柴枳平肝汤联合多潘立酮片治疗功能性消化不良肝胃不和证临床研究

Clinical Study on Chaizhi Pinggan Decoction Combined with Domperidone Tablets for Functional Dyspepsia with Liver-Stomach Disharmony Syndrome

目的:观察柴枳平肝汤联合多潘立酮片治疗功能性消化不良(FD)的临床疗效及对中医证候积分、胃排空及胃肠激素的影响。方法:选取肝胃不和证FD患者100例,按照治疗方法不同分为研究组49例和对照组51例,对照组给予多潘立酮片治疗,研究组在对照组基础上给予柴枳平肝汤治疗。比较2组临床疗效、不良反应及复发情况,比较2组治疗前后中医证候积分、胃排空率及胃肠激素指标[血管活性肠肽(VIP)、胆囊收缩素(CCK)、胃泌素(GAS)、胃动素(MTL)]。结果:研究组治疗总有效率89.80%,高于对照组70.59%(P<0.05)。治疗前,2组中医证候积分、胃排空率比较,差异均无统计学意义(P>0.05);治疗后,2组中医证候积分降低(P<0.05),胃排空率升高(P<0.05),且研究组中医证候积分低于对照组(P<0.05),胃排空率高于对照组(P<0.05)。治疗前,2组VIP、CCK、GAS、MTL水平比较,差异均无统计学意义(P>0.05);治疗后,2组VIP、CCK水平均降低(P<0.05),GAS、MTL水平均升高(P<0.05),且研究组VIP、CCK水平低于对照组(P<0.05),GAS、MTL水平高于对照组(P<0.05)。研究组不良反应发生率2.04%,对照组不良反应发生率3.92%,2组比较,差异无统计学意义(P>0.05)。研究组复发率15.91%,低于对照组55.56%(P<0.05)。结论:柴枳平肝汤联合多潘立酮片治疗肝胃不和证FD患者,可有效改善临床症状,调节胃肠激素分泌,提高胃排空率,减少复发,提高临床效果,且安全性高。

Objective:To observe the clinical effect of Chaizhi Pinggan Decoction combined with Domperidone Tablets on functional dyspepsia(FD)and its effect on traditional Chinese medicine(TCM)syndrome scores,gastric empty and gastrointestinal hormone.Methods:A total of 100 FD patients with liver-stomach disharmony syndrome were selected and divided into the study group and the control group according to different treatment methods,with 49 and 51 cases in each group,respectively.The control group was treated with Domperidone Tablets,and the study group was additionally given Chaizhi Pinggan Decoction based on the treatment of the control group.The clinical effects,incidence of adverse reactions,recurrences,TCM syndrome scores,gastric empty rates and indexes of gastrointestinal hormone,including vasoactive intestinal peptide(VIP),cholecystokinin(CCK),gastrin(GAS)and motilin(MTL)were compared before and after treatment between the two groups.Results:The total effective rate was 89.80%in the study group,higher than that of 70.59%in the control group(P<0.05).Before treatment,there was no significant difference being found in the comparisons of TCM syndrome scores and gastric empty rates between the two groups(P>0.05);after treatment,the TCM syndrome scores in both groups were decreased(P<0.05),and the gastric empty rates were increased(P<0.05);the TCM syndrome scores in the study group were lower than those in the control group(P<0.05),and the gastric empty rate was higher than that in the control group(P<0.05).Before treatment,there was no significant difference being found in the comparisons of levels of VIP,CCK,GAS and MTL between the two groups(P>0.05);after treatment,the levels of VIP and CCK in both groups were decreased(P<0.05),and the levels of GAS and MTL were increased(P>0.05);the levels of VIP and MLT in the study group were lower than those in the control group,and the levels of GAS and MLT were higher than those in the control group(P<0.05).The incidence of adverse reactions was 2.04%in the study group,and 3.92%in the control group,there being no significance in the difference(P>0.05).The recurrence rate was 15.91%in the study group,lower than that of 55.56%(P<0.05).Conclusion:Chaizhi Pinggan Decoction combined with Domperidone Tablets for FD patients with syndrome liver-stomach disharmony can effectively improve the clinical symptoms,adjust the secretion of gastrointestinal hormone,increase the gastric empty rate,reduce recurrences and enhance the clinical effect with good safety.