张霓　姜慧晖　陈吉文

[摘要]目的 比较加味柴胡疏肝散与西药泮托拉唑及多潘立酮治疗肝郁气滞型功能性消化不良的临床效果。方法 选择2016年2月～2017年5月于我院治疗的肝郁气滞型功能性消化不良患者140例，将其随机分为观察组和对照组，每组各70例。对照组口服泮托拉唑肠溶胶囊及多潘立酮片剂治疗，观察组服用加味柴胡疏肝散治疗。评价两组患者治疗后临床效果、中医证候积分以及血清胃动素、胃泌素水平。结果 观察组患者的总有效率显著高于对照组（P<0.05）。治疗前，两组的中医证候总积分比较，差异无统计学意义（P>0.05）。治疗后，两组的中医证候总积分均较治療前显著下降，且观察组治疗后的中医证候总积分显著低于对照组（P<0.05）。治疗后，两组患者的血清胃动素水平均较治疗前显著升高，胃泌素水平均较治疗前显著下降（P<0.05）。治疗后，观察组患者的血清胃动素水平显著高于对照组，血清胃泌素水平显著低于对照组（P<0.05）。结论 加味柴胡疏肝散治疗肝郁气滞型功能性消化不良能够显著改善患者的中医证候，加强胃动力，促进胃排空，值得临床进一步推广。

[关键词]加味柴胡疏肝散；功能性消化不良；肝郁气滞证；中医证候

[中图分类号] R57 [文献标识码] A [文章编号] 1674-4721（2018）7（b）-0147-04

[Abstract] Objective To compare the clinical effect of Modified Chaihu Shugan Powder and western medicine in the treatment of functional dyspepsia with liver depression and qi stagnation. Methods All of 140 patients functional dyspepsia of liver depression and qi stagnation treated in our hospital from February 2016 to May 2017 were selected and they were randomly divided into the observation group and control group，and there were 70 cases in each group. The control group was treated with Pantoprazole Enteric Capsules and Domperidone Tablets， while the observation group was treated with Modified Chaihu Shugan Powder. The clinical effect， the change of TCM syndrome score and the serum motilin and gastrin in patients of the two groups after treatment were evaluated. Results The total effective rate of the observation group was significantly higher than that of the control group （P<0.05）. Before treatment， there was no significant difference in the total score of TCM syndrome between the two groups （P>0.05）. After treatment， the total score of TCM syndrome in the two groups was significantly lower than that before treatment， and the total score of TCM syndrome after treatment in the observation group was significantly lower than that of the control group （P<0.05）. After treatment， serum motilin level in the two groups were significantly higher than those before treatment， and gastrin level were significantly lower than those before treatment （P<0.05）. After treatment， the serum motilin level in the observation group was significantly higher than that in the control group， and the serum gastrin level was significantly lower than that in the control group （P<0.05）. Conclusion Modified Chaihu Shugan Powder and western medicine in the treatment of functional dyspepsia with liver depression and qi stagnation can significantly improve TCM syndrome， promote the gastric motility and promote gastric emptying， and it is worthy of further clinical popularization.

[Key words] Modified Chaihu Shugan Powder； Functional dyspepsia； Liver depression and Qi stagnation syndrome； TCM syndrome

功能性消化不良是临床最常见的功能性胃肠病，其主要临床表现为上腹部疼痛、胃部烧灼感、早饱等，且经检查无可引起以上症状的器质性病变，可反复发作或持续性发作，临床病程很长且不易治愈[1]。功能性消化不良的发病诱因较多，其中精神因素较常见，精神紧张或抑郁状态下，胃运动及分泌减弱甚至停止，并且引起体内某些激素异常分泌及植物神经功能紊乱。功能性消化不良的中医发病机制是脾胃纳运失常，中医证型中肝郁气滞型所占比例最高[2]。柴胡疏肝散具有疏肝理气，活血止痛之功效，主治肝气郁滞证，遵《内经》“木郁达之”之旨，治宜疏肝理气之法[3]。本研究在原方基础上加味，评价该方对功能性消化不良肝郁气滞证的临床疗效，现报道如下。……