行气通降片治疗餐后不适综合征肝胃不和证的临床疗效

doi:10.11958/20250337

摘要/Abstract

摘要：

目的探究行气通降片治疗餐后不适综合征（PDS）肝胃不和证的临床疗效及对患者胃电图指标的影响。方法前瞻性选取300例PDS患者，按照随机数字表法分为对照组（采用枸橼酸莫沙必利+行气通降片模拟剂治疗，151例）和观察组（采用枸橼酸莫沙必利+行气通降片治疗，149例），比较2组中医证候积分、临床疗效、胃电图指标、负性情绪评分、生活质量评分和不良反应发生率。结果 2组治疗后中医证候积分均降低，且观察组较对照组积分更低（P<0.05）；观察组总有效率高于对照组（P<0.05）；2组治疗后整体胃、胃窦的餐前和餐后正常慢波百分比（NGSW）均升高，过缓比例（SR）均降低，且观察组NGSW升高和SR降低均更明显（P<0.05）；2组治疗后汉密尔顿焦虑量表（HAMA）和抑郁量表（HAMD）评分均降低，且观察组评分更低（P<0.05）；2组治疗后尼平消化不良生活质量指数（NDLQI）均升高，且观察组得分更高（P<0.05）；2组不良反应发生率比较，其差异无统计学意义。结论行气通降片能够有效改善餐后不适综合征肝胃不和证患者的胃电图指标，提高临床治疗效果。

关键词: 肝胃不和, 胃电描记术, 餐后不适综合征, 行气通降片, 临床疗效

Abstract:

Objective To explore the clinical efficacy of Xingqi Tongjiang tablets in treating postprandial distress syndrome (PDS) of liver-stomach disharmony syndrome and its impact on electrogastrogram indicators. Methods A total of 300 patients with PDS were prospectively selected and randomly divided into the control group (treated with mosapride citrate + placebo of Xingqi Tongjiang tablets, n=151) and the observation group (treated with mosapride citrate + Xingqi Tongjiang tablets, n=149) according to the random number table method. The levels of traditional Chinese medicine (TCM) syndrome scores, clinical efficacy, electrogastrography indicators, negative emotion scores, quality of life scores and adverse reactions were compared between the two groups. Results After treatment, the TCM syndrome scores of both groups decreased, and the scores of the observation group were lower than those of the control group (P<0.05). The total effective rate of the observation group was higher than that of the control group (P<0.05). After treatment, the percentages of normal gastric slow waves (NGSW) in the overall stomach and gastric antrum before and after meals of both groups increased, and the proportion of slow waves (SR) decreased. Moreover, the increased NGSW and the decreased SR in the observation group were more significant (P<0.05). The scores of the Hamilton Anxiety Scale (HAMA) and the Hamilton Depression Scale (HAMD) decreased after treatment in both groups, and the scores of the observation group were lower (P<0.05). The scores of the Nepean Dyspepsia Quality of Life Index (NDLQI) increased after treatment in both groups, and the scores of the observation group were higher (P<0.05). There were no significant differences in adverse reactions between the two groups. Conclusion Xingqi Tongjiang tablets can effectively improve the electrogastrogram indicators of patients with postprandial distress syndrome of liver-stomach disharmony syndrome, and enhance clinical efficacy.

Key words: syndrome of incoordination between liver and stomach, electrogastrography, postprandial distress syndrome, Xingqi Tongjiang tablets, clinical efficacy

中图分类号:

