健脾理气法联合盐酸伊托必利片治疗脾虚气滞型糖尿病胃轻瘫疗效观察  

Clinical effect of Jianwei Liqi therapy combined with itopride hydrochloride tablets for diabetic gastroparesis of spleen-deficiency and qi-stagnation

作　　者：陈亮 刘晓琳 赵佳 CHEN Liang;LIU Xiaolin;ZHAO Jia(Department of Gastroenterology,Tangshan Nanhu Hospital,Tangshan,Hebei 063000)

机构地区：[1]河北省唐山南湖医院消化内科,河北唐山063000

出　　处：《河北中医》2022年第4期632-635,645,共5页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的观察健脾理气法联合盐酸伊托必利片治疗糖尿病胃轻瘫的临床疗效。方法选择2019年1月至2021年10月我院消化内科脾虚气滞型糖尿病胃轻瘫门诊患者80例,按随机数字表法分为对照组与观察组,各40例。2组均给予控制血糖、调整饮食等基础治疗,对照组在基础治疗同时给予盐酸伊托必利片,观察组在对照组基础上联合健脾理气法中药治疗,均连续治疗4周。比较治疗前后空腹血糖(FPG)、餐后2 h血糖(2 hPG)、空腹胰岛素、糖化血红蛋白(HbA_(1)c)及胃排空率(GER)、胃排空时间,比较治疗前后中医证候评分,统计临床疗效,记录不良反应发生情况。结果2组治疗后FPG、2 hPG、HbA_(1)c较本组治疗前降低,空腹胰岛素升高(P<0.05),但2组治疗后组间比较差异无统计学意义(P>0.05)。与治疗前比较,2组治疗后GER增加,胃排空时间缩短(P<0.05),且观察组治疗后GER高于对照组(P<0.05),胃排空时间低于对照组(P<0.05)。2组治疗后中医证候各项评分及总分均较本组治疗前降低,且观察组治疗后中医证候各项评分及总分均低于对照组(P<0.05)。观察组总有效率92.50%(37/40),对照组总有效率75.00%(30/40),观察组疗效优于对照组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论健脾理气法联合盐酸伊托必利片能显著降低糖尿病胃轻瘫症状,提高胃排空率,降低胃排空时间,临床疗效确切,且用药安全。Objective To observe the clinical effect of Jianwei Liqi method therapy combined with itopride hydrochloride tablets for diabetic gastroparesis(DGP)of spleen-deficiency and qi-stagnation.Methods Totally 80 patients with DGP(spleen-deficiency and qi-stagnation)from January 2019 to October 2021 in Department of Gastroenterology of our hospital were randomly divided into the control group(n=40)and the observation group(n=40).All patients were managed by basal treatment(control of blood glucose,adjusting diet),the control group received itopride hydrochloride tablets,and the observation group received traditional Chinese medicine(TCM)therapy of Jianwei Liqi method based on the control group.A 4-week treatment was performed to compare fasting plasma glucose(FPG),two hour plasma glucose(2 hPG),fasting insulin(FINS),glycosylated hemoglobin(HbA_(1)c),gastric emptying rate(GER),gastric evacuation time(GET),TCM syndrome scores;the curative effect and adverse reaction were assessed.Results Decreased levels of FPG,2 hPG and HbA_(1)c and increased levels of FINS were detected in groups after treatment(P<0.05),the difference was not statistically significant between groups(P>0.05).After treatment,GER in groups was increased,the observation group was more prevalent(P<0.05);while GET in groups was decreased,the reduction in the observation group was more common(P<0.05);TCM symptom scores in groups were decreased(P<0.05),which were decreased in the observation group compared with the control group(P<0.05).The overall effective rate was 92.50%(37/40)in the observation group,higher than that of 75.00%(30/40)in the control group(P<0.05).None of the incidence of adverse reactions differed significantly between groups(P>0.05).Conclusion For patients with DGP(spleen-deficiency and qi-stagnation),Jianwei Liqi therapy combined with itopride hydrochloride tablets can significantly reduce clinical symptoms,improve GER,and reduce GET,with definite clinical efficacy and safe medication.

关 键 词：糖尿病 2型 胃肌轻瘫 健脾 理气 中西医结合疗法 

分 类 号：R781.63[医药卫生—口腔医学]