脾气虚证患者胃泌酸、胃肠运动和胃肠电活动的变化  

Significant changes of gastric acid secretion, gastroduodenal movement and electrogastrography in patients with spleen-asthenia

作　　者：任平[1] 黄熙[1] 张航向[1] 黄裕新[2] 杨喜忠[1] 赵保民[2] 赵艳玲[1] 

机构地区：[1]中国人民解放军第四军医大学附属西京医院,陕西省西安市710032 [2]中国人民解放军第四军医大学附属唐都医院,陕西省西安市710038

出　　处：《世界华人消化杂志》2004年第3期726-729,共4页World Chinese Journal of Digestology

基　　金：国家自然科学基金资助;No.30271648国家中医药管理局资助课题;No 02-03JP45~~

摘　　要：目的:观察脾气虚患者胃泌酸功能、小肠传递时间和胃、十二指肠球部电活动,探讨临床脾气虚证客观可靠、简便易行的辨证施治方法. 方法:选择中医辨证符合脾气虚证、胃热证和肝火上炎证的患者,分别进行口服镁盐呼氢实验(OMBHT)、口服乳果糖呼氢实验(SBTT)及胃电图检查. 结果:脾气虚组患者OMBHT测定产氢量(H2/excess)值各时间点均低于正常值(15 min,13.16±4.5l;30 min,14.33±4.18;45 min,15.57±4.89vs20-60 ppm);与正常参考值比较(75-150 min),脾气虚组(SBTT 225.6±21.3 min) 的测定值显著增大,而肝火上炎组的SBTT为60.4±34.5. 且与脾气虚组比较有显著差异(P<0.01);胃肠电图检查显示: 脾气虚组胃窦、胃体、胃小弯和十二指肠球部的平均峰值幅度虽在正常范围内,但较胃热组和肝火上炎组明显减低(P<0.01);脾气虚组四个部位的主频值均明显低于正常值(胃窦1.82±0.57、胃体1.65±0.36、胃小弯0.15±0.03和十二指肠球部0.15±0.05,正常2.4-3.7cpm),且与胃热和肝火上炎组比较显著减低(P<0.05),尤其是胃小弯和十二指肠球部差距更为明显(P<0.01);此外脾气虚组胃窦部的平均过零频率低于正常值(1.73±0.49 vs 2.4-3.7 cpm),其他部位的虽在正常值范围内,但较胃热和肝火上炎组减低(P<0.05).胃热和肝火上炎两组患者上述3项指标的检测值均无明显差异性. 结论:脾气虚证患者“脾失健运”的客观表现之一为胃泌酸功能减低、小肠运动功能减退和胃电活动紊乱.AIM: To search for some objective indexes with high specificity and sensitivity to provide new dinical evidence for elucidating the essence of spleen-asthenia syndrome by investigating the gastric acid secretion, gastroduodenal movement and electrogastrography in patients with spleen-asthenia (SA). METHODS: Patients with SA, stomach-heat (SH)and flam-ing-up of liver-fire (FULF) according to the theory of traditional Chinese medicine (TCM) were selected, in which breath hydrogen test (BHT) and electrogastrography were examined. RESULTS: In comparison with clinical normal reference standard, the values of H2/excess in patients with SA were lowered at 15 min, 30 min, and 45 min (13.16±4.51,14.33± 4.18; G45 min, 15.57±4.89 vs 20-60 ppm, P<0.01), but the groups of SH and FULF were normal. The results of small bowel transit test (SBTT) after oral lactose BHT showed that the time in groups of SH was increased (225.6±21.3 min vs 75-150 min and 60.4±34 min, P<0.01), compared with clinical normal reference standard and the group of FULF. The electrogastrography amplitude and frequency of antrum, cavity, lesser curvature and duodenal bulb reduced in the group of SA as compared with groups of SH and FULF (P<0.01). There was no difference between SH and FULF groups. CONCLUSION: In patients with SA, the function of gastric acid secretion is reduced, the small bowel transit time is increased and the amplitude and frequency of electrogastrography are reduced, which may be important objective indexes in the clinical diagnosis and treatment of spleen-asthenia.

关 键 词：脾气虚证 胃泌酸 胃肠运动 胃肠电活动 中医证型 

分 类 号：R256.3[医药卫生—中医内科学]