R259

图/表 7

参考文献 21

[1]	YOSHIDA K, ABE T, KANBARA K, et al. Patients with postprandial distress syndrome experience problems with their interoceptive perceptual function to the gastric region,but their heartbeat perception is normal:a case control study[J]. Biopsychosoc Med, 2023, 17(1):35. doi:10.1186/s13030-023-00290-5.
[2]	WAUTERS L, DICKMAN R, DRUG V, et al. United European Gastroenterology(UEG)and European Society for Neurogastroenterology and Motility(ESNM)consensus on functional dyspepsia[J]. United European Gastroenterol J, 2021, 9(3):307-331. doi:10.1002/ueg2.12061.
[3]	OSHIMA T. Functional dyspepsia:current understanding and future perspective[J]. Digestion, 2024, 105(1):26-33. doi:10.1159/000532082.
[4]	TZIATZIOS G, GKOLFAKIS P, LEITE G, et al. Probiotics in functional dyspepsia[J]. Microorganisms, 2023, 11(2):351. doi:10.3390/microorganisms11020351.
[5]	XIAO M, ZHONG L, LAM W C, et al. Zhizhu Kuanzhong Capsule in treating patients with functional dyspepsia postprandial distress syndrome:study protocol for a multicenter,randomized,double-blind,placebo-controlled,parallel-group clinical trial[J]. Trials, 2022, 23(1):454. doi:10.1186/s13063-022-06396-5.
[6]	DROSSMAN D A. Functional gastrointestinal disorders:history,pathophysiology,clinical features,and Rome Ⅳ[J]. Gastroenterology, 2016, S0016-5085(16)00223-7. doi:10.1053/j.gastro.2016.02.032.
[7]	中国中西医结合学会消化系统疾病专业委员会. 功能性消化不良中西医结合诊疗共识意见(2017年)[J]. 中国中西医结合消化杂志, 2017, 25(12):889-894.
	Digestive Disease Committee, Chinese Association of Integrative Medicine. Consensus Opinions on the Diagnosis and Treatment of Functional dyspepsia Combined with Traditional Chinese and Western Medicine(2017)[J]. Chin J Integr Trad West Med Dig, 2017, 25(12):889-894. doi:10.3969/j.issn.1671-038X.2017.12.01.
[8]	中华中医药学会脾胃病分会, 张声生. 功能性消化不良中医诊疗专家共识意见(2017)[J]. 中华中医药杂志, 2017, 32(6):2595-2598.
	Branch of Gastrointestinal Diseases,China Association of Chinese Medicine, ZHANG S S. Expert consensus on traditional Chinese medicine diagnosis and treatment of functional dyspepsia(2017)[J]. CJTCMP, 2017, 32(6):2595-2598.
[9]	郑筱萸. 中药新药临床研究指导原则[M]. 北京: 中国医药科技出版社, 2002:157.
	ZHENG X Y. Guiding principles for clinical research of new traditional Chinese medicine drugs[M]. Beijing: China Medical Science and Technology Press, 2002:157.
[10]	CHEN N, XI J, FAN X. Correlations among psychological resilience,cognitive fusion,and depressed emotions in patients with depression[J]. Behav Sci (Basel), 2023, 13(2):100. doi:10.3390/bs13020100.
[11]	TALLEY N J, VERLINDEN M, JONES M. Validity of a new quality of life scale for functional dyspepsia:a United States multicenter trial of the Nepean Dyspepsia Index[J]. Am J Gastroenterol, 1999, 94(9):2390-2397. doi:10.1111/j.1572-0241.1999.01363.x.
[12]	CARBONE F, VANDENBERGHE A, HOLVOET L, et al. A double-blind randomized,multicenter,placebo-controlled study of itopride in functional dyspepsia postprandial distress syndrome[J]. Neurogastroenterol Motil, 2022, 34(8):e14337. doi:10.1111/nmo.14337.
[13]	DU J, FENG Y, YUAN Q, et al. Efficacy of acupuncture treatment for postprandial distress syndrome:a systematic review and meta-analysis[J]. J Immunol Res, 2022, 2022:6969960. doi:10.1155/2022/6969960.
[14]	WATANABE T, MASAOKA T, KAMEYAMA H, et al. Efficacy of slow nutrient drinking test for evaluating postprandial distress symptom in Japanese patients with functional dyspepsia[J]. J Neurogastroenterol Motil, 2022, 28(3):424-430. doi:10.5056/jnm21075.
[15]	SINHA S, CHARY S, THAKUR P, et al. Efficacy and safety of acotiamide versus mosapride in patients with functional dyspepsia associated with meal-induced postprandial distress syndrome:a phase III randomized clinical trial[J]. Cureus, 2021, 13(9):e18109. doi:10.7759/cureus.18109.
[16]	林晴, 余如丹, 王文荣. 超声检查对脾胃虚寒(弱)证和肝胃不和证餐后不适综合征患者胃容受性及胃排空功能的评估[J]. 河北中医, 2022, 44(5):743-747.
	LIN Q, YU R D, WANG W R. Evaluation of ultrasonography for gastric accommodation and gastric emptying function in patients with postprandial distress syndrome of spleen-stomach deficiency cold and liver-stomach disharmony syndrome[J]. Hebei Journal of Traditional Chinese Medicine, 2022, 44(5):743-747. doi:10.3969/j.issn.1002-2619.2022.05.009.
[17]	黄逸, 李敏, 袁星茹, 等. 引气归元针法联合电磁波治疗仪治疗肝胃不和型餐后不适综合征的临床研究[J]. 广州中医药大学学报, 2021, 38(12):2674-2680.
	HUANG Y, LI M, YUAN X R, et al. Clinical study on acupuncture therapy with conducting Qi Back to its source combined with teding diancibo pu therapeutic apparatus in treatment of postprandial discomfort syndrome of disharmony between liver and stomach type[J]. Journal of Guangzhou University of Traditional Chinese Medicine, 2021, 38(12):2674-2680. doi:10.13359/j.cnki.gzxbtcm.2021.12.022.
[18]	章静, 王超, 范美庆. 择时中药热奄包配合五音疗法治疗餐后不适综合征临床研究[J]. 浙江中西医结合杂志, 2022, 32(9):847-850.
	ZHANG J, WANG C, FAN M Q. Traditional Chinese medicine Reyanbao combined with five-tone therapy for postprandial discomfort syndrome[J]. Zhejiang Journal of Integrated Traditional Chinese and Western Medicine, 2022, 32(9):847-850. doi:10.3969/j.issn.1005-4561.2022.09.016.
[19]	LU J, LI W, GAO T, et al. The association study of chemical compositions and their pharmacological effects of Cyperi Rhizoma(Xiangfu),a potential traditional Chinese medicine for treating depression[J]. J Ethnopharmacol, 2022, 287:114962. doi:10.1016/j.jep.2021.114962.
[20]	ZHAO Q, LIU J, CHEN L, et al. Phytomedicine Fructus Aurantii-derived two absorbed compounds unlock antidepressant and prokinetic multi-functions via modulating 5-HT(3)/GHSR[J]. J Ethnopharmacol, 2024, 323:117703. doi:10.1016/j.jep.2024.117703.
[21]	CHEN C, GONG W, TIAN J, et al. Radix Paeoniae Alba attenuates Radix Bupleuri-induced hepatotoxicity by modulating gut microbiota to alleviate the inhibition of saikosaponins on glutathione synthetase[J]. J Pharm Anal, 2023, 13(6):640-659. doi:10.1016/j.jpha.2023.04.016.

