陈波+崔云竹

【摘要】目的：观察莫沙必利合加味小柴胡汤治疗肝郁脾虚型2型糖尿病胃轻瘫的临床效果。方法：将60例肝郁脾虚型2型糖尿病胃轻瘫患者随机分为对照组和观察组各30例。观察组在降糖基础上均给予枸橼酸莫沙必利片治疗，治疗组在此基础上加用加味小柴胡汤。两组均以14d为1个疗程，1个疗程后观察临床疗效及胃泌素（GAS）、生长抑制素（SS）变化情况。结果：治疗组总有效率为93.3%，高于对照组的70.0%，差异具有统计学意义（P<0.05）；GAS、SS检测治疗前后及组间比较差异具有高度统计学意义（P<0.01）， 结论：莫沙必利合加味小柴胡汤方案效果无论从临床表现还是GAS、SS检测结果上均优于单纯服用莫沙必利方案，值得进行进一步研究，为临床治疗肝郁脾虚型2型糖尿病胃轻瘫提供治疗方法与思路。

【关键词】莫沙必利；加味小柴胡汤；肝郁脾虚；2型糖尿病胃轻瘫

【中图分类号】R587.2 【文献标志码】 A 【文章编号】1007-8517（2016）08-0043-02

Abstract：Objective Related to the performance of Mosapride combined with Xiaocaihu decoction in the treatment of liver stagnation and spleen deficiency type 2 diabetic gastroparesis；Methods The 60 cases of liver stagnation and spleen deficiency type 2 diabetes stomach paresis patients were randomly divided into control group and treatment group， two groups of patients on basal insulin were given mosapride citrate mosapride tablets a day 3 times， 15 mg， the treatment group based on the combined with modified Minor Radix Bupleuri decoction. Eachgroup was treated for 14 days， the clinical effect and GAS and SS were observed after 1 courses of treatment， two groups.Results The total effective rate in the treatment group was 93.3%， and the control group was 70%（P<0.05）， SS and GAS before and after treatment were compared with the group， with statistical significanceP<0.01.Conclusion Modified Minor Radix Bupleuri Decoction with Mosapride will benefit effect of the scheme in terms of the clinical manifestations and detection of gas and SS were better than the simple use of Mosapride will benefit scheme， and is worthy of further research and for clinical treatment of liver stagnation and spleen deficiency type 2 diabetes stomach paresis provide treatment methods and ideas.

Keywords：Mosapride； Xiaocaihu Decoction； Liver Stagnation and Spleen Deficiency Type 2 Diabetic Gastroparesis

糖尿病胃轻瘫（diabetic gastro paresis，DGP）是糖尿病（diabetes mellitus，DM）的常见并发症之一，以胃功能减弱，胃蠕动减慢及胃内容物排空延迟为特征，主要症状为胃脘胀满、早饱、厌食、嗳气、恶心、呕吐等，症状通常在餐后较为严重，其发病机制复杂，目前认为与糖尿病引起植物神经功能紊乱，造成胃张力缺乏，胃动力紊乱有关。笔者在西药莫沙必利治疗的基础上选用加味小柴胡汤治疗肝郁脾虚型2型糖尿病胃轻瘫30例，临床疗效较好，现报道如下。

1资料与方法

1.1一般资料将2014年3月至2015年10月在山东中医药大学附属医院内分泌科住院的肝郁脾虚型2型糖尿病患者按就诊顺序随机分为观察组及对照组各30例，观察组中男14例，女16例，平均年龄（30.60±16.03）岁，平均病程（4.10±8.03）年；对照组中男13例，女17例，平均年龄（32.30±18.05）岁，平均病程（4.60±7.79）年。两组患者性别、年龄、病程等一般资料比较，差异无统计学意义（P>0.05），具有可比性。

1.2诊断标准依据2007年《糖尿病中医防治指南》的糖尿病诊断标准[1]，符合肝郁脾虚型2型糖尿病；……