不同证型功能性消化不良患者胃容受性及胃排空功能差异的临床研究

目的 通过液体营养餐负荷实验结合B超检查，探讨分析不同证型功能性消化不良（FD）患者胃容受性舒张及排空功能的差异。方法 入选74例研究对象，健康者14例（HS组），FD患者60例（脾虚气滞型33例，脾虚湿阻型16例，脾阳虚型11例）。所有研究对象均进行液体营养餐负荷实验，结合VAS视觉评分，记录阈值和最大饮入量；并且通过超声测量，比较不同证型的胃排空率及半排空时间。结果 FD组3种证型最大饮入量均低于HS组(P<0.05~0.01)，脾虚湿阻型最大饮入量低于脾虚气滞、脾阳虚型(P<0.05)；FD组3种证型与HS组比较，脾阳虚型餐后90min远端胃排空率低于HS组(P<0.05)；脾虚湿阻型远端胃半排空时间较HS组、脾虚气滞型和脾阳虚型均延长(P<0.05)。结论 不同证型FD患者胃肠运动功能有差异，辨证为脾虚湿阻型患者减退更显著，为中医辨证施治提供理论依据。 

Clinical Study on Differences of Gastric Receptivity and Emptying Function of Functional Dyspepsia Patients with Different Syndromes

OBJECTIVE To study the differences of gastric receptivity and emptying function of functional dyspepsia (FD) patients with different syndromes by liquid nutrient load test combined with B ultrasound examination. METHODS Seventy four subjects were included， which included 14 healthy cases (HS group)， 60 FD patients (33 cases of spleen deficiency and qi stagnation， 16 cases of spleen deficiency and dampness accumulation， 11 cases of spleen yang deficiency). Liquid nutrient loading test was performed for all subjects， and the threshold and maximum intake were recorded combined with VAS visual score. Gastric emptying rate and half emptying time of patients with different syndromes were compared by ultrasonic measurement. RESULTS The maximum intakes of three syndromes in FD group were lower than that in the HS group (P<0.05~0.01)， and the maximum intake of spleen deficiency and dampness accumulation syndrome was lower than those of spleen deficiency and qi stagnation syndrome and spleen yang syndrome (P<0.05). Compared three syndromes in FD group with HS group， distal gastric emptying rate of postprandial 90min of spleen yang deficiency syndrome was lower than that of HS group (P<0.05). distal gastric emptying time of spleen deficiency and dampness accumulation syndrome was longer than that of spleen deficiency and qi stagnation syndrome and spleen yang deficiency syndrome in HS group (P<0.05). CONCLUSIONS There is difference in gastrointestinal motility between FD patients with the same syndrome， and that of the patients with spleen deficiency and dampness accumulation syndrome decreased more significant， which provides theoretical basis for TCM syndrome differentiation and treatment.