宦徽　魏清　涂庆丽　宋洁　邓世玉　刘秋梅　李晓萍

【摘要】目的 探討不同药物对藏族功能性消化不良（FD）患者的疗效及对胃容受、胃肌电图的影响。方法 选取诊断为FD患者的120例藏族患者作为研究对象，按照随机数表法分为A、B、C 3组，A组患者给予莫沙必利治疗，B组给予曲美布汀治疗，C组同时采取A、B组给药方式治疗，连续治疗28 d。比较3组FD患者治疗前后胃肠道症状分级量表（GSRS）评分、胃容受、空腹和餐后胃电参数中的胃电频率、慢波百分比、胃电节律紊乱百分比和偶联百分比，记录患者临床疗效、不良反应。结果 治疗后，A、B、C组治疗总有效率分别为67.50%、65.00%和87.50%，3组比较差异无统计学意义（P > 0.05）;治疗前，3组FD患者GSRS评分、胃容受及空腹、餐后胃电图参数比较差异均无统计学意义（P均> 0.05）;治疗后，3组患者GSRS评分及空腹、餐后的胃电频率与胃电节律紊乱百分比均低于治疗前，胃容受及空腹、餐后慢波百分比与偶联百分比均高于治疗前，C组改善更为明显，与A、B组比较差异均有统计学意义（P均< 0.05）。3组FD患者不良反应的发生率比较差异无统计学意义（P = 0.617）。结论 莫沙必利或曲美布汀可有效改善藏族FD患者临床症状，疗效确切，安全性好。两者协同用药在改善临床症状及胃容受性功能和胃电节律上优于单独用药，但总体有效率仍需进一步验证。

【关键词】藏族;功能性消化不良;莫沙必利;曲美布汀;胃容受;胃电图

【Abstract】Objective To explore the effect of different drugs on Tibetan functional dyspepsia （FD） and their effects on gastric receptivity and electromyogram. Methods A total of 120 Tibetan patients diagnosed with FD in our hospital were selected as the study subjects. According to the random number method， patients were divided into 3 groups： A， B and C. Patients in group A were treated with mosapride; patients in group B were treated with trimebutine; and patients in group C were treated with combination of drugs used in group A and B. The treatment period was 28 consecutive days. Patients in the three groups were compared in terms of gastrointestinal symptom rating scale（GSRS） scores， gastric receptivity， and fasting and postprandial electrogastrogram parameters including frequency， percentage of slow waves， percentage of gastric myoelectric arrhythmias， and percentage of couplings before and after treatment. The clinical efficacy and adverse reactions were recorded. Results After treatment， the total effective rate in group A， B， and C was 67.50%， 65.00%， and 87.50% respectively. The comparison differences across three groups had no statistical significance （P > 0.05）. Before treatment， there were no statistically significant differences in GSRS scores， gastric receptivity， and fasting and postprandial electrogastrogram parameters among the three groups （P > 0.05）. In each group， total symptom scores， fasting and postprandial gastric electrical frequency， and percentage of gastric myoelectric arrhythmias were lower after treatment than those before treatment. Moreover， the gastric receptivity， fasting and postprandial slow wave percentage， and coupling percentage were higher in each group after treatment than those before treatment. The improvement was more prominent in group C compared with group A and B， and the differences were statistically significant （P < 0.05）.There was no significant difference in the incidence of adverse reactions among the three groups （P = 0.617）. Conclusions Mosapride or trimebutine could effectively improve the clinical symptoms of Tibetan FD patients with definite efficacy and good safety. The combinatorial medication outperformed either drug alone in improving clinical symptoms， gastric receptivity， and gastric electric rhythm， whereas the total effective rate need further validation

【Key words】Tibetan;Functional dyspepsia;Mosapride;Trimebutine;Gastric receptivity;

Electrogastrogram

功能性消化不良（FD）是临床常见的消化系统疾病，具有发病范围广且复发率高的特点，以上腹痛、烧灼感、餐后饱胀、早饱感、嗳气、食欲不振、恶心等为主要临床表现[1-2]。据统计，我国FD的发病率接近19%，随着人们生活节奏的加快、饮食结构的改变等原因，发病率呈逐年上升的趋势[3]。汪波等（2017年）研究表明，胃动力障碍是FD发病的重要机制之一，主要表现为胃容受降低及胃电节律紊乱。莫沙必利……