中西医结合治疗功能性消化不良的临床研究

目的探索中西医结合治疗功能性消化不良(Functional Dyspepsia,FD)疗效机理,评估中西医结合治疗FD疗效。方法通过多中心对798例FD患者,随机分成3组,分别用吗丁啉(A组),中药复方(B组)及吗丁啉加中药复方(C组)对其进行治疗,同时检测胃排空率、胃半排空时间、胃电参数、血浆胃动素及胃泌素水平,并观察各组疗效情况。结果 A组治愈46例,显效89例,进步49例,治愈率20.35％,总有效率81.42％;B组治愈58例,显效71例,进步50例,治愈率27.5％,总有效率84.83％;C组治愈187例,显效122例,进步40例,治愈率51.8％,总有效率96.68％,C组治愈率及总有效率都明显高于A、B组,具有统计学意义,胃排空率、胃半排空时间、胃电活动及胃电参数均较治疗前明显改善(P<0.05),胃动素水平较治疗前明显提高(P<0.05),而血浆胃泌素水平治疗前后无明显变化(P>0.05)结论中西医结合组治疗FD无论是总有效率还是治愈率均明显高于单一中约组或吗丁啉组,为日前治疗FD较为理想的方法,其机制主要是通过各个环节改善胃电活动,增加胃动力,从而达到治疗FD目的。

Clinical study on the treatment of functional dyspepsia with integration of western and traditional Chinese therapy

Aim To investigate the mechanism and evaluate the therapeutic efficacy of integration of western and traditional Chinese therapy on functional dyspepsia (FD). Methods 798 patients with FD were enrolled in a multi-center clinical trial. Patients were divided into three groups receiving different therapy at random. Group A: taking Motilum; Group B: taking traditional Chinese medicine (TCM); Group C: taking both Motilum and TCM. At the same time, the gastric empty ratio, gastric half empty time, gastric electrical parameters, plasma motilin and gastrin levels were analyzed before and after treatment. Results The cure case, effective case and improved case were 46, 89, 49 respectively, and the cure and total effective rate was 20.35% and 81.42% respectively in Group A. The cure case, effective case and improved case were 58, 71, and 50 respectively, and the cure and total effective rate was 27.5% and 84.83% respectively in Group B. The cure case, effective case and improved case were 187, 122, and 40 respectively, and the cure and total effective rate was 51.8% and 96.68% respectively in Group C. The cure and total effective rate in Group C were significantly higher than those in group A and B. The gastric empty ratio, gastric half empty time, gastric electrical parameters and plasma motilin levels were improved significantly after treatment (P<0.05). But the plasma gastrin level had no obvious changes after treatment (P>0.05). Conclusions Integration of western and traditional Chinese therapy is more effective than Motilum and TCM alone for the treatment of FD. The mechanism might be that the combined therapy can improve gastric electrical activity, strengthen the gastric power and eventually achieve the therapy of FD.