组别	n	治疗前	治疗后	t
对照组	151	15.28±2.31	8.55±1.87	27.702^＊＊
观察组	149	15.37±2.25	7.16±1.48	38.439^＊＊
t		0.086	8.701^＊＊

组别	n	治疗前	治疗后	t
对照组	151	15.28±2.31	8.55±1.87	27.702^＊＊
观察组	149	15.37±2.25	7.16±1.48	38.439^＊＊
t		0.086	8.701^＊＊

组别	n	痊愈	显效	有效	无效	总有效
对照组	151	16（10.60）	55（36.42）	44（29.14）	36（23.84）	115（76.16）
观察组	149	33（22.15）	64（42.95）	37（24.83）	15（10.07）	134（89.93）
Z或χ²		3.862^＊＊				10.084^＊＊

组别	n	痊愈	显效	有效	无效	总有效
对照组	151	16（10.60）	55（36.42）	44（29.14）	36（23.84）	115（76.16）
观察组	149	33（22.15）	64（42.95）	37（24.83）	15（10.07）	134（89.93）
Z或χ²		3.862^＊＊				10.084^＊＊

组别	n		整体胃NGSW						整体胃SR
组别	n		治疗前		治疗后		t		治疗前		治疗后		t
对照组	151		45.42±4.27		64.38±4.56		38.692^＊＊		36.12±2.47		18.67±3.27		56.450^＊＊
观察组	149		45.13±4.66		71.43±5.21		46.880^＊＊		35.79±2.58		15.23±2.34		75.113^＊＊
t			0.058		13.706^＊＊				1.920		11.069^＊＊
组别		胃窦NGSW						胃窦SR
组别		治疗前		治疗后		t		治疗前		治疗后		t
对照组		44.14±4.47		62.84±4.66		37.197^＊＊		39.55±5.23		13.22±4.44		44.047^＊＊
观察组		44.21±4.38		68.55±4.96		44.412^＊＊		39.68±5.19		10.56±4.89		50.109^＊＊
t		0.099		10.644^＊＊				0.346		5.922^＊＊