不同中医证型功能性消化不良患者核素胃排空特点的研究

目的探讨不同中医证型功能性消化不良(functional dyspepsia,FD)患者核素胃排空的特点。方法将多中心的84例FD患者分为湿热壅滞证、脾虚气滞证、肝胃气滞证和肝胃郁热证四组,并进行核素胃排空检查,分析比较不同中医证型的胃半排空时间、胃排空速率、2小时存留率。结果 (1)84例FD患者中,胃排空延迟者46例(54.8%),胃排空正常者38例(45.2%);(2)胃半排空时间肝胃气滞型最长(140.7±55.3)分钟,其次为脾虚气滞型(134.3±64.6)分钟,肝胃郁热证(118.7±27.4)分钟,湿热壅滞型最短(100.8±26.7)分钟,经方差分析各证型之间差异有统计学意义(P<0.05);湿热壅滞证与肝胃气滞证、脾虚气滞证两两比较差异有统计学意义(P<0.05)。(3)胃排空速率经方差分析比较发现,不同中医证型之间差异有统计学意义(P<0.05);湿热壅滞型最高(0.53±0.12)与其它三个证型两两比较均差异有统计学意义(P<0.05);(4)2小时存留率经方差分析比较发现,不同证型之间差异有统计学意义(P<0.05);湿热壅滞证(37.2%±12.8%)与肝胃气滞证(51.0%±14.7%)、肝胃郁热证(46.9%±11.6%)两两比较差异有统计学意义(P<0.05),湿热壅滞证与脾虚气滞证两两比较无显著性差异。结论不同中医证型功能性消化不良具有不同的核素胃排空特点,湿热壅滞证呈胃排空加速表现,肝胃气滞证、脾虚气滞证呈胃排空延迟表现。

Study of radionuclide gastric emptying on different TCM syndrome types in patients with functional dyspepsia

Objective To explore the characteristic of radionuclide gastric emptying on different TCM syndrome types in patients with functional dyspepsia. Methods We recruited 84 cases of muti-center with FD and divided into 4 groups： the stagnation of damp-heat type,spleen deficiency and Qi stagnation type ,Liver and stomach Qi stagnation type,and stagnated heat in liver and stomach type. All cases were conducted radionuclide gastric emptying test to collected gastric half-emptying time,emptying rate and 2 hour residual rate. Results （ 1） Gastric emptying time was delayed in 46 cases （ 54. 8% ） and normal in 38 cases （ 45. 2% ） . （ 2） Gastric half-emptying time analysis： Liver Qi stagnation type （ 140. 7 ± 55. 3） min was longest,spleen deficiency and Qi stagnation type （ 134. 3 ± 64. 6） min and stagnation of dampheat type （ 118. 7 ± 27. 4） min. Stagnation of damp-heat type （ 100. 8 ± 26. 7） min was shortest ,the analysis of variance test found that there： was significant difference among different types. （ 3） Gastric emptying rate was significant difference among different types through the analysis of variance test： stagnation of damp-heat type （ 0. 53 ± 0. 12） was significantly faster than other types（ P〈0. 05） ,and there was no significant difference between the other types （ P〈0. 05） . （ 4） 2 hour retention rate was significant difference among different types through the analysis of variance test： Stagnation of damp-heat type （ 37. 2% ± 12. 8% ） was significant lower than Liver and stomach Qi stagnation type （ 51% ± 14. 7% ） and stagnation of liver and stomach heat type （ 46. 9% ± 11. 6% ） ,and there was no significant difference between stagnation of damp-heat type and spleen deficiency and Qi stagnation type （ P〈0. 05） . Conclusions Different TCM syndrome types had different characteristics of gastric emptying function in FD patients. Gastric emptying function was accelerated in stagnation of damp-heat type ,delayed in spleen deficiency and Qi stagnation type and Liver and stomach Qi stagnation type.