Clinical Efficacy of Jieyu Fuwei Powder Combined with Acupoint Catgut Embedding in the Treatment of Syndrome Functional Dyspepsia with Liver and Stomach Disharmony and Its Impact on Brain-Gut Peptides
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摘要:
目的 研究解郁复胃散联合穴位埋线治疗肝胃不和型功能性消化不良(Functional dyspepsia, FD)的临床疗效及对脑肠肽的影响。 方法 纳入海安市中医院消化科及针灸科门诊62例肝胃不和型FD患者, 随机分为对照组和治疗组各31例(对照组脱落1例)。对照组予枸橼酸莫沙必利口服治疗, 治疗组予解郁复胃散口服联合穴位埋线治疗。治疗前后观察2组患者中医证候积分、改良消化不良严重程度评估量表(mSODA)评分, 比较2组临床有效率, 检测血清相关脑肠肽[降钙素基因相关肽(Calcitonin-gene-related peptide, CGRP)、P物质(Substance P, SP)、胃动素(Motilin, MTL)及胃泌素(Gastrin, GAS)]水平, 治疗期间观察2组患者不良反应发生情况。 结果 治疗后, 2组患者两胁胀满、胃脘胀满、疼痛、嗳气等中医证候积分及mSODA评分明显改善(P < 0.05, P < 0.01), 治疗组优于对照组(P < 0.05, P < 0.01)。治疗组总有效率显著优于对照组(P < 0.05)。2组患者血清CGRP、SP水平明显下降(P < 0.01), MTL、GAS水平显著升高(P < 0.01), 治疗组优于对照组(P < 0.05, P < 0.01)。治疗组不良反应发生率低于对照组(P < 0.05)。 结论 解郁复胃散联合穴位埋线治疗肝胃不和型FD疗效优于枸橼酸莫沙必利对照组, 其机制可能与调控脑肠肽水平有关。 Abstract:OBJECTIVE To study the clinical efficacy of Jieyu Fuwei Powder combined with acupoint catgut embedding in the treatment of functional dyspepsia (FD) with liver and stomach disharmony and its impact on brain gut peptides. METHODS 62 cases of FD patients with chronic liver and stomach disharmony were enrolled in the digestive department and acupuncture and moxibustion department of Hai'an Hospital of Chinese Medicine, and were randomly divided into a control group and a treatment group, with 31 cases in each group (1 case dropped out of the control group). The control group was orally treated with mosapride citrate, and the treatment group was treated with Jieyu Fuwei Powder combined with acupoint catgut embedding. The clinical efficiency of the two groups was compared. Before and after treatment, the TCM syndrome score, modified severity of dyspepsia assessment (mSODA) score of the two groups of patients were observed, and serum levels of brain-gut peptides [Calcitonin gene related peptide (CGRP), Substance P (SP), Motilin (MTL), and Gastrin (GAS)] were detected. During the treatment, the adverse reactions of the two groups of patients were observed. RESULTS After treatment, the total effective rate of the treatment group was significantly higher than that of the control group (P < 0.05). The TCM syndrome scores of bilateral fullness, epigastric fullness, pain, and belching, as well as mSODA scores of the two groups of patients were improved compared to those before treatment (P < 0.05, P < 0.01), and the treatment group showed better efficacy than the control group (P < 0.05, P < 0.01). The levels of serum CGRP and SP in the two groups of patients were significantly decreased (P < 0.01), with average significant increases in MTL and GAS(P < 0.01), and the treatment group displayed better improvement than the control group (P < 0.05, P < 0.01). The incidence of adverse reactions in the treatment group was lower than that in the control group (P < 0.05). CONCLUSION Jieyu Fuwei Powder combined with acupoint catgut embedding is more effective than mosapride citrate group in the treatment of FD with liver and stomach disharmony, and its mechanism may be related to the regulation of brain-gut peptides. -
