干姜黄芩黄连人参汤治疗寒热错杂型糖尿病胃轻瘫疗效观察

Clinical Observation of Ganjiang Huangqin Huanglian Renshen Decoction in Treating Diabetic Gastroparesis with Concurrence of Cold and Heat Syndrome

【目的】探讨干姜黄芩黄连人参汤治疗寒热错杂型糖尿病胃轻瘫(DGP)的临床疗效。【方法】将64例寒热错杂型DGP患者随机分为试验组和对照组,每组各32例。对照组在常规治疗的基础上联合多潘立酮片治疗,试验组在常规治疗的基础上给予干姜黄芩黄连人参汤治疗,2周为1个疗程,共治疗2个疗程。观察2组患者治疗前后中医证候评分、胃排空率及血糖(空腹血糖、餐后2 h血糖)水平的变化情况,并评价2组患者的疗效和安全性。【结果】(1)观察过程中,2组各有1例患者脱落,最终2组各有31例患者完成试验。(2)治疗4周后,试验组的总有效率为93.5%(29/31),对照组为80.6%(25/31),试验组的疗效明显优于对照组,差异有统计学意义(P<0.01)。(3)治疗后,2组患者的各项中医证候评分均较治疗前明显降低(P<0.05或P<0.01),且试验组的降低作用均明显优于对照组(P<0.01)。(4)治疗后,2组患者的胃排空率均较治疗前明显升高(P<0.01),且试验组的升高作用明显优于对照组(P<0.05)。(5)治疗后,2组患者的空腹血糖和餐后2 h血糖均较治疗前明显降低(P<0.01),且治疗组的降低作用均明显优于对照组(P<0.05或P<0.01)。(6)安全性评价:在整个治疗过程中2组患者均未发生明显的不良反应。【结论】干姜黄芩黄连人参汤治疗寒热错杂型DGP疗效确切,其有较好的促胃动力作用,能有效提高患者的胃排空率,改善患者的症状,且有一定的降糖作用。

Objective To investigate the clinical efficacy of Ganjiang Huangqin Huanglian Renshen Decoction,a Chinese medicine recipe composed of dried Rhizoma Zingiberis, Radix Scutellariae, Rhizoma Coptidis, and Radix Ginseng for the treatment of diabetic gastroparesis with the concurrence of cold and heat syndrome. Methods A total of 64 patients diagnosed as diabetic gastroparesis with the concurrence of cold and heat syndrome were randomly divided into trial group and control group,with 32 cases in each group. The control group was given conventional fundamental treatment combined with oral use of domperidone tablets,and the trial group was given conventional fundamental treatment combined with Ganjiang Huangqin Huanglian Renshen Decoction. Two weeks constituted one course of treatment, and the treatment for the two groups covered 2 courses. Before and after treatment,we observed the traditional Chinese medicine(TCM)syndrome scores,gastric emptying rate,fasting plasma glucose,and 2-hour postprandial blood glucose of the two groups. After treatment,the clinical efficacy and safety of the two groups were also evaluated. Results(1)During the trial, the two groups separately had one cases dropped out, and 31 cases of each group finished the trial.(2)After treatment for 4 weeks, the total effective rate of the trial group was 93.5% and that of the control group was 80.6%. The trial group had stronger efficacy than the control group,and the difference was statistically significant(P<0.01).(3)After treatment,the scores of various TCM syndrome symptoms in the two groups were obviously decreased in comparison with those before treatment(P<0.05 or P<0.01),and the decrease in the trial group was superior to that in the control group(P < 0.01).(4)After treatment,the gastric emptying rate in the two groups was obviously increased in comparison with that before treatment(P<0.01),and the increase in the trial group was superior to that in the control group(P < 0.05).(5)After treatment,the levels of fasting plasma glucose and 2-hour postprandial blood glucose in the two groups were obviously increased in comparison with those before treatment(P<0.01),and the decrease in the trial group was superior to that in the control group(P < 0.05 or P<0.01).(6)During the trial, no obvious adverse reaction occurred in the two groups. Conclusion Ganjiang Huangqin Huanglian Renshen Decoction exerts certain therapeutic effect for the treatment of diabetic gastroparesis with the concurrence of cold and heat syndrome.The decoction can effectively promote gastric motility,increase the gastric emptying rate,and relieve the clinical symptoms of the patients with diabetic gastroparesis, and the decoction also has certain efficacy on decreasing blood glucose level.