四磨汤对老年2型糖尿病胃轻瘫患者胃肠激素、胃动力学指标的影响  

Effect of Simo Decoction on Gastrointestinal Hormones and Gastric Motility in Elderly Type 2 Diabetic Patients with Gastroparesis

作　　者：褚江洪 徐婷 符鸿钧 

机构地区：[1]台州恩泽医疗中心集团路桥医院内科,浙江台州318050 [2]台州恩泽医疗中心集团台州医院内分泌科,浙江临海317000

出　　处：《中华中医药学刊》2017年第11期2962-2965,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：台州市科技计划项目(081KY40)

摘　　要：目的:观察四磨汤对老年2型糖尿病胃轻瘫患者血清胃肠激素、胃动力学指标的影响。方法:选择100例符合入组标准的老年2型糖尿病胃轻瘫患者作为研究对象,按随机数字表分为研究组50例和对照组50例,对照组给予α-硫辛酸、枸橼酸莫沙必利联合治疗,α-硫辛酸0.6 g/次,1天1次,连用14 d,枸橼酸莫沙必利5mg/次,1天3次,连用6周,研究组在对照组的基础上再口服四磨汤治疗,1天1剂,连用6周,所有患者均随访半年,治疗前、治疗6周观察上腹胀痛、早饱、恶心/呕吐、厌食及反酸/嗳气症状改善情况,进行胃动力学指标[胃收缩频率、胃收缩幅度、胃排空时间、胃排空率]及胃肠激素[胃泌素(GAS)、胃动素(MTL)、生长抑素(SS)]测定,比较两组临床疗效差异,统计随访期间胃轻瘫复发情况。结果:两组治疗6周后上腹胀痛、早饱、恶心/呕吐、厌食及反酸/嗳气评分均较治疗前明显降低(P<0.05),研究组上述症状评分均低于对照组(P<0.05)。两组治疗6周后胃收缩频率、胃收缩幅度、胃排空率明显高于治疗前,胃排空时间明显短于治疗前(P<0.05),研究组治疗6周后上述胃动力学指标均明显优于对照组(P<0.05)。两组治疗后GAS、MTL较治疗前明显降低(P<0.05),SS较治疗前明显升高(P<0.05),研究组治疗后GAS、MTL明显低于对照组(P<0.05),SS明显高于对照组(P<0.05)。研究组临床疗效明显高于对照组(P<0.05),随访半年复发率明显低于对照组(P<0.05)。结论:四磨汤是治疗老年2型糖尿病胃轻瘫高疗效、低复发的药物,能够有效改善临床症状及降低疾病复发率,其作用机制可能与改善胃肠动力紊乱、调节胃肠激素有关。Objective ： To observe the effect of Simo Decoction on gastrointestinal hormones and gastric motility in elderly type 2 diabetic patients with gastroparesis. Methods ： A total of 100 elderly type 2 diabetic patients with gastroparesis who were admitted to our hospital from January 2015 to January 2016 were randomly divided into study group （50 cases） and control group （50 cases）. The control group were given A - lipoic acid for 14 d,0.6 g each time, once a day, mosapride citrate for 6 weeks,5 mg each time, 3 times a day. The study group were given Simo Decoction for 6 weeks on the basis of the control group , 1 dose a day. All patients had been followed up for six months. The symptoms of upper abdominal pain, early satiety, nausea/vomiting, anorexia and acid/belching were observed before and after 6 weeks of treatment. The gastric motility index [ gastric contraction frequency, gastric contraction amplitude, gastric emptying time, gastric emptying rate ] and gastrointestinal hormones [ Gastrin （ GAS）, motilin （ MTL）, somatostatin （SS） ] were been detected. The difference of clinical curative effect between the two groups was compared and the recurrence of gastroparesis during the follow - up was analyzed. Results： The scores of upper abdominal pain, early satiety, nausea/vomiting, anorexia and regurgitation/belching of both groups after treatment were significantly lower than those before treatment （P 〈 0. 05）. The above symptoms score of the study group were lower than those of the control grou （ P 〈 0.05 ）. The gastric contraction frequency, gastric contraction amplitude and gastric emptying rate of both groups after treatment were higher than those before treatment（P 〈 0.05 ）. The gastric emptying time was significantly shorter than that before treatment （P 〈 0. 05）. The above gastric motility index of the study group was better than that of the control group （ P 〈 0. 05）. The levels of GAS and MTL of both groups after treatment were significantly lower t

关 键 词：老年2型糖尿病 胃轻瘫 四磨汤 胃肠激素 胃动力 

分 类 号：R781.64[医药卫生—口腔医学]