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运脾和胃法治疗餐后不适综合征的疗效观察及机制探索
The Observation of the Clinical Curative Effect of Yun Pi He Wei Method Treating Postprandial Distress Syndrome and Research on the Action Mechanism
【作者】 韩诚正；
【导师】 沈洪；
【作者基本信息】 南京中医药大学 ， 中医内科学， 2010， 硕士
【摘要】 目的观察运脾和胃法治疗功能性消化不良餐后不适综合征的临床疗效,并通过动物实验探讨运脾和胃法治疗功能性消化不良餐后不适综合征的作用机理。方法临床研究：采用随机对照研究方法,将60例确诊的功能性消化不良餐后不适综合征脾虚气滞证患者分为两组,治疗组30例予以运脾和胃汤口服治疗,对照组30例予以口服多潘立酮治疗,疗程为4周,1个疗程结束后,观察治疗前后两组主要临床症状改善情况,进行疗效评价。实验研究：采用碘乙酰胺灌胃制备功能性消化不良模型,SD大鼠随机分为4组：正常组、模型组、运脾和胃汤组及多潘立酮组,各组连续给药3周后,观察各组大鼠胃窦黏膜组织病理的情况,运用酚红排空实验测定各组大鼠胃排空率,免疫组化法测定胃窦组织中DOG-1表达水平。结果临床研究：两组患者在餐后饱胀、早饱、嗳气、上腹胀、餐后恶心等症状改善方面,治疗组优于对照组,差异有统计学意义。治疗组总有效率为93%,对照组总有效率为70%,差异有统计学意义(P<0.05)。实验研究：各组大鼠胃窦黏膜未见明显损伤。与模型组相比,运脾和胃汤组和多潘立酮组大鼠胃排空率及胃窦组织中DOG-1表达均有升高,差异有统计学意义(P<0.05)。运脾和胃汤组与多潘立酮组相比,胃排空率和胃窦组织中DOG-1表达升高,差异有统计学意义(P<0.05)。结论运脾和胃法治疗餐后不适综合征有较好的临床疗效,说明运脾和胃法是治疗功能性消化不良餐后不适综合征脾虚气滞证的有效方法。运脾和胃法治疗功能性消化不良的作用机制可能与促进胃排空,提高胃窦组织中DOG-1表达有关。
【Abstract】 Objective The goal of the present study were to observe the clinical curative effect of the Method of invigorating spleen and harmonize the function of the stomach treating Postprandial Distress Syndrome and to explore the possible action mechanism by zoopery.Method Clinical part:Patients with postprandial distress syndrme were randomly divided into two groups,assigned 30 patients in controlled group to receive domperidone tablets,another 30 patients in treated group was taken a Chinese herbal formula called Yupi Hewei Decoction. After 4 weeks of treatment, the clinical curative effect was analyzed. Experimental part:The male SD rats were receive 0.1% iodoacetamide to make the model of functional dyspepsia,then divided randomly into 4 groups——Yupi Hewei Decoction,domperidone tablets,model and normal groups.Rats in normal group were not given any intervention measures.The gastric emptying changes of rats were assayed and distributions of the expressions of DOG-1 were detected.Result The treated group showed a higher efficiency rate (93%) in compared to the controlled group (70%).The treated group showed a significant difference of statistical probability level of (P<0.05)PDS. Yupi Hewei Decoction could increase the gastric emptying and the level of DOG-1 in rat model of functional dyspepsia. There was no significant gastric mucosa damage in rats in each group.Conclude The Method of invigorating spleen and harmonize the function of the stomach has a significant effect on treating Postprandial distress syndrme. Yupi Hewei Decoction could increase the gastric emptying and the level of DOG-1 in rat model of functional dyspepsia. The action mechanism maybe related to increasing the level of the DOG-1.