枳术丸对2型糖尿病功能性便秘血清胃肠激素的影响  

Effect of Zhizhuwan on gastrointestinal peptide concentrations in plasma of diabetic gastroenteropathy with constipation patients

作　　者：刘昳[1] 赵小睿[1] 王锐[1] 邱根全[1] 章梅[1] 

机构地区：[1]西安交通大学医学院第一附属医院,陕西西安710061

出　　处：《中国中药杂志》2008年第24期2966-2968,共3页China Journal of Chinese Materia Medica

摘　　要：目的:观察枳术丸治疗2型糖尿病功能性便秘的临床疗效,及其对糖尿病患者血清胃肠激素的影响。方法:将56例患者随机分为2组,并设健康对照组。治疗组以枳术丸治疗;对照组以西沙必利治疗,疗程均为1月。观察枳术丸疗效及其对糖尿病患者血清胃动素(MTL),P物质(SP),血管活性肠肽(VIP)的影响。结果:治疗组在改善排便自觉症状以及大便的频率方面优于对照组(P<0.05)。2组糖尿病便秘患者,在降糖及促进肠动力药物综合治疗后,MTL治疗前后变化不大,但是均可升高血浆SP的水平,降低血浆VIP的水平。其中治疗组SP水平接近健康组,高于对照组(P<0.05)。结论:枳术丸可能通过升高血浆SP水平和降低VIP的水平,从而改善2型糖尿病患者的便秘症状。Objective： To determine the therapeutic efficacy and elucidate the probable pharmacological mechanism of Zhizhuwan （ZZ）, a known formula for GI/Dysmotility and constipation in Traditional Chinese medicine, in managing constipating diabetes mellitus （DM）. Method： Subjects, composed of both males and females, ranged from 55 to 76 years of age, and had constipating DM. Subjects with severe colon, rectum, heart, renal, or hepatic disease, obesity and those on medications known to alter gastrointestinal motility were excluded. 28 healthy subjects were also recruited. The study group （ n = 28） received 90 g per day of ZZ and the control group （ n = 28） received 30 mg per day of cisapride for a 1 month period. Conservative therapy was similar in both groups and administered by a person blinded to randomization code. Patients were assessed pre-treatment and post-treatment by a blinded interviewer. A constipation visual analogue scale （CVAS） was constructed to evaluate the patients＇ constipation status. To analyze neuropeptides motilin （MTL）, vasoactive intestinal polypeptide （VIP）, substance P （SP） levels in plasma, a radio y technique was adopted. Data were analyzed for treatment effects using the ＂t＂ test. Result： Base line characteristics were similar in both treatment groups. There were significant effects on symptom relief, increases in serum SP level, and decreases in VIP level in both groups （P 〈 0. 05）. ZZ was significantly more effective than cisapride in ameliorating patients＇ subjective symptoms of defecating and stool frequency, and increasing serum SP level （P 〈 0. 05 ）. Conclusion： ZZ is beneficial in constipating DM via increasing SP levels and decreasing VIP levels of serum.

关 键 词：枳术丸 糖尿病 便秘 胃肠激素 

分 类 号：R259[医药卫生—中西医结合]