加味抑肝散治疗肝胃不和型功能性消化不良疗效及对胃激素、胃动力的影响OA
Therapeutic Effects of Modified Yigan San on Functional Dyspepsia of Liver-Stomach Disharmony Type and Its Influence on Gastric Hormones and Gastric Motility
目的:探讨加味抑肝散对肝胃不和型功能性消化不良(FD)患者的治疗效果及对胃激素、胃动力的影响.方法:选择符合纳入标准的106例肝胃不和型FD患者,采用随机数字表抽取法随机分为对照组和观察组,每组各53例.对照组采取常规西药治疗,观察组在对照组治疗基础上给予加味抑肝散治疗,连续治疗4周为1个疗程.比较两组患者治疗前后中医主症、次症和总积分及胃肠激素指标、胃肠动力学指标、抑郁焦虑症状评分、5-羟色胺(5-HT)的变化情况,并比较临床疗效和随访3个月、6个月的复发率.结果:治疗后,两组患者主症、次症和总积分及生长抑素、5-HT水平均低于治疗前(P<0.05),血清胃泌素、胃动素、血管P物质水平、胃半排空率、胃运动节律均高于治疗前(P<0.05),观察组HAMA、HAMD评分低于治疗前(P<0.05);治疗后组间比较,观察组主症、次症和总积分及生长抑素、5-HT水平、HAMA、HAMD评分明显低于对照组(P<0.05),血清胃泌素、胃动素、血管P物质水平、胃半排空率、胃运动节律均高于对照组(P<0.05);观察组治疗后临床总有效率94.34%(50/53)高于对照组77.36%(41/53)(P<0.05);随访3个月复发率7.55%(4/53)、6个月复发率16.98%(9/53)均明显低于对照组22.64%(12/53)、43.4%(23/53)(P<0.05).结论:加味抑肝散结合西药治疗肝胃不和型FD患者效果明显,能有效改善胃激素、胃动力学指标,减轻临床症状和焦虑抑郁症状,降低复发率.
Objective:To investigate the therapeutic effects of Modified Yigan San on functional dyspepsia(FD)of liver-stomach disharmony type and its impact on gastric hormones and gastric motility.Methods:A total of 106 patients with liver-stomach disharmony type FD meeting the inclusion criteria were randomly divided into a control group(53 cases)and an observation group(53 cases)using a random number table.The control group received conventional Western medical treatment,while the observation group was additionally treated with Modified Yigan San for 4 weeks.Primary and secondary symptom scores,total scores,gastrointestinal hormone levels,gastrointestinal motility indices,anxiety and depression scores,and 5-hydroxytryptamine(5-HT)levels were compared before and after treatment.Clinical efficacy and recurrence rates at 3 and 6 months post-treatment were also analyzed.Results:After treatment,both groups showed reduced primary and secondary symptom scores,total scores,somatostatin,and 5-HT levels(P<0.05),while serum gastrin,motilin,substance P levels,gastric emptying rate,and gastric motility rhythm increased compared to baseline(P<0.05).The observation group had significantly lower Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale(HAMD)scores than before treatment(P<0.05).Post-treatment,the observation group demonstrated significantly lower symptom scores,somatostatin,5-HT levels,HAMA,and HAMD scores(P<0.05)and higher serum gastrin,motilin,substance P levels,gastric emptying rate,and gastric motility rhythm than the control group(P<0.05).The clinical total effective rate in the observation group(94.34%,50/53)was higher than that in the control group(77.36%,41/53,P<0.05).Recurrence rates at 3 months(7.55%,4/53)and 6 months(16.98%,9/53)were significantly lower in the observation group compared to the control group(22.64%,12/53 and 43.4%,23/53,P<0.05).Conclusion:Modified Yigan San combined with Western medicine significantly improves symptoms,gastric hormone levels,and gastric motility indices in patients with FD with liver-stomach disharmony.It alleviates anxiety and depression symptoms and reduces recurrence rates.
张博
郑州大学第五附属医院,河南 郑州 450000
肝胃不和功能性消化不良抑肝散胃激素胃动力焦虑抑郁
Liver-stomach disharmonyFunctional dyspepsiaYigan SanGastric hormonesGastric motilityAnxietyDepression
《中医药信息》 2025 (2)
46-51,6
2023年河南省科技发展项目(232102310493)
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