枳术宽中胶囊联合替普瑞酮治疗胃癌术后胃肠动力障碍的临床疗效及其对胃动力相关激素的影响

Effect of Zhizhu Kuanzhong Capsules Combined with Teprenone on Gastric Motility-related Hormones in Patients with Gastrointestinal Motility Disorder After Gastric Cancer Operation

目的探讨枳术宽中胶囊联合替普瑞酮对胃癌术后胃肠动力障碍的临床疗效及其对胃动力相关激素的影响。方法收集2019年6月—2021年6月期间于解放军960医院淄博院区(原解放军148医院消化科)行胃癌根治术后胃肠动力障碍患者84例作为研究对象,采用随机抽签法分为对照组和观察组,每组各42例。对照组采用替普瑞酮治疗,观察组在对照组基础上加用枳术宽中胶囊治疗。治疗10 d后,观察比较两组患者临床疗效、不良反应发生情况,治疗前后胃肠症状积分及胃动力[血管活性肠肽(Vasoactive intestinal peptide,VIP)、胃泌素(Gastrin,GAS)、胃动素(Motilin,MTL)]水平。结果治疗后两组患者胃肠症状嗳气、腹胀、恶心呕吐、胃烧灼感积分均较治疗前下降,差异有统计学意义(P<0.05);且观察组胃肠症状嗳气、腹胀、恶心呕吐、胃烧灼感积分均较对照组明显降低,差异有统计学意义(P<0.05)。治疗后两组患者胃动力MTL、GAS水平均较治疗前升高,VIP水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组胃动力MTL、GAS水平均较对照组明显升高;VIP水平较对照组明显降低,差异有统计学意义(P<0.05)。治疗后观察组总有效率85.71%(36/42)明显优于对照组66.67%(28/42),差异有统计学意义(P<0.05)。治疗期间,观察组不良反应发生率为7.14%与对照组23.81%比较,差异有统计学意义(P<0.05)。结论枳术宽中胶囊联合替普瑞酮能改善胃癌术后胃肠动力障碍患者胃肠症状,促进胃泌素及胃动素分泌,抑制血管活性肠肽分泌,从而有效治疗胃肠动力障碍,且安全性可靠。

Objective To explore the effect of Zhizhu Kuanzhong Capsules combined with teprenone on gastric motility-related hormones in patients with gastrointestinal motility disorder after gastric cancer operation.Methods Eighty-four patients with gastrointestinal motility disorder after radical gastrectomy for gastric cancer in Zibo Hospital,960 Hospital of the People′s Liberation Army from June 2019 to June 2021 were included and randomly divided into a control group and an observation group,with 42 cases in each group.The control group was treated with teprenone,and the observation group was additionally treated with Zhizhu Kuanzhong Capsules based on the treatment of the control group.Both groups were treated for 10 days.The clinical efficacy after treatment and the incidence of adverse reactions during treatment of the two groups were observed.The gastrointestinal symptom scores and levels of gastric motility[vasoactive intestinal peptide(VIP),gastrin(GAS),and motilin(MTL)]before and after treatment of the two groups were observed.Results After treatment,the scores of belching,abdominal distension,nausea and vomiting,and burning sensation in the two groups were decreased(P<0.05),and the scores in the observation group decreased more significantly than those in the control group(P<0.05).After treatment,the levels of MTL and GAS were increased as compared with those before treatment,whereas the level of VIP was decreased(P<0.05).As compared with the control group,the levels of MTL and GAS in the observation group increased and the level of VIP decreased(P<0.05).The total effective rate of the observation group was 85.71%(36/42),which was significantly higher than that of the control group[66.67%(36/42)](P<0.05).There was a significant difference in the incidence of adverse reactions between the observation group(7.14%)and the control group(23.81%)(P<0.05).Conclusion Zhizhu Kuanzhong Capsules combined with teprenone can improve gastrointestinal symptoms,promote the secretion of GAS and MTL,and inhibit the secretion of VIP in patients with gastrointestinal motility disorder after gastric cancer operation,thereby effectively treating gastrointestinal motility disorders,with safety and reliability,which is worthy of clinical application.