通腑泄热祛瘀疏利方治疗脾胃湿热兼气滞血瘀型功能性消化不良的临床研究

Clinical Study on Tongfu Xiere Quyu Shuli Prescription in the Treatment of Functional Dyspepsia of Spleen and Stomach Damp-Heat and Qi Stagnation and Blood Stasis Type

  • 摘要:
    目的 研究李炳茂教授通腑泄热祛瘀疏利方治疗脾胃湿热兼气滞血瘀型功能性消化不良患者的临床疗效。
    方法 纳入衡水市人民医院脾胃湿热兼气滞血瘀型功能性消化不良患者206例为研究对象,随机分为研究组与对照组各103例,治疗期间2组各脱落3例。对照组采取常规功能性消化不良西医治疗方案(莫沙必利+雷贝拉唑),研究组在对照组治疗基础上加服通腑泄热祛瘀疏利方,2组疗程均为4周。观察2组患者治疗前后中医证候积分、心理状况、生活质量变化并评估临床疗效;ELISA法检测患者血清中胃动素(MTL)、胃促生长素(Ghrelin)、胃泌素(GAS)、促肾上腺皮质激素释放激素(CRH)及胃蛋白酶原(PGⅠ、PGⅡ);胃电图分析仪分析胃动力指标变化;滴注法检测肠道菌群变化。治疗期间监测2组患者不良反应发生情况。
    结果 治疗后,2组中医证候积分均明显降低(P < 0.05,P < 0.01),研究组低于对照组(P < 0.01),研究组总有效率明显优于对照组(P < 0.01);2组MTL、Ghrelin、GAS、PGⅠ、PGⅡ表达水平均增高,CRH均下降,且研究组改善程度优于对照组(P < 0.01);2组胃电图主频与慢波百分比均增加,研究组优于对照组(P < 0.01);2组双歧杆菌、乳酸杆菌数量均增加,研究组多于对照组,肠杆菌、肠球菌及酵母菌数量均下降,研究组少于对照组(P < 0.01);2组不良反应未见明显差异(P>0.05)。
    结论 通腑泄热祛瘀疏利方治疗脾胃湿热兼气滞血瘀型功能性消化不良疗效显著,可改善患者临床症状、生活质量与焦虑、抑郁症状,调节胃肠激素表达水平、胃动力状况及肠道菌群表达,且安全可靠。

     

    Abstract:
    OBJECTIVE To study the clinical efficacy of Professor Li Bingmao's Tongfu Xiere Quyu Shuli Prescription in the treatment of patients with functional dyspepsia (FD) of spleen and stomach damp-heat and qi stagnation and blood stasis type.
    METHODS A total of 206 patients with functional dyspepsia of spleen and stomach damp-heat and qi stagnation and blood stasis type diagnosed by Hengshui People's Hospital were included in the study and randomly divided into a study group and a control group with 103 cases in each group. During the treatment, 3 cases dropped out in each group. The control group adopted the conventional Western medicine treatment plan for functional dyspepsia (mosapride + rabeprazole), and the study group took Tongfu Xiere Quyu Shuli Prescription on the basis of the treatment of the control group. The treatment course of both groups was 4 weeks. The traditional Chinese medicine (TCM) syndrome scores, psychological status, and quality of life of the two groups of patients before and after treatment were observed and the clinical efficacy was evaluated; serum motilin (MTL), ghrelin, gastrin (GAS), corticotropin-releasing hormone (CRH) and pepsinogen (PG Ⅰ, PG Ⅱ) were measured by enzyme-linked immunosorbent assay; changes in gastric motility indexes were analyzed by electrogastrogram analyzer; changes in intestinal flora were detected by instillation method. The occurrence of adverse reactions in the two groups of patients was monitored during treatment.
    RESULTS After treatment, the TCM syndrome scores of the two groups were significantly reduced (P < 0.05, P < 0.01), and the score in the study group was lower than that in the control group (P < 0.01). The total effective rate of the study group was significantly higher than that in the control group (P < 0.01). After treatment, the expression levels of MTL, Ghrelin, GAS, PG Ⅰ and PG Ⅱ in the two groups increased, and CRH decreased, and the improvement degree of the study group was better than that of the control group (P < 0.01). After treatment, the main frequency and slow wave percentage of the electrogastrogram increased in the two groups, and the study group was better than that of the control group (P < 0.01). After treatment, the number of bifidobacteria and lactobacilli in the two groups increased, and the number in the study group was greater than that in the control group, while the number of enterobacteria, enterococci and yeast decreased, and the number in the study group was less than that in the control group (P < 0.01). There was no significant difference in adverse reactions between the two groups (P>0.05).
    CONCLUSION Tongfu Xiere Quyu Shuli Prescription is effective in the treatment of FD patients with spleen and stomach damp-heat syndrome, and can improve FD clinical symptoms, quality of life, anxiety and depression symptoms, regulate gastrointestinal hormone expression levels, gastric motility and intestinal flora expression, and does not increase adverse reactions, and is safe and reliable.

     

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