【作者】 王颖；

【导师】 曹泽伟；

【作者基本信息】 天津医科大学 ， 中西医结合临床， 2011， 硕士

【摘要】 目的功能性消化不良(Functional dyspepsia, FD)是临床常见而且难治的消化系统功能紊乱性疾病。本课题旨在观察艽龙胶囊联合多潘立酮治疗功能性消化不良肝胃郁热型的的临床疗效,及其对胃排空的影响,为临床治疗该病提供新的依据。方法参照中医、西医两个诊断标准,将符合功能性消化不良肝胃郁热型的患者90例随机分成艽龙胶囊组(A组),多潘立酮组(B组),艽龙胶囊+多潘立酮组(C组),每组30例,分别于餐前口服规定的药物及剂量,治疗时间为两周。治疗前及治疗两周后观察并记录患者胃脘饱胀、脘部烧灼、口干口苦等症状改善情况,对各症状进行评分,并计算疗效指数及临床有效率。治疗前及治疗两周后,分别进行13C-辛酸呼气试验测定患者胃固体排空情况。治疗结束后随访8周,观察患者有无复发及不良反应。结果1治疗后3组中胃脘饱胀、胃脘烧灼等各症状积分较前均下降,与治疗前相比差异有统计学意义(P<0.05)。23组治疗后症状总积分较治疗前均有不同程度下降,与治疗前相比差异有统计学意义(P<0.05)。3组间比较,C组改善程度优于A、B两组(P<0.05),A、B两组间差异无统计学意义(P>0.05)。33组治疗后,总有效例数分别为22、21、28,总有效率分别为73.3%、70%和93.3%。总有效例数相比,C组优于A、B两组(P<0.05),A、B两组间差异无统计学意义(P>0.05)。4胃固体排空试验显示,治疗后3组胃排空时间较治疗前均有明显改善(P<0.05),3组间比较差异无统计学意义(P>0.05)。5治疗期间,A组有两位患者出现轻微腹痛,C组有4位患者出现轻微腹痛、腹泻(2次/天),症状在用药结束后消失。在8周的随访过程中,仅B组有一位患者出现进食后胃脘饱胀症状,其余组无复发病例。结论1艽龙胶囊联合多潘立酮治疗功能性消化不良肝胃郁热型具有较好的临床效果,对患者胃脘饱胀、胃脘烧灼、口干口苦等症状具有明显的改善作用。2艽龙胶囊联合多潘立酮可以减少功能性消化不良肝胃郁热型患者的胃固体排空时间,具有明显促进胃动力的作用。3艽龙胶囊联合多潘立酮治疗功能性消化不良肝胃郁热型,无明显不良反应,值得进一步研究及推广。更多还原

【Abstract】 ObjectiveFunctional dyspepsia (FD) is a common clinical disorder of digestive system and refractory disease. The purper of this subject isto observe the curative effect of Jiaolong Capsules combined with Domperidone on FD with stagnant heat of liver and stomach and its effects on gastric emptying.It is intend to provide innovative new drugs of clinical treatment for the disease.MethodsReference to traditional Chinese medicine,and Western medicine diagnostic criteria, FD patients were randomly divided into three groups:patients only treated with Jiaolong Capsules(Group A), patients treated with Domperidone (Group B),and patients treated with Jiaolong Capsules combined with Domperidone(Group C).Each group had 30 cases.All patients were treated for two wceks.The changes in FD symptoms such as upper abdominal fullness,stomach cauterization,dry and bitter taste were recorded before and after treatment.Efficacy index was calculated.Using 13C-octanoic acid breath test the emptying function of stomach was determined.Results1 After treatment, upper abdominal fullness,stomach cauterization and other symptom scores of three groups decreased than before,and after treatment than before treatment was significantly(P<0.05).2 Three groups of symptoms total score after treatment than before treatment were decreased. And after treatment than before treatment was significantly (P<0.05). Comparison between the 3 groups, group C improvement is better than group A, B (P<0.05), the difference between group A and group B was not significant (P> 0.05).3 After treatment, the total effective number of three groups are 22,21,28. And the total effective rate was 73.3%,70%and 93.3%. Compared to the total numer of valid cases, C group was better than group A, B (P<0.05).The difference between group A and B was not significant (P> 0.05).4 Gastric emptying test showed that after treatment, gastric emptying time of three groups were significantly improved compared with before treatment (P<0.05). In the three groups, the difference was not significant (P> 0.05).5 During treatment, two patients had mild abdominal pain in group A, and 4 patients had mild abdominal pain and diarrhea in group C(2 times/day). These symptoms disappeared afterthe treatment. In the follow-up process, only one patie-nt in group B occurred early satiety symptoms.The other group had no recurrence.Conclusion1 Combined therapy of Jiaolong Capsules and Domperidone can significantly improve general efficacy in patients of functional dyspepsia with stagnant heat of liver and stomach syndrome. Patients with upper abdominal fullness,stomach cauterization,dry and bitter taste has obvious improvement.2 Combined therapy of Jiaolong Capsules and Domperidone in patients of functional dyspepsia with stagnant heat of liver and stomach syndrome can accelerate the gastric emptying,.They have a clear role in promoting gastric motility.3 Combined therapy of Jiaolong Capsules and Domperidone in patients of functional dyspepsia with stagnant heat of liver and stomach syndrome has no adverse reaction. It deserves further study and promotion.更多还原