胃舒散对功能性消化不良的疗效与幽门螺杆菌的关系  

Effect of weishusan on patients with functional dyspepsia and H. pylori infection

作　　者：吴灵飞[1] 郑宗茂[1] 李国平 王炳周[1] 詹海勇[1] 曾哲[1] 周泽清[1] 

机构地区：[1]汕头大学医学院第二附属医院消化科,广东省汕头市515041

出　　处：《世界华人消化杂志》2002年第3期275-278,共4页World Chinese Journal of Digestology

基　　金：广东省中医药管理局资助项目;No.99591

摘　　要：目的:观察胃舒散对功能性消化不良的疗效并探讨其机制,同时探讨其与幽门螺杆菌的关系。 方法:选择FD患者87例,按性别、年龄分层后采用单育法随机分为二组:胃舒散组56例,服胃舒散3.0,每天3次。莫沙必利组31例,服莫沙必利5mg,每天3次,疗程为6wk。采用症状积分及内镜下胃炎积分法,观察各组临床疗效及内镜下胃炎变化。同时检测治疗前后血浆胃动素(Mot),促胃液素(Gas)和幽门螺杆菌(Hp)。 结果:胃舒散和莫沙必利临床总有效率分别为85.7％和80.6％。疗效差异无显著性意义(P>0.05).二组治疗后Mot水平均较治疗前显著升高(457±119ng·L^(-1) vs 410±106ng·L^(-1),469±130ng·L^(-1) vs 378±119ng·L^(-1),P<0.01),Gas水平变化不明显(P>0.05).胃舒散对Hp的根除率(18/31,41.9％)显著高于莫沙必利(0/14,P<0.01).根据Hp情况分组,Hp根除组,Hp未根除组及Hp阴性组临床症状总有效率分别为88.9％,81.5％和83.3％,各组相比差异无显著性意义(P>0.05)。内镜观察Hp根除组总有效率为83.3％,显著高于Hp未根除组(14.8％,P<0.01)及Hp阴性组(47.2％,P<0.05).Hp阴性组内镜下总有效率(47.2％)亦显著高于Hp未根除组(14.8％,P<0.05)。Hp阳性患者Gas水平显著高于Hp阴性患者(47±17ng·L^(-1) vs36±13ng·L^(-1),P<0.05)。AIM: To evaluate the efficacy of weishusan on functional dyspepsia and to investigate the potential effect of eradication of H. pylori on gastritis and symptomatology of H. pylori -positive dyspepsia.METHODS: Total 87 patients with functional dyspepsia were randomized to receive weishusan (3. 0 tid, n = 56) or mosapride (5 mg tid, n = 31) for 4 weeks. The symptom score and severity of gastritis were assessed by clinical practitioners and endoscopy separately. Serum motilin (Mot), gastrin (Gas) and H. pylori were detected.RESULTS: Symptom improvement was significant in weishusan group and mosapride group (85.7 % vs 80.6 %, NS). The motilin level was significantly higher after treatment in both groups (457 ± 119 ng· L-1 vs 410 ± 106 ng· L-1, P < 0. 01). The total effective rate of gastritis improvement in weishusan group (57.7 %) was significantly higher than that in mosapride group (20.7 %, P < 0.01). Regarding H. pylori status, eradication of H. pylori was achieved in 41.9 % (18/ 31) in weishusan group and no one in mosapride group (0/14,0%, P<0.01). No differences in the symptom score improvement were observed between patients with eradication, persistent infection and without infection. The gastritis improvement in patients with eradication (83. 8 %) was significantly higher than those without infection (47.2 %, P < 0. 05), and those persistent infection (14.8 %, P<0.01). The gastrin level in H. pylori positive patients was significantly higher than that in H. pylori negative patients (47 ± 17 ng· L-1 vs 36 ± 13 ng· L-1 P < 0.05). After eradication the gastrin level decreased but no significant differences were observed (P> 0.05).CONCLUSION :Weishusan is a good prokinetic drug and has effect on functional dyspepsia. It also has effects on protection of gastric mucosa and on eradication of H. pylori, which seems not to contribute to the timely symptom improvement of dyspepsia.

关 键 词：胃舒散 功能性消化不良 疗效 幽门螺杆菌 治疗 

分 类 号：R57[医药卫生—消化系统]