFD). Methods Totally 60 cases were randomly divided into observation group and control group according to random number table method, with 30 cases in each group. The observation group was given Ganwei Baihe Decoction, one dosage a day, twice a day, orally, and fluoxetine tablet 20 mg, once a day. The control group was given mosapride tablet 5 mg, three times a day and fluoxetine tablet 20 mg, once a day. The course of treatment in both groups lasted for four weeks. Nepean dyspepsia symptom index (NDSI) score, nepean dyspepsia life quality index (NDLQI) score, hamilton anxiety scale (HAMA) score, hamilton depression scale (HAMD) score, serum levels of gastrin (GAS) and motilin (MTL) of both groups were observed before and after treatment. TCM clinical efficacy was evaluated. Results The total effective rate was 93.33%(28/30) in the observation group and 80.00%(24/30) in the control group. The observation group was significantly better than the control group (P<0.05). Compared with before treatment, the TCM symptom scores, NDSI score, HAMA score and HAMD score of both groups significantly decreased (P<0.05, P<0.01), and the NDLQI score significantly increased (P<0.05). Compared with the control group, the improvement of the scores in the observation group was more significant than that in the control group (P<0.05). Compared with before treatment, the serum levels of GAS and MTL significantly increased in both groups (P<0.05). The levels of GAS and MTL in the observation group were significantly higher than those in the control group (P<0.05). Conclusion Ganwei Baihe Decoction combined with fluoxetine has obvious efficacy for MPFD, which can relieve clinical symptoms, enhance mental state, and increase levels of GAS and MTL.