摘要
目的观察自拟方和胃舒痞饮治疗肝郁脾虚型老年功能性消化不良(FD)患者的疗效。方法选取泉州市中医院2018年2月至2019年6月就诊的肝郁脾虚型老年FD患者70例为研究对象,采用随机数字表法分为对照组、观察组,各35例,观察组予和胃舒痞饮煎服治疗,对照组予莫沙必利治疗,两组疗程均为4周。观察两组患者治疗前后总体症状积分、中医证候疗效、胃电图(EGG)参数、汉密尔顿抑郁量表(HAMD)评分变化和血清5-羟色胺含量的变化。结果治疗后,两组总体症状积分均降低,且观察组总体症状积分[(8.03±4.23)分]低于对照组[(10.36±4.67)分],差异有统计学意义(t=2.145,P<0.05)。观察组中医症候疗效有效率为88.2%(30/35),优于对照组的72.8%(24/35),差异有统计学意义(Z=-2.473,P<0.05)。治疗后,两组餐后胃电图参数均不同程度升高,观察组餐后的主频率[(3.39±0.34)cpm]高于对照组[(3.18±0.36)cpm],差异有统计学意义(t=-2.202,P<0.05);观察组正常慢波百分比[(68.91±4.79)%]高于对照组[(66.33±3.00)%],差异有统计学意义(t=-2.549,P<0.05);观察组反应面积[(99.09±13.58)μV/s]较对照组[(90.27±14.70)μV/s]升高,差异有统计学意义(t=-2.390,P<0.05)。治疗后,观察组HAMD评分[(14.94±2.42)分]低于对照组[(16.94±4.29)分],两组差异有统计学意义(t=2.355,P<0.05)。治疗后,观察组血清5-羟色胺水平[(110.46±16.69)μmol/L]高于对照组[(99.04±19.86)μmol/L],差异有统计学意义(t=-2.551,P<0.05)。结论和胃舒痞饮在改善肝郁脾虚型老年FD患者的总体症状疗效、中医证候疗效方面优于莫沙比利,和胃舒痞饮可改善老年人FD的抑郁状态,改善胃电节律紊乱的作用,可能与调节血清5-羟色胺的水平有关。
Objective To observe the clinical efficacy of Heweishupiyin decoction in the treatment of functional dyspepsia(FD)in elderly patients with liver stagnation and spleen deficiency.Methods A randomized controlled method was performed in this study,and 70 FD patients were selected from February 2018 to June 2019 in accordance with the inclusion criteria.The patients were divided into the observation group and the control group according to the random digital table method,with 35 cases in each group.The observation group was treated with Heweishupiyin decoction,the control group was given mosapride citrate tablets.The period of treatment was 4 weeks.The changes of total symptom scores,TCM syndrome evaluation,electrogastrogram(EGG)parameters,serum serotonin,and Hamilton depression scale(HAMD)scores before and after treatment were recorded.The statistical analysis was performed to evaluate the clinical efficacy of Heweishupiyin decoction.Results After treatment,the overall symptom scores in both two groups were decreased.The overall symptom score of the observation group after treatment[(8.03±4.23)points]was lower than that of the control group[(10.36±4.67)points],and the difference was statistically significant(t=2.145,P<0.05).The overall efficacy of TCM symptoms of the observation group was 88.2%(30/35),which was significantly higher than 72.8%(24/35)of the control group(Z=-2.473,P<0.05).After treatment,the EGG parameters of two groups had different degrees of increase,the main frequency of the observation group after meal[(3.39±0.34)cpm]was higher than that of the control group[(3.18±0.36)cpm],the difference was statistically significant(t=-2.202,P<0.05).The percentage of normal slow wave in the observation group[(68.91±4.79)%]was higher than that in the control group[(66.33±3.00)%],and the difference was statistically significant(t=-2.549,P<0.05).The reaction area of the observation group[(99.09±13.58)μV/s]was higher than that of the control group[(90.27±14.70)μV/s],and the difference was statistically significant(t=-2.390,P<0.05).After 4 weeks of treatment,the HAMD score of the observation group[(14.94±2.42)points]was lower than that of the control group[(16.94±4.29)points],and the difference was statistically significant(t=2.355,P<0.05).The serum level of serotonin after treatment in the observation group[(110.46±16.69)μmol/L]was higher than that in the control group[(99.04±19.86)μmol/L],the difference was statistically significant(t=-2.551,P<0.05).Conclusion Heweishupiyin decoction is superior to mosapride citrate tablets in improving the overall symptomatic efficacy and TCM syndrome efficacy of FD patients with liver stagnation and spleen deficiency.Heweishupiyin not only can improve the depression state of FD in the elderly,but also has the effect of improving the gastric electrical rhythm disorder,which may be related to the regulation of serum serotonin levels.
作者
张闽光
李超群
曾凯萍
郑颖
杨淞龙
雷超凡
Zhang Minguang;Li Chaoqun;Zeng Kaiping;Zheng Ying;Yang Songlong;Lei Chaofan(Department of Spleen,Stomach and Hepatobiliary,Quanzhou Hospital of Traditional Chinese Medicine,Quanzhou,Fujian 362000,China)
出处
《中国基层医药》
CAS
2020年第9期1095-1100,共6页
Chinese Journal of Primary Medicine and Pharmacy
关键词
消化不良
肝郁脾虚型
和胃舒痞饮
胃电图
抑郁
5-羟色胺
老年人
Dyspepsia
Liver stagnation and spleen deficiency
Heweishupiyin decoction
Electrogastrogram
Depressed
5-Hydroxytryptamine
Aged
