胃下垂的常见中医分型与胃肠动力学指标的相关性研究

A study on correlation between common TCM typing of gastroptosis and gastrointestinal dynamics indexes

目的:探讨胃下垂的常见中医分型与胃肠动力学指标的相关性。方法:选取2012年1月-2016年6月我院收治的胃下垂患者54例为研究对象,根据中医证型分为肝胃不和组30例和脾虚饮停组24例。选取同期25例健康志愿者为正常对照组。均进行胃十二指肠同步测压,比较三组的消化间期移行性复合运动(Migrating Motor Complex,MMC)周期的时程和振幅指数、消化期的远端胃振幅指数(Amplitude Meal Index,AMI),胃肠收缩类型以及病史资料。结果:肝胃不和组胃痛、便秘的症状发生率高于脾虚饮停组(P<0.05)。脾虚饮停组胃内振水音、餐后腹胀的症状发生率高于肝胃不和组(P<0.05)。消化间期,肝胃不和组、脾虚饮停组的MMC周期Ⅲ相时程均小于正常对照组(P<0.05),且脾虚饮停组的MMC周期Ⅲ相时程小于肝胃不和组(P<0.05)。脾虚饮停组的十二指肠通道、空肠通道Ⅲ相振幅指数均小于正常对照组和肝胃不和组(P<0.05)。消化期,肝胃不和组和脾虚饮停组胃幽门十二指肠协同收缩(APDCC)和胃幽门十二指肠收缩(PDC)的发生率明显低于正常对照组(P<0.05),孤立幽门压力波(IPPW)的发生率明显高于正常对照组(P<0.05)。结论:胃十二指肠同步测压可在一定程度上鉴别胃下垂肝胃不和、脾虚饮停两种中医分型,相比正常人群,脾虚饮停证在胃肠动力学指标、临床症状上更具有特异性。

Objective:To explore correlation between common TCM typing of gastroptosis and gastrointestinal dynamics indexes.Methods:54 gastroptosis patients who were admitted to the hospital from January 2012 to June 2016 were enrolled.According to TCM typing,there were divided into the Ganwei Buhe group(肝胃不和)(30 cases)and the Pixu Yinting group(脾虚饮停)(24 cases).25 healthy volunteers were enrolled as the healthy control group.Simultaneous pressure measurement of gastroduodenum was performed.The time course and amplitude index of migrating motor complex(MMC)cycle during digestion period,distal gastric amplitude index and type of gastrointestinal contraction during digestive period,medical history data were compared among the three groups.Results:The incidence of stomachache and constipation in the Ganwei Buhe group was higher than that in the Pixu Yinting group(P﹤0.05).The incidence of intragastric succussion splash and postprandial abdominal bloating in the Pixu Yinting group was higher than that in the Ganwei Buhe group(P﹤0.05).The III phase time course of MMC cycle in the Ganwei Buhe group and the Pixu Yinting group was lower than that in the healthy control group(P﹤0.05),and above indexes in the Pixu Yinting group was lower than that in the Ganwei Buhe group(P﹤0.05).The III phase amplitude index of duodenal passage and jejunal passage in the Pixu Yinting group was lower than that in the healthy control group and the Ganwei Buhe group(P﹤0.05).The incidence of APDCC and PDC in the Ganwei Buhe group and the Pixu Yinting group was significantly lower than that in the healthy control group(P﹤0.05),and the incidence of IPPW was significantly higher than that in the healthy control group(P﹤0.05).Conclusion:Simultaneous pressure measurement of gastroduodenum can identify the two TCM types of Ganwei Buhe and Pixu Yinting.Compared with normal people,Pixu Yinting is more specific in gastrointestinal dynamics index and clinical symptoms.