黄连解毒汤辅助治疗脑梗死急性期并发胃动力障碍的临床疗效  

Clinical Efficacy of Huanglian Jiedutang in Adjuvant Treatment of Acute Cerebral Infarction Complicated with Gastric Motility Disorder

作　　者：安朋朋 兰雅文 刘欢欢 王春燕[2] 高召凯 张增 孔晓璇 李雯雯[2] 唐明[1] 任志珍 AN Pengpeng;LAN Yawen;LIU Huanhuan;WANG Chunyan;GAO Zhaokai;ZHANG Zeng;KONG Xiaoxuan;LI Wenwen;TANG Ming;REN Zhizhen(Qingdao Hiser Hospital Affiliated of Qingdao University,Qingdao 266033,China;Shandong University of TCM,Jinan 250014,China;Shinan District Community Health Service Center,Qingdao 266073,China)

机构地区：[1]青岛大学附属青岛市海慈医院(青岛市中医医院),山东青岛266033 [2]山东中医药大学,济南250014 [3]青岛市市南区社区卫生服务中心,山东青岛266073

出　　处：《中国实验方剂学杂志》2023年第20期81-87,共7页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：山东省中医药科技发展计划项目(2017-321);青岛市民生科技计划项目(18-6-1-69-NSH)。

摘　　要：目的:探讨黄连解毒汤辅助治疗脑梗死急性期并发胃动力障碍的临床疗效。方法:将60名脑梗死急性期并发胃动力障碍火毒证患者随机分为西医对照组(对照组)和中医联合治疗组(观察组),每组各30例。对照组给予脑梗死基础治疗,另据患者胃肠道症状,予相关西医对症治疗。观察组在对照组的基础上加用黄连解毒汤。疗程均为7 d。观察两组患者治疗前、治疗第4、7天的神经功能缺损评分、胃肠功能障碍评分。分别于治疗前、治疗第7天测量两组患者胃电图参数、血清瓜氨酸(CIT)、胃动素(MTL)水平。并比较两组患者临床疗效。结果:与本组治疗前比较,两组患者治疗第4、7天神经功能缺损评分、胃肠功能障碍评分均明显降低(P<0.05);与第4天比较,两组患者治疗第7天上述指标降低更明显(P<0.05)。治疗后与对照组同期比较,观察组患者治疗第4、7天神经功能缺损评分、胃肠功能障碍评分均明显降低(P<0.05)。与本组治疗前比较,两组患者治疗第7天胃窦、胃体胃电振幅及血清CIT、MTL水平均明显升高(P<0.05),胃窦、胃体胃电频率差异无统计学意义。与对照组治疗后比较,治疗第7天观察组患者胃窦、胃体胃电振幅及血清CIT、MTL水平均明显升高(P<0.05),胃窦、胃体胃电频率差异无统计学意义。治疗7 d后,观察组患者总有效率为90.00%(27/30),对照组患者总有效率为76.67%(23/30),观察组高于对照组,但差异无统计学意义。两组患者治疗过程中均未出现不良反应。结论:黄连解毒汤辅助治疗可有效改善脑梗死急性期并发胃动力障碍患者的神经功能损伤症状及胃肠功能障碍症状,升高患者胃窦、胃体部胃电慢波振幅,改善胃动力障碍,同时升高血清CIT、MTL水平,改善失衡的胃肠分泌功能。Objective:To explore the clinical efficacy of Huanglian Jiedutang as an adjunctive treatment for acute cerebral infarction complicated with gastric motility disorder.Method:Sixty patients with acute cerebral infarction complicated with gastric motility disorder with fire toxin syndrome were randomly divided into a western medicine control group(control group)and a traditional Chinese medicine(TCM)combined treatment group(observation group),with 30 cases in each group.The control group received basic treatment for cerebral infarction and relevant western medical symptomatic treatment based on the patients'gastrointestinal symptoms.The observation group received Huanglian Jiedutang in addition to the treatment provided to the control group.The treatment course was 7 days.Neurological deficit scores and gastrointestinal dysfunction scores were assessed in both groups before treatment and on the 4th and 7th days of treatment.Gastrointestinal electrographic parameters,serum citrulline(CIT),and motilin(MTL)levels were measured in both groups before treatment and on the 7th day of treatment.Clinical efficacy was compared between the two groups.Result:Compared with the baseline in both groups,the neurological deficit scores and gastrointestinal dysfunction scores were significantly reduced on the 4th and 7th days of treatment(P<0.05).The reductions in these scores were more significant on the 7th day compared with those on the 4th day of treatment(P<0.05).On the 4th and 7th days of treatment,the observation group showed a significantly greater reduction in neurological deficit scores and gastrointestinal dysfunction scores compared with the control group(P<0.05).On the 7th day of treatment,compared with the baseline,both groups showed a significant increase in gastric antral and gastric body electric wave amplitudes as well as serum CIT and MTL levels(P<0.05),and there were no statistically significant differences in the frequency of gastric antral and gastric body electric waves.On the 7th day of treatment,compared with

关 键 词：黄连解毒汤 脑梗死急性期 胃动力障碍 胃电图 血清瓜氨酸(CIT) 胃动素(MTL) 

分 类 号：R2-0[医药卫生—中医学] R22R242R2-031R259R256.3R255.2R743.3