温针联合香砂六君汤治疗功能性消化不良的临床研究

目的观察温针联合香砂六君汤治疗功能性消化不良的临床疗效及其对患者胃肠激素的影响。方法纳入功能性消化不良患者88例,随机分为对照组和联合组,每组44例。对照组采用口服香砂六君汤治疗;联合组在对照组治疗基础上予温针治疗。观察两组治疗前后中医证候评分和临床症状评分的变化,观察两组血清胃动素、胃泌素、生长抑素水平的变化,观察两组胃半排空时间、胃窦收缩频率、胃窦收缩幅度、胃窦面积收缩幅度指标的变化。比较两组临床疗效和临床症状改善或消失时间。结果联合组上腹胀痛、恶心的临床症状消失或改善时间均短于对照组(P<0.05)。治疗前两组中医证候评分和主症评分比较,差异均无统计学意义(P>0.05);两组治疗后中医证候评分和主要症状评分均低于治疗前(P<0.05),且联合组中医证候评分和主要症状评分均低于对照组(P<0.05)。两组治疗前胃动素、胃泌素和生长抑素水平比较,差异无统计学意义(P>0.05)。两组治疗后胃动素、胃泌素和生长抑素水平均较治疗前有所改善(P<0.05);且联合组治疗后胃动素水平高于对照组(P<0.05),胃泌素和生长抑素水平均低于对照组(P<0.05)。联合组治疗后胃半排空时间短于对照组(P<0.05),且胃窦收缩频率、胃窦收缩幅度显著上升(P<0.05);而胃窦面积收缩频率无明显变化(P>0.05)。联合组临床总有效率高于对照组,两组比较差异有统计学意义(P<0.05)。结论温针联合香砂六君汤治疗功能性消化不良的疗效优于单一香砂六君汤治疗,能缩短临床症状改善或消退时间,调节胃肠激素分泌,促进胃肠道功能恢复,对加快胃排空有明显作用。

Clinical Study on Warm Needling plus Xiang Sha Liu Jun Decoction for Functional Dyspepsia

Objective To observe the clinical efficacy of warm needling plus Xiang Sha Liu Jun decoction for functional dyspepsia and its effect on gastrointestinal hormones of the patients.Method Eighty-eight patients with functional dyspepsia were enrolled and randomized to a control group and a combination group,with 44 cases in each group.The control group received oral administration of Xiang Sha Liu Jun decoction and the combination group received warm needling in addition.The TCM syndrome score and the clinical symptom score were recorded in the two groups before and after treatment.Serum motilin,gastrin and somatostatin levels were measured in the two groups.Gastric emptying half-time,antrum contraction frequency,antral contraction amplitude and the area under the curve of antral contraction were observed in the two groups.The clinical therapeutic effects were compared between the two groups,as well as the time for the clinical symptoms of epigastric distending pain and nausea to disappear or be relieved.Result The time for the clinical symptoms of epigastric distending pain and nausea to disappear or be relieved was shorter in the combination group than in the control group(P<0.05).There were no statistically significant pre-treatment differences in the TCM syndrome score and the main symptom score between the two groups(P>0.05).After treatment,the TCM syndrome score and the main symptom score decreased in the two groups compared with before and were lower in the combination group than in the control group(P<0.05).There were no statistically significant pre-treatment differences in motilin,gastrin and somatostatin levels between the two groups(P>0.05).After treatment,motilin,gastrin and somatostatin levels improved in the two groups compared with before(P<0.05),and motilin levels were higher and gastrin and somatostatin levels were lower in the combination group than in the control group(P<0.05).After treatment,gastric emptying half-time was shorter in the combination group than in the control group(P<0.05),and antrum contraction frequency and antral contraction amplitude increased significantly(P<0.05),but the area under the curve of antral contraction did not change significantly(P>0.05)in the combination group.The clinical total efficacy rate was higher in the combination group than in the control group with a statistically significant difference between the two groups(P<0.05).Conclusion Warm needling plus Xiang Sha Liu Jun decoction is more effective than Xiang Sha Liu Jun decoction alone in treating functional dyspepsia.It can shorten the time for the clinical symptoms to be relieved or disappear,regulate the secretion of gastrointestinal hormones and promote the recovery of gastrointestinal function and has a marked accelerating effect on gastric emptying.