加味星蒌承气汤对痰热腑实型脑梗死患者呃逆的康复作用及其机制的初步研究

Rehabilitation of Jiawei Xinglou Chengqi Decoction on hiccups in patients with phlegm-heat and fu-viscera excess syndrome caused by cerebral infarction

目的:探讨加味星蒌承气汤对痰热腑实型脑梗死患者呃逆的康复作用及其作用机制。方法:采用随机对照试验,80例痰热腑实型脑梗死后呃逆患者被随机分入加味星蒌承气汤组(40例)和对照组(40例)。在常规西医治疗的基础上,加味星蒌承气汤组加用加味星蒌承气汤口服治疗10 d。10 d治疗结束时,评价呃逆的治疗效果。比较治疗前、10 d治疗结束时以及治疗开始后第30天的呃逆发生频率及每次呃逆的持续时间,以及外周血Ca^2+、Mg^2+和Na^+浓度以及血清促胃动素水平。结果:10 d治疗结束时,2组患者的呃逆均有所缓解,加味星蒌承气汤组有效率(92.1%)显著高于对照组(82.1%)(P<0.05)。2组治疗后的呃逆发生频率及每次呃逆的持续时间均较治疗前显著减少(P<0.01)。加味星蒌承气汤组10 d治疗结束时以及治疗开始后第30天的呃逆发生频率及每次呃逆的持续时间均较同期的对照组显著减少(P<0.05,P<0.01)。治疗后,2组的外周血Ca^2+、Mg^2+和Na^+浓度均较治疗前升高,但差异均无统计学意义(P>0.05);血清促胃动素水平均较治疗前显著增加(P<0.05),但2组之间的差异无统计学意义(P>0.05)。结论:加味星蒌承气汤辨证治疗痰热腑实型脑梗死后呃逆的疗效显著,不良反应少,但是其作用机制并不明确。

Objective:To explore the rehabilitation effect and mechanism of Jiawei Xinglou Chengqi Decoction on hiccup in patients with phlegm-heat and fu-viscera excess syndrome caused by cerebral infarction.Methods:In a randomized controlled trial,80 patients with hiccup after cerebral infarction with phlegm-heat and fu-viscera excess syndrome were randomly divided into Jiawei Xinglou Chengqi Decoction group(n=40)and control group(n=40).On the basis of conventional western medicine treatment,Jiawei Xinglou Chengqi Decoction group was treated with Jiawei Xinglou Chengqi Decoction for 10 days.At the end of 10-day treatment,the therapeutic effect for hiccup was evaluated.The frequency and duration of each hiccup,the concentrations of Ca^2+,Mg^2+and Na^+in peripheral blood and serum motilin level were compared before treatment,at the end of 10-day treatment and 30 days after treatment.Results:At the end of 10-day treatment,hiccups in both groups were relieved,and the response rate of Jiawei Xinglou Chengqi Decoction group(92.1%)was significantly higher than that of the control group(82.1%)(P<0.05).The frequency of hiccup and the duration of each hiccup after treatment in both groups were significantly lower than those before treatment(P<0.01).The frequency of hiccup and the duration of each hiccup in Jiawei Xinglou Chengqi Decoction group were significantly lower than those in the control group at the end of 10-day treatment and 30 days after treatment(P<0.05,P<0.01).After treatment,the concentrations of Ca^2+,Mg^2+and Na^2+in peripheral blood in both groups were higher than those before treatment,but the differences were not statistically significant(P>0.05);the serum motilin levels were significantly increased(P<0.05),but there was no significant difference between the two groups(P>0.05).Conclusion:Jiawei Xinglou Chengqi Decoction has significant curative effect on hiccup after cerebral infarction with phlegm-heat and fu-viscera excess syndrome,and there are less adverse reactions during the treatment,but the mechanism of treatment is not clear.