韩笑 王秀阁 何泽 隋晓丹 包扬 金美英

[摘要] 目的 观察消痞通络方干预糖尿病胃轻瘫（寒热错杂证）的临床疗效，探讨其作用机制。方法 选取2018年7月—2019年3月该院收治的70例糖尿病胃轻瘫患者，随机分为实验组和对照组，前者给予中药消痞通络方联合枸橼酸莫沙必利片治疗，后者给予枸橼酸莫沙必利片治疗，每组各35例。观察治疗前后各组中医证候积分、胃排空、胃泌素、胃动素的指标变化。结果 实验组有效率91.4%，对照组有效率85.7%，差异有统计学意义（P<0.05）;治疗前后两组中医证候积分、胃动素、胃泌素组内和组间对比，差异有统计学意义（P<0.05）。 结论 消痞通络方能够改善糖尿病胃轻瘫（寒热错杂证）临床症状，促进胃排空，作用机制与调节胃动素、胃泌素有关。

[关键词] 中医药;胃轻瘫;糖尿病;络病;临床观察

[中图分类号] R259          [文献标识码] A          [文章编号] 1672-4062（2020）01（b）-0012-03

[Abstract] Objective To observe the clinical efficacy of Xiaopitongluo Recipe in intervention of diabetic gastroparesis （cold fever and miscellaneous syndrome） and to explore its mechanism. Methods Seventy patients with diabetic gastroparesis admitted to the hospital from July 2018 to March 2019 were randomly divided into experimental group and control group. The former was given Chinese medicine Xiaopitongluo combined with mosapride citrate tablets， and the latter was treated with mosapride citrate tablets. Each group has 35 cases. The changes of TCM syndrome scores， gastric emptying， gastrin and motilin were observed before and after treatment. Results The effective rate of the experimental group was 91.4%， and the effective rate of the control group was 85.7%. The difference was statistically significant（P<0.05）. The difference between TCM syndrome scores， motilin， gastrin group and group between the two groups before and after treatment， statistically significant（P<0.05）. Conclusion Xiaopitongluo Recipe can improve the clinical symptoms of diabetic gastroparesis （cold fever and miscellaneous syndrome） and promote gastric emptying. The mechanism of action is related to the regulation of motilin and gastrin.

[Key words] Traditional Chinese medicine; Gastroparesis; Diabetes; Collateral disease; Clinical observation

糖尿病胃轻瘫是糖尿病的慢性并发症之一，以腹胀、恶心、呕吐为主要临床表现，严重者可并发酮症、低血糖、营养不良等危证，导致患者生活质量下降。现代医学以促进胃动力药及手术治疗为主，中医药治疗简、便、易、廉，近年来显示良好的治疗前景，课题组采用消痞通络方治疗2018年7月—2019年3月收治的35例糖尿病胃轻瘫患者，取得较好的临床疗效，并从胃肠激素机制探讨如下。

1  资料与方法

1.1 一般资料

选取糖尿病胃轻瘫患者70例，随机分为实验组和对照组，每组各35例，所有病例来源于长春中医药大学附属医院内分泌科门诊及疗区的患者，实验组给予消痞通络方联合枸橼酸莫沙必利片治疗，对照组应用枸橼莫沙必利片治疗，两组患者性别、年龄、病程一般情况如下（表1）。

1.2  西医诊断标准

参照《胃轻瘫临床管理指南》[1]（ACG，2013，1）和《实用糖尿病学》（第三版）。……