糖尿病胃轻瘫证型分布相关因素及自拟消痞启膈汤联合耳穴压豆治疗临床观察  

Clinical Observation of Diabetic Gastroparesis Treated by Xiaopi Qige Decoction Combined with Auricular Points Plaster Therapy

作　　者：刘芳芳[1] 詹国良 LIU Fangfang;ZHAN Guoliang(The 3th Departmentof Internal Medicine,Huizhou Hospital of Traditional Chinese Medicine,Huizhou 516001,Guangdong,China)

机构地区：[1]广州中医药大学惠州医院,广东惠州516001

出　　处：《实用中医内科杂志》2020年第11期71-74,共4页Journal of Practical Traditional Chinese Internal Medicine

基　　金：广东省中医药管理局科研计划(20181260)。

摘　　要：目的探讨本地区消渴病胃痞(糖尿病胃轻瘫)的证型分布及其相关因素,观察消痞启膈汤联合耳穴压豆治疗糖尿病胃轻瘫的临床疗效。方法120例糖尿病胃轻瘫患者给与临床信息采集及中医辨证,后随机分为空白对照组、药物对照组、中医治疗组各40例。空白对照组仅给予基础治疗,药物对照组给予常规西药(伊托必利)治疗、中医治疗组给予消痞启膈汤联合耳穴压豆治疗,以4周为疗程,观察:消渴病胃痞中医证型分布情况,各证型年龄、BMI、Hb A1C(%)的比较,各证型患者与其他并发症关系;治疗前后中医临床证候积分、胃半排空时间的变化,对比各组的疗效。结果总结出本地区消渴病胃痞的5种常见中医证型,各型出现的比例是脾胃虚弱>痰湿中阻>胃阴亏虚>肝郁气滞>寒热错杂。其与年龄、性别、体质指数、病程、并发症等相关因素的关系,在年龄上构成情况:脾胃虚弱年龄高于其他证型,体质指数各型无统计学差异,胃阴亏虚证糖化血红蛋白显著高于其他证型,差异有统计学意义。寒热错杂与痰湿中阻患糖尿病肾病比率高于其它组,肝胃不和证视网膜病变高于其他各组,寒热错杂证,胃阴亏虚周围神经炎高于其他各组(P<0.05)。治疗后三组中医临床证候积分皆较前有所改善,且中医治疗组总有效率为90.0%(36/40),明显高于空白对照组45.0%(28/40)、药物对照组82.5%(33/40)(P<0.05)。与治疗前比较,治疗后三组患者胃半排空时间皆降低,且中药治疗组改善情况显著优于对照组(P<0.05)。结论自拟消痞启膈汤联合耳穴压豆治疗糖尿病胃轻瘫具有显著的疗效。Objective To explore the syndrome distribution and related factors of diabetic gastroparesis in this areaandobserve the clinical effect of Xiaopi Qige decoction combined with auricular points plaster therapy in the treatment of diabetic gastroparesis.Methods A total of 120 cases of diabetic gastroparesis were randomly divided into blank control group,drug control group and Chinese medicine treatment group.The blank control group was only given basic treatment,the drug control group was given conventional western medicine(Itopride)treatment,and the traditional Chinese medicine treatment group was given Xiaopi Qige Decoction combined with auricular points plaster therapy for 4 weeks to observe the changes of clinical symptom score and gastric half emptying time before and after treatmentandcompare the curative effect of each group.Results The five common TCM syndromes of diabetic gastroparesis in this area and their relationship with age,gender,body mass index,course of disease,complications and other related factors were summarized.After treatment,the clinical syndrome scores of the three groups were improved,and the total effective rate of the Chinese medicine treatment group was 90.0%(36/40),significantly higher than that of the blank control group 45.0%(28/40).The drug control groups effective rate was 82.5%(33/40)(P<0.05).Compared with that before treatment,the half emptying time of stomach in the three groups decreased after treatment,and the improvement of the Chinese medicine treatment group was significantly better than that of the control groups(P<0.05).Conclusion Xiaopi Qige decoction combined with auricular points plaster therapy has significant effect on diabetic gastroparesis.

关 键 词：消痞启膈汤 耳穴压豆 消渴病胃痞 糖尿病胃轻瘫 证型分布 中医临床证候积分 胃半排空时间 临床研究 

分 类 号：R255.4[医药卫生—中医内科学]