【作者】 吴英锋；

【导师】 齐清会；

【作者基本信息】 天津医科大学 ， 中西医结合临床， 2003， 硕士

【摘要】 目的：观察脾气虚证患者胃电图(EGG)和血浆胃肠激素变化并试图探讨它们之间的关系；观察某些中药治疗脾气虚证的疗效，探讨其作用机理。方法：选择53例脾气虚证患者，检测进餐前后EGG及放免测定血浆胃泌素(Gas)、胃动素(MTL)、生长抑素(SS)和血管活性肠肽(VIP)的含量；选取其中34例患者分为2组，分别予以香砂六君子汤或以西沙必利为主的西药治疗2周，观察疗效及治疗前后EGG、血浆Gas、MTL、SS和VIP的变化。结果：脾气虚证患者EGG明显紊乱，以餐后正常节律百分比(N％)降低、胃动过缓百分比(B％)增加、餐后餐前功率比(PR)＜1为特点；血浆Gas、MTL降低，SS、VIP增高；中药、西药均能明显改善脾气虚证患者症状，治疗后EGG的餐后N％增加，血浆MTL增高，SS、VIP降低，Gas有增高趋势；两个治疗组间疗效无明显差别；经计算，血浆SS与EGG中主频率(DF)、N％负相关，与B％正相关，血浆Gas与EGG中B％呈负相关趋势，与N％呈正相关趋势；胃肠激素间，血浆SS与Gas负相关。结论：脾气虚证时EGG明显紊乱，以餐后N％降低、B％增加、PR＜1为特点，血浆Gas、MTL降低、SS、VIP增高。EGG改变的原因可能与血浆中SS、Gas，特别是SS的变化有关，MTL、VIP在脾气虚证中的作用尚需进一步研究。香砂六君子汤和以西沙必利为主的西药在脾气虚证治疗中有一定作用。更多还原

【Abstract】 Objective: To observe the changes of EGG and four kinds of plasma gastrointestinal hormones in Spleen-Qi Deficiency(SQD) and try to explore the relationship among them. Meanwhile, to observe the role of XiangSha LiuJunZi decoction and some western medicine in the treatment of SQD, the changes of EGG and gastrointestinal hormones in SQD. Method: Fifty three cases of SQD were elected and their EGG and the levels of plasma gastrin( Gas), motilin (MIL), somatostatin (SS) and vasoactive intestinal peptide(VIP) were measured. The thirty four cases were divided into two groups and were chosen for treatment with XiangSha LiuJunZi decoction or some western medicine, of which cisapride is in chief. The efficacy of treatment, changes of EGG and the content of plasma gastrointestinal hormones were also observed after treatment. Result: The EGG of SQD was disordered, which was characterized by decreased postprandial dominant frequency in normal range(N%) and dominant power(DP), increased postprandial percent of bradygastria(B%).The levels of Gas and MTL were lower than the normal controls and the levels of SS and VIP were higher. After being treated, the symptoms were efficiently relieved, postprandial N% and the levels of MTL increased and the levels of SS and VIP decreased. There was an increasing tendency in the level of Gas but there was not significance in statistics(P>0. 05). The efficacy was not difference between the two therapies. There was a negative correlation between the level of plasmaSS and Gas, DF, N% of EGG respectively. There was a positive correlation between the level of SS and B% of EGG. Conclusion: In SQD, the EGG was disordered, which is characterized by decreased postprandial N% and power, increased postprandial B%, and the levels of plasma Gas and MTL were decreased and the levels of plasma SS and VIP increased. The reason of EGG alteration is perhaps associated with the changes of levels of plasma SS and Gas, especially the SS. The reason of the alterated plasma level of MTL and VIP in SQD need further study. The two therapies have certain effect in treatment of the disease.更多还原