小柴胡汤合左金丸加味治疗肝胃郁热型功能性消化不良疗效观察

Effect observation of Xiaochaihu Decoction combined with modified Zuojin Pill on functional dyspepsia with liver and stomach stagnation heat syndrome and its impact on gastrointestinal motility and gastrointestinal hormones

关键词:  功能性消化不良  肝胃郁热  中药  小柴胡汤合左金丸加味  胃肠动力  胃肠激素

Key words:  functional dyspepsia  liver and stomach stagnation heat  traditional Chinese medicine  Xiaochaihu Decoction combined with modified Zuojin Pill  gastrointestinal motility  gastrointestinal hormones

摘要:

[目的] 探讨小柴胡汤合左金丸加味治疗肝胃郁热型功能性消化不良（FD）的效果。[方法] 选择2022年1月—2024年7月期间收治的FD患者104例，按照随机数字表法随机分为观察组（52例）和对照组（52例）。对照组予以枸橼酸莫沙必利分散片口服，每次5 mg，每日3次；观察组在此基础上予中药小柴胡汤合左金丸加味口服，每日1剂，早晚分2次温服，两组疗程均为4周。比较两组治疗前后主要症状评分、胃肠动力指标[胃体部胃电图波形的平均幅值（VPP）和平均频率（f）、胃窦部胃电图波形的VPP和f]、胃肠激素[胃泌素（GAS）、胃动素（MLT）、生长抑素（SS）、生长激素释放肽（Ghrelin）、神经肽S受体1（NPSR1）]、尼平消化不良指数[尼平消化不良生活指数（NDLQI）、尼平消化不良症状指数（NDSI）]，比较两组治疗总有效率。[结果] 治疗后观察组主要症状评分低于对照组（P<0.05）、VPP、f均高于对照组（P<0.05）；血清GAS、MLT、Ghrelin、NPSR1水平高于对照组（P<0.05），SS水平低于对照组；NDLQI高于对照组（P<0.05），NDSI低于对照组（P<0.05）。治疗总有效率高于对照组（P<0.05）。[结论] 小柴胡汤合左金丸加味可有效缓解FD相关症状，治疗肝胃郁热型FD效果显著。

Abstract:

[Objective] To explore the effect of Xiaochaihu Decoction combined with modified Zuojin Pills in the treatment of functional dyspepsia（FD） of liver stomach stagnation heat type. [Methods] The 104 FD patients from January，2022 to July，2024 were selected and randomly divided into observation group（52 cases） and control group（52 cases） according to the random number table method. The control group were given Mosapride Citrate dispersible tablets orally，5 mg each time，3 times a day. On this basis，the observation group were given a modified oral administration of traditional Chinese medicine Xiaochaihu Decoction and modified Zuojin Pills，one dose per day，divided into two warm doses in the morning and evening. The treatment course of the both groups was for 4 weeks. The main symptom scores，gastrointestinal motility indicators [average amplitude（VPP） and average frequency（f） of the wave form of the gastric body electrogastrogram，the VPP and average f of the waveform of the gastric fundus electrogastrogram]，gastrointestinal hormones [gastrin（GAS），motilin（MLT），somatostatin（SS），growth hormone releasing peptide（Ghrelin），neuropeptide S receptor 1（NPSR1）]，and Niping dyspepsia index [Niping dyspepsia lifestyle index（NDLQI），Niping dyspepsia symptom index（NDSI）] before and after treatment between two groups were compared，and the total effective rate of the two groups was compared. [Results] After treatment，the main symptom scores of the observation group were lower than those of the control group（P<0.05），while VPP and fwere higher than those of the control group（P<0.05）. The levels of serum GAS，MLT，Ghrelin and NPSR1 were higher than those of the control group（P<0.05），while the levels of SS were lower than those of the control group；NDLQI was higher than that of the control group（P<0.05），and NDSI was lower than that of the control group（P<0.05）. The total effective rate of treatment was higher than that of the control group（P<0.05）. [Conclusion] The combination of Xiaochaihu Decoction and modified Zuojin Pills can effectively alleviate FD related symptoms and it has a significant therapeutic effect on liver stomach stagnation heat type FD.