香砂养胃汤治疗功能性消化不良的临床与实验研究

发布时间：2018-05-18 15:11

  本文选题：功能性消化不良 + 香砂养胃汤　； 参考：《延边大学》2017年硕士论文

【摘要】：研究目的:通过香砂养胃汤治疗功能性消化不良的临床与实验研究,探讨临床上采用朝医少阴人方治疗功能性胃肠病的有效性、安全性,为临床应用提供更可靠的依据。研究方法:1.临床研究:将辨象为少阴人并符合诊断标准及纳入标准的60例患者,随机分成治疗组和对照组,各30例。治疗组给予香砂养胃汤,将每味药量按原方增加1倍,每日1剂水煎分早晚餐前服用。对照组为莫沙必利片,5mg/次,日三次口服。疗程为2周。疗程结束后,观察两组治疗前后的愈显率、证候总积分、总体有效率、检测外周血胃动素值等指标,最终判定该方的临床疗效。2.实验研究:将60只大鼠随机分成6组,即正常对照组、模型对照组、阳性对照组、香砂养胃汤高、中、低剂量组,每组10只,雌雄各半。适应性喂养5天后,采用利血平法制造功能性消化不良模型。正常组和模型组每日给予无菌生理盐水2ml,阳性对照组给予0.3mg/kg体重的莫沙必利片混悬液2ml,香砂养胃汤高、中、低剂量组的给药量为4.4g/kg、2.2g/kg、1.1g/kg,给药体积均为2ml,灌喂14天后,禁食不禁水24小时,次日在麻醉状态下,进行眼球取血,并处理样本。最后检测大鼠血清胃动素及胃泌素等指标,进行比较分析。研究结果:1.临床试验研究结果:(1)香砂养胃汤治疗组愈显率为60%,对照组为51.7%,两组比较无显著性差异(P0.05);治疗组总有效率为93.3%,对照组为65.5%,两组比较具有显著性差异(P0.05),说明香砂养胃汤对功能性消化不良的总体疗效优于莫沙必利。香砂养胃汤组症状总积分以及胃脘疼痛、喜温喜按、手足不温、神疲倦怠等症状,与对照组比较,有显著性差异(P0.05),说明香砂养胃汤各项症状总体改善程度优于对照组,特别是在胃脘疼痛、喜温喜按、手足不温、神疲倦怠等症状的改善程度明显优于对照组。(2)香砂养胃汤治疗前后血清人胃动素浓度差异有统计学意义(P0.05),说明香砂养胃汤能增高FD患者静脉血胃动素浓度;香砂养胃汤和莫沙必利治疗组治疗后血清胃动素浓度进行比较,发现香砂养胃汤增高FD患者静脉血胃动素浓度的作用优于对照组。(3)本研究具体治疗前后,对比复查三大常规,肝、肾功能及心电图等均未出现明显异常。2.动物实验研究结果:(1)香砂养胃汤对大鼠血清胃动素的影响方面,与模型组相比,香砂养胃汤各剂量组与莫沙必利组差异均有统计学意义(P0.05),血清胃动素浓度增高,而香砂养胃汤组与莫沙必利组比较无统计学意义(P0.05),提示香砂养胃汤各剂量与莫沙必利均能增强胃肠蠕动功能,而两种药物作用效果无显著性差异。(2)香砂养胃汤对大鼠血清胃泌素的影响方面,与模型组相比,香砂养胃汤高、中剂量组与莫沙必利组差异均有统计学意义(P0.05),而香砂养胃汤组与对照组比较无统计学意义(P0.05),提示香砂养胃汤高、中剂量组与莫沙必利组均能增高血清胃泌素浓度,而两种药物作用效果无显著性差异。结论:通过临床试验,香砂养胃汤在功能性消化不良患者各项症状总体改善程度优于对照组,还能提高功能性消化不良患者静脉血胃动素浓度,从而可以有效地去除患者的不适症状,提高有效率。通过动物实验,发现香砂养胃汤增加大鼠血清胃动素及胃泌素含量,从而增强胃肠蠕动,调节胃肠功能。临床试验和动物实验过程中均未出现明显异常反应及毒副反应,说明香砂养胃汤方无毒副作用,用药安全可靠。
[Abstract]:Objective: To explore the clinical and experimental study on functional dyspepsia treated by Xiang Sha Yangwei decoction, and to explore the effectiveness and safety of treating functional gastrointestinal diseases with the treatment of Shao Yin people in clinical medicine, and to provide more reliable basis for clinical application. 1. clinical studies: the diagnosis is to identify less Yin people and conform to the standard of diagnosis and the standard of inclusion. 60 patients were randomly divided into the treatment group and the control group, each 30 cases. The treatment group was given the Xiang sand nourishing stomach soup, the dosage of each flavor was increased by 1 times, and 1 doses of water were taken every day before the meal. The control group was mosapride tablets, 5mg/ times, and three times on the day for 2 weeks. After the course of treatment, the healing rate of two groups before and after treatment was observed and the syndrome score, total score, was observed. The overall efficiency, detection of peripheral blood motilin value and other indicators, the final determination of the clinical efficacy of the.2. experimental study: 60 rats were randomly divided into 6 groups, namely the normal control group, the model control group, the positive control group, the fragrant sand Yangwei decoction, the middle, low dose group, each group of 10, and male and male each. After 5 days of adaptive feeding, the use of reserpine method to make the function The normal group and the model group were given the aseptic saline 2ml daily, the positive control group gave the 0.3mg/kg weight of Mosapride suspension 2ml, the fragrant sand nourishing stomach soup high, the medium, the low dose group was 4.4g/kg, 2.2g/kg, 1.1g/kg, the dosage was 2ml, 14 days after feeding, the fasting could not help water for 24 hours, the next day in the anesthetic state. The results of the 1. clinical trials were as follows: (1) the healing rate of the treatment group was 60%, the control group was 51.7%, and the