调气和胃汤联合针刺治疗脾虚气滞型功能性消化不良疗效及对患者胃肠激素的影响  

Effects of Tiaoqi Hewei decoction combined with acupuncture on gastric emptying and serum CCK,MTL and Ghrelin levels in patients with functional dyspepsia with spleen deficiency and qi stagnation

作　　者：韩静 徐鑫 孙云霞 HAN Jing;XU Xin;SUN Yunxia(National Medical Hall of Cangzhou Central Hospital,Cangzhou 061000,China)

机构地区：[1]沧州市中心医院国医堂,河北沧州061000 [2]沧州市中心医院中医一科,河北沧州061000

出　　处：《陕西中医》2024年第5期622-626,共5页Shaanxi Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(2020520)。

摘　　要：目的:观察调气和胃汤联合针刺对脾虚气滞型功能性消化不良患者胃排空及血清胆囊收缩素(CCK)、胃动素(MTL)和生长激素释放肽(Ghrelin)水平的影响。方法:将98例脾虚气滞型功能性消化不良患者采用随机法分为对照组(n=49)和观察组(n=49)。对照组给予枸橼酸莫沙必利片联合针刺治疗,观察组在枸橼酸莫沙必利片基础上给予调气和胃汤联合针刺治疗,两组均连续治疗4周。比较两组胃肠动力指标、中医症状积分、肠道菌群及血清CCK、生长抑素(SS)、胃蛋白酶Ⅰ等相关因子水平,统计两组疗效。结果:治疗后,两组胃半排空和胃排空时间较治疗前缩短,小肠推进率较治疗前升高,2h存留率较治疗前降低(P<0.05);观察组治疗后胃半排空和胃排空时间短于对照组,小肠推进率高于对照组,2h存留率低于对照组(P<0.05)。治疗后,两组血清CCK、SS较治疗前降低,MTL、Ghrelin、胃蛋白酶Ⅰ、神经肽S受体1(NPSR1)较治疗前升高(P<0.05);观察组治疗后血清CCK、SS低于对照组,MTL、Ghrelin、胃蛋白酶Ⅰ、NPSR1高于对照组(P<0.05)。治疗后,两组肠杆菌、肠球菌、酵母菌数量较治疗前降低,且观察组治疗后更低(P<0.05)。治疗后,两组胃脘痞闷或胀痛、纳呆、早饱、疲乏、便溏、嗳气等中医症状积分较治疗前降低,且观察组治疗后中医症状积分低于对照组(P<0.05)。观察组总有效率为95.92%(47/49)高于对照组的83.67%(41/49),差异有统计学意义(P<0.05)。结论:调气和胃汤联合针刺可减轻脾虚气滞型功能性消化不良患者症状,调节胃肠激素和肠道菌群,促进胃排空,提高疗效。Objective:To observe the effects of Tiaoqi Hewei decoction combined with acupuncture on gastric emptying and serum levels of cholecystockinin(CCK),motilin(MTL)and growth hormone releasing peptide(Ghrelin)in patients with functional dyspepsia with spleen deficiency and qi stagnation.Methods:Ninety-eight patients with functional dyspepsia with spleen deficiency and qi stagnation were randomly divided into control group(n=49)and acupuncture and drug combination group(n=49).The control group was treated with Mosapride citrate tablets combined with acupuncture,and the acupuncture and drug combination group was treated with Tiaoqi Hewei decoction combined with acupuncture on the basis of Mosapride citrate tablets.Both groups were treated continuously for 4 weeks.Gastrointestinal motility index,TCM symptom score,intestinal flora and serum CCK,somatostatin(SS),pepsinⅠand other related factors were compared between the two groups,and the therapeutic effect was statistically analyzed.Results:After treatment,gastric semi-emptier and gastric emptier time in both groups were shorter than before treatment,small intestine propulsion rate was higher than before treatment,and 2 h retention rate was lower than before treatment(P<0.05).After treatment,the gastric semi-emptying and gastric emptying time in the combination group were shorter than those in the control group,the small intestine propulsion rate was higher than that in the control group,and the 2 h retention rate was lower than that in the control group(P<0.05).After treatment,serum CCK and SS were decreased,MTL,Ghrelin,pepsinⅠ,neuropeptide S receptor 1(NPSR1)were increased in 2 groups compared with before treatment(P<0.05).After treatment,serum CCK and SS in combination group were lower than those in control group,MTL,Ghrelin,pepsinⅠand NPSR1 were higher than those in control group(P<0.05).After treatment,the number of enterobacter,enterococcus and yeast in the two groups was lower than before treatment,and the number was lower in the combination of acupuncture an

关 键 词：功能性消化不良 胃肠激素 胃排空 调气和胃汤 针刺 脾虚气滞型 

分 类 号：R723.1[医药卫生—儿科]