基于脑-肠互动观点探讨解郁复胃散对功能性消化不良的疗效及机制  

Efficacy and mechanism of Jieyu Fuwei Powder in treating functional dyspepsia based on brain-gut interaction viewpoint

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作  者:于红梅 李堃 季瑜 田祖成 梅莉 葛飞 YU Hongmei;LI Kun;JI Yu;TIAN Zucheng;MEI Li;GE Fei(Department of Neurology,Hai′an Hospital of Traditional Chinese Medicine Affiliated to Medical College of Yangzhou University,Nantong,Jiangsu,226600;Department of Gastroenterology,Hai′an Hospital of Traditional Chinese Medicine Affiliated to Medical College of Yangzhou University,Nantong,Jiangsu,226600)

机构地区:[1]扬州大学医学院附属海安市中医院神经内科,江苏海安226600 [2]扬州大学医学院附属海安市中医院消化内科,江苏海安226600

出  处:《实用临床医药杂志》2024年第7期53-57,共5页Journal of Clinical Medicine in Practice

基  金:江苏省重大神经精神疾病研究重点实验室开放课题(KL20211211);南京中医药大学自然科学基金项目(XZR2020084);南通市卫生健康委科研课题(MS2022102)。

摘  要:目的观察解郁复胃散对功能性消化不良(FD)患者的疗效。方法将海安市中医院门诊66例慢性FD(肝胃不和型)患者随机分为2组,每组33例。对照组应用多潘立酮治疗,治疗组应用解郁复胃散治疗。比较2组总有效率、中医证候积分以及血清5-羟色胺(5-HT)、P物质(SP)、胃泌素(GAS)、胃动素(MTL)水平和不良反应发生率。募集2组治疗后志愿者(对照组为14例,治疗组为13例)接受门诊胃镜检查并获取活检组织,进行组织病理及GAS、MTL的免疫组化分析。结果治疗组总有效率为90.91%,高于对照组的69.70%,差异有统计学意义(P<0.05)。治疗后,治疗组两胁串通、胃脘痞满、上腹不适、嗳气、烧心反酸、急躁易怒症状积分均低于对照组,差异均有统计学意义(P<0.01)。治疗后,2组血清5-HT、SP水平下降,MTL、GAS水平升高,且治疗组血清5-HT、SP水平低于对照组,MTL、GAS水平高于对照组,差异均有统计学意义(P<0.05或P<0.01)。治疗组不良反应发生率为6.06%(2/33),对照组不良反应发生率为9.09%(3/33),差异无统计学意义(P>0.05)。活检组织苏木精-伊红(HE)染色显示2组病理无显著差异,免疫组化结果提示治疗组的GAS、MTL表达较对照组增加。结论解郁复胃散对肝胃不和型FD的疗效优于多潘立酮,其机制可能与干预脑-肠互动有关。Objective To observe the efficacy of Jieyu Fuwei Powder in the treatment of patients with functional dyspepsia(FD).Methods A total of 66 patients with chronic FD(type of disharmony between liver and stomach)from the outpatient clinic of Hai′an Hospital of Traditional Chinese Medicine were randomly divided into two groups,with 33 cases in each group.Control group was treated with domperidone,while treatment group was treated with Jieyu Fuwei Powder.The total effective rate,scores of traditional Chinese medicine syndromes,levels of serum 5-hydroxytryptamine(5-HT),substance P(SP),gastrin(GAS)and motilin(MTL)as well as the incidence of adverse reactions were compared between the two groups.Volunteers from the two groups after treatment(14 cases in the control group and 13 cases in the treatment group)were recruited to receive outpatient gastroscopy and obtain biopsy tissues for histopathological and immunohistochemical analysis of GAS and MTL.Results The total effective rate in the treatment group was 90.91%,which was significantly higher than 69.70%in the control group(P<0.05).After treatment,the scores of symptoms such as pain in both sides of the chest,epigastric fullness,upper abdominal discomfort,belching,heartburn and irritability in the treatment group were significantly lower than those in the control group(P<0.01).After treatment,the levels of serum 5-HT and SP decreased significantly while the levels of MTL and GAS increased significantly in both groups,and the levels of serum 5-HT and SP were significantly lower in the treatment group than those in the control group,while the levels of MTL and GAS were significantly higher in the treatment group than those in the control group(P<0.05 or P<0.01).The incidence of adverse reactions was 6.06%(2/33)in the treatment group and 9.09%(3/33)in the control group,with no significant difference between two groups(P>0.05).Hematoxylin an eosin(HE)staining of biopsy tissues showed no significant difference in pathology between the two groups,and immunohistochemical resu

关 键 词:解郁复胃散 肝胃不和型 功能性消化不良 脑-肠互动 脑肠轴 

分 类 号:R723.1[医药卫生—儿科] R573[医药卫生—临床医学] R242

 

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