曲美布汀联合复方枸橼酸阿尔维林治疗功能性消化不良的临床疗效观察

发布时间：2018-06-07 02:42

本文选题：曲美布汀 + 复方枸橼酸阿尔维林　；参考：《吉林大学》2014年硕士论文

【摘要】：目的：通过观察治疗前后患者餐后饱胀、早饱、上腹痛、上腹部烧灼感症状缓解情况、症状改善的平均时间、综合疗效情况、不良反应发生情况、胃电图参数变化情况，探讨曲美布汀与复方枸橼酸阿尔维林联合治疗功能性消化不良的临床疗效及安全性。方法：选取2012年9月至2013年10月在我院消化内科门诊及住院的功能性消化不良患者100例（按照功能性消化不良罗马III诊断标准，经相关检查排除器质性、系统性及代谢性疾病），将患者随机分为A、B、C三组，各组患者在年龄、性别、临床症状构成等方面均无差异，具有可比性，患者在入组前1周均未服用任何对本研究疗效评价有影响的药物。A组（33例）：马来酸曲美布汀片0.2g，3次/日，餐前口服；B组（33例）：复方枸橼酸阿尔维林1粒，2次/日，餐前口服；C组（34例）：马来酸曲美布汀片0.2g，，3次/日，餐前口服，联合复方枸橼酸阿尔维林1粒，2次/日，餐前口服。疗程共4周。观察各组主要临床症状缓解情况、症状改善平均时间、综合疗效情况、不良反应发生情况、胃电图参数变化情况等。疗程结束后应用统计学方法比较三组患者的临床疗效。结果：治疗4周后所有患者均完成临床观察 1、治疗后曲美布汀联合复方枸橼酸阿尔维林组（C组）在餐后饱胀、早饱、上腹痛方面的缓解率明显高于单用曲美布汀组（A组）及单用枸橼酸阿尔维林组（B组），差异有统计学意义（P＜0.05）；C组的上腹部烧灼感缓解率较A组及B组高，但差异无统计学意义（P＞0.05），A组与B组各项症状缓解率差异无统计学意义（P＞0.05）。 2、治疗后曲美布汀联合复方枸橼酸阿尔维林组（C组）总有效率明显高于单用曲美布汀组（A组）及单用枸橼酸阿尔维林组（B组），差异有统计学意义（P＜0.05）；A、B两组间总有效率相似，差异无统计学意义（P＞0.05）。 3、曲美布汀联合复方枸橼酸阿尔维林组（C组）的症状改善平均时间为明显短于单用曲美布汀组（A组）及单用枸橼酸阿尔维林组（B组），差异有统计学意义（P＜0.05）；A组与B组的症状改善平均时间相近，差异无统计学意义（P＞0.05）。 4、治疗期间三组均有少数患者出现不良反应，但三组间不良反应发生率的差异无统计学意义（P＞0.05）。 5、治疗后三组患者胃电图的正常慢波百分比均较治疗前增加，C组最为明显，A组次之，三组的胃动过缓及胃动过速百分比均较治疗前下降，C组最明显，A组次之。结论：曲美布汀联合复方枸橼酸阿尔维林对改善功能性消化不良患者的餐后饱胀、早饱、上腹痛症状、症状改善平均时间、总有效率方面均明显优于单用曲美布汀及单用复方枸橼酸阿尔维林组，且不良反应发生率未见明显增加，同时能明显改善患者胃电节律紊乱情况，促使胃肠运动恢复正常，具有较好的临床应用价值。
[Abstract]:Objective: to observe the relief of symptoms of postprandial fullness, early satiety, epigastric pain and burning sensation in the upper abdomen, the average time of symptom improvement, the comprehensive curative effect, the occurrence of adverse reactions and the changes of electrogastrogram parameters before and after treatment. To explore the clinical efficacy and safety of trimebutine combined with compound Alverin citrate in the treatment of functional dyspepsia. Methods: from September 2012 to October 2013, 100 patients with functional dyspepsia were selected from outpatients and inpatients in our hospital from September 2012 to October 2013. According to III diagnostic criteria of functional dyspepsia, organic factors were excluded by relevant examination. Patients with systemic and metabolic diseases were randomly divided into three groups: group A, B, B, C, and there were no differences in age, sex, clinical symptom composition and so on. 33 patients in group A received trimebutine maleate (0.2g / d) three times a day, 33 patients in group B were treated with trimebutine maleate 3 times a day, and 33 patients in group B were treated with trimebutine maleate once a day. Thirty-four patients in group C were treated with trimebutine maleate 0.2g / d before meal combined with Alverin citrate once a day and orally before meal. The course of treatment was 4 weeks. The main clinical symptoms were relieved, the average time of symptom improvement, the comprehensive curative effect, the occurrence of adverse reactions and the changes of electrogastrogram parameters were observed. The clinical effects of the three groups were compared by statistical method after the end of the course of treatment. Results: all the patients completed the clinical observation after 4 weeks of treatment. 1. After treatment, trimebutine combined with compound Alverin citrate group C) was full after meal. The relief rate of epigastric pain was significantly higher than that of trimebutine group (A group) and Alverin citrate group (P < 0.05). The relief rate of upper abdominal burning sensation in group C was higher than that in group A and group B. But there was no significant difference (P > 0.05) between group A and group B, there was no significant difference in the remission rate of symptoms between group A and group B (P > 0.05). 2. After treatment, the total effective rate of trimebutine combined with compound Alverin citrate group (C) was significantly higher than that of trimebutine group (A group) and alviridine citrate group (B group). The difference was statistically significant (P < 0.05) and the total effective rate was similar between the two groups. The difference was not statistically significant (P > 0.05). 3. The average time of symptom improvement in trimebutine combined with compound Alverin citrate group was significantly shorter than that in trimebutine group A (P < 0.05) and Alverin citrate group (P < 0.05). The mean time of symptom improvement in the group was similar. The difference was not statistically significant (P > 0.05). 4. There were a few adverse reactions in the three groups during the treatment period, but there was no significant difference in the incidence of adverse reactions among the three groups (P > 0.05). 5. After treatment, the percentage of normal slow wave of electrogastrogram in the three groups was significantly higher than that in group C before treatment, followed by group A, and the percentage of slow motility and over motility in group A was lower than that in group C before treatment. Conclusion: trimebutine combined with compound Alverin citrate can improve the symptoms of postprandial fullness, early satiety, upper abdominal pain and symptom improvement in patients with functional dyspepsia. The total effective rate was significantly better than that of trimebutine alone and Alverin citrate alone, and the incidence of adverse reactions was not significantly increased. At the same time, the gastric electrical rhythm disorder was significantly improved and gastrointestinal motility returned to normal. It has good clinical application value.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R57

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