control group was 51.7% (P0.05); the total effective rate was 93.3% in the treatment group and 65.5% in the control group. The two groups had significant difference (P0.05), which showed that the overall effect of Xiang sand Yangwei Decoction on functional dyspepsia was better than that of Mosapride. The symptoms total integral of the group of Xiang sand Yangwei decoction, epigastric pain, warm and happy press, untemperature of hand and foot, deity tired and so on, compared with the control group, there were significant differences (P0.05), indicating the symptoms of Xiang sand nourishing stomach soup. The overall improvement degree was better than the control group, especially in the epigastric pain, hsiwen Xi press, hand and foot temperature, deity tiredness and other symptoms improved significantly better than the control group. (2) the difference of serum motilin concentration in serum was statistically significant (P0.05) before and after the treatment of Xiang sand Yangwei decoction, which indicated that Xiang sand Yangwei decoction could increase the concentration of motilin in venous blood of FD patients; The serum motilin concentration in the Yangwei Decoction and the mosapride treatment group was compared, and the effect of the concentration of motilin in the venous blood of FD patients was better than that of the control group. (3) before and after the specific treatment, three routine examinations were compared, and the liver, renal function and electrocardiogram had no obvious abnormal.2. animal experiment results: (1) Compared with the model group, the effect of Xiang sand Yangwei Decoction on Motilin in rat serum was statistically significant (P0.05), and the concentration of serum motilin was higher than that in the model group (P0.05), but there was no statistically significant difference between the Xiang sand Yangwei Decoction group and the mosapride group (P0.05), suggesting that the dosage of the Xiang sand Yangwei Decoction and the mosapride were different. The effect of the two drugs had no significant difference. (2) the effect of Xiang sand Yangwei Decoction on serum gastrin in rats was higher than that in the model group, and the difference between the medium dose group and the mosapride group was statistically significant (P0.05), but there was no significant difference between the group and the control group (P0. 05), suggesting that Xiang sand nourishing stomach soup is high, both medium dose group and Mosapride group can increase serum gastrin concentration, but the effect of two kinds of drugs have no significant difference. Conclusion: through clinical trial, the overall improvement degree of Xiang sand nourishing stomach soup in functional dyspepsia is better than that of the control group, and it can also improve the static patients with functional dyspepsia. The concentration of motilin in blood can effectively remove the discomfort symptoms and improve the efficiency of the patients. Through animal experiments, it is found that the fragrant sand nourishing stomach soup increases the serum motilin and gastrin content in rats, thus enhancing the gastrointestinal peristalsis and regulating the gastrointestinal function. There is no obvious abnormal reaction and side effects in the clinical trials and animal experiments. It shows that Xiang Sha Yangwei decoction has no toxic side effects and is safe and reliable.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259
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本文编号：1906316