Key words:
- Jieyu Fuwei Powder /
- acupoint catgut embedding /
- functional dyspepsia /
- brain-gut peptide
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表 1 2组患者基线资料比较(x±s)
Table 1. Comparison of baseline data between the two groups of patients (x±s)
组别 例数 男 女 平均年龄/岁 平均病程/月 治疗组 31 15 16 43.52±2.77 3.77±0.67 对照组 30 13 17 41.15±5.20 3.55±0.86 
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表 2 临床疗效判断标准
Table 2. Clinical efficacy evaluation criteria
疗效评价 判断标准 痊愈 中医证候积分减少≥95%, 临床症状及体征消失或基本消失 显效 70%≤中医证候积分减少 < 95%, 临床症状及体征显著改善 有效 30%≤中医证候积分减少 < 70%, 临床症状及体征均有好转 无效 中医证候积分减少 < 30%, 临床症状及体征均无明显改善, 甚至加重
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表 3 2组治疗前后中医证候积分比较(x±s)
Table 3. Comparison of TCM syndrome scores before and after treatment between the two groups (x±s)
组别 时间 例数 两胁胀满 胃脘胀满 疼痛 嗳气 善叹息 心烦 总积分 治疗组 治疗前 31 2.56±0.44 2.41±0.49 2.32±0.58 2.45±0.53 2.37±0.55 2.68±0.40 14.81±3.25 治疗后 31 0.93±0.35**## 0.83±0.37**## 0.73±0.47**# 0.95±0.34**# 0.90±0.46**## 0.87±0.36**## 2.23±1.03**## 对照组 治疗前 30 2.39±0.37 2.37±0.39 2.27±0.84 2.74±0.45 2.22±0.28 2.80±0.42 14.76±2.18 治疗后 30 1.56±0.58** 1.96±0.54* 1.32±0.60** 1.37±0.33** 1.98±0.35 2.59±0.37 10.78±2.97 注: 组内比较, *P < 0.05, * *P < 0.01;组间比较, #P < 0.05, ##P < 0.01。
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表 4 2组患者临床总有效率比较
Table 4. Comparison of clinical total effective rates between the two groups of patients
组别 例数 痊愈 显效 有效 无效 总有效率/% 治疗组 31 18 8 3 2 93.55# 对照组 30 10 5 6 9 70.00 注: 组间比较, χ2=8.418, #P < 0.05。
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表 5 2组患者治疗前后mSODA评分比较(x±s)
Table 5. Comparison of mSODA scores between the two groups of patients before and after treatment (x±s)
项目 例数 时间 腹胀痛严重程度 非腹胀痛症状严重程度 生活满意度 治疗组 31 治疗前 28.51±5.77 23.98±3.54 7.74±1.95 31 治疗后 11.47±1.65**## 8.93±0.51**## 18.98±3.54**## 对照组 30 治疗前 25.65±4.43 20.33±3.24 8.53±2.52 30 治疗后 19.88±3.25** 14.73±2.52** 12.45±1.61** 注: 组内比较, * *P < 0.01;组间比较, ##P < 0.01。
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表 6 2组患者治疗前后血清脑肠肽水平比较(x±s, pg·mL-1)
Table 6. Comparison of serum brain-gut peptide levels between the two groups of patients before and after treatment (x±s, pg·mL-1)
组别 例数 时间 CGRP SP MTL GAS 治疗组 31 治疗前 89.62±13.72 55.80±8.21 159.34±8.35 47.72±13.75 31 治疗后 52.61±8.20**# 35.13±5.73**## 276.77±4.82**## 80.45±8.53**# 对照组 30 治疗前 87.44±14.73 56.96±7.96 178.33±19.11 46.88±12.80 30 治疗后 64.10±12.78** 45.06±5.49** 235.68±20.15** 67.44±9.91** 注: 组内比较, * *P < 0.01;组间比较, #P < 0.05, ##P < 0.01。
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表 7 2组患者治疗期间不良反应发生情况比较
Table 7. Comparison of adverse reactions between the two groups of patients during treatment
组别 例数 皮疹 腹泻 恶心 口干 总不良反应发生率/% 治疗组 31 1 0 0 0 3.22# 对照组 30 1 2 1 2 20.00 注: 组间比较, χ2=5.653, #P < 0.05。
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