健脾理气法治疗功能性消化不良脾虚气滞证及对内脏敏感性影响的研究

目的:评价健脾理气法治疗功能性消化不良脾虚气滞证的临床疗效及探讨其对内脏敏感性的影响。方法:采用随机单盲阳性药对照方法,将80例功能性消化不良脾虚气滞证患者随机分为试验组和对照组各40例,最后纳入疗效统计78例,其中治疗组40例、对照组38例,分别给予健脾理气方和多潘立酮治疗,治疗疗程均为4周。分别在治疗前、治疗后、治疗结束后1个月,记录患者的中医证候积分、中医单项症状积分,水负荷试验指标进行评价。结果:①中医证候总体疗效评价:试验组治疗后有效率为82.5%,明显优于治疗前(P<0.001),且试验组优于对照组(P<0.05)。②试验组对缓解胃脘或脘腹胀满、胃脘疼痛、嗳气、呃逆的效果优于对照组(P<0.001)。③内脏敏感性评价:两组治疗前与治疗后,阈值饮水量、饱足饮水量、饱足近端胃容积差异具有统计学意义(P<0.05)。其中,水负荷试验各指标两组比较,治疗后在阈值饮水量、饱足饮水量,差异有统计学意义(P<0.05)。结论:健脾理气方治疗功能性消化不良脾虚气滞证具有良好的临床疗效,并有改善功能性消化不良患者内脏敏感性的作用。

Study on functional dyspepsia with syndrome of spleen deficiency and Qi stagnation treated by invigorating spleen and regulating Qi method and its effect on visceral sensitivity

Objective: To evaluate the clinical effects of functional dyspepsia(FD) with syndrome of spleen deficiency and Qi stagnation treated by invigorating spleen and regulating Qi method,and its effects on visceral sensitivity.Methods: 80 patients were divided into two groups for a randomized,single-blind,positive drug-controlled clinical study,and 78 cases finally included into the efficacy of statistics,including 40 cases in the treatment group and 38 cases in the control group.The treatment group received the decoction of invigorating spleen and regulating Qi,while the control group received domperidone.The course was 4 weeks,and the follow-up was 1 month.The scores of TCM symptoms were recorded before the treatment and 4th week during the treatment,1st month of follow-up.The water load test was evaluated before the treatment and 4th week during the treatment.Results: ①On aspect of syndromes: The effective rate of the treatment group was 82.5%,significantly better than before treatment(P<0.001),the difference between the two groups had statistical significance(P<0.05).②The treatment group for relieving epigastric or flatulence,epigastric pain,belching,hiccup was better than the control group(P<0.001).③Evaluation of the sensitivity of internal organs: TV\SV\SPSV of two groups has been significantly improved after treatment(P<0.05).Among them,TV/SV between the two groups has statistical significance(P<0.05).Conclusion: Decoction of invigorating spleen and regulating Qi can improve the clinical symptoms of the patients with functional dyspepsia,spleen deficiency and Qi stagnation syndrome,and can improve visceral sensitivity of the patients.