CAJ | 학술논문

背景:现代医学对糖尿病性胃轻瘫的发病机制尚未完全阐明,应用胃动康治疗可能获得一定的疗效.目的:观察胃动康治疗糖尿病性胃轻瘫的临床疗效,并与吗丁啉的疗效进行对比.设计:病例-对照观察.单位:重庆师范大学校医院中医科,重庆市中医研究院.对象:选择2001-04/2005-12重庆师范大学校医院和重庆市中医研究院门诊及住院的糖尿病性胃轻瘫患者60例,随机分为两组:①治疗组(n=30):男20例,女10例,年龄31～58 岁,病程0.5～26 年.②对照组(n=30):男18例,女12例;年龄30～69 岁,病程0.5～20 年.所有患者对实验均知情同意.方法:治疗组口服胃动康水煎剂(由厚朴、枳实、槟榔、大黄、柴胡、白术、石斛组成,100 mL/瓶,含生药100 mg,由重庆市中医研究院制剂室提供),3次/d,30 mL/次;对照组用吗丁啉,10 mg/次,3次/d.用药4周.分别于治疗前后观察两组患者的症状积分、胃液体半排空时间、疗效评价、生活质量得分及安全性.主要观察指标:两组治疗前后的症状积分、胃液体半排空时间、疗效评价、生活质量得分及安全性比较.结果:60例糖尿病性胃轻瘫患者全部进入结果分析.①消化不良症状改善情况:治疗后,两组的症状积分和总积分均明显低于治疗前(P＜0.01),治疗组的上腹胀满、恶心呕吐、食欲减退及上腹痛症状积分均明显低于对照组(P＜0.05～0.01).②临床疗效:治疗组总有效率90.0%(27/30),明显高于对照组[73.3%(22/30),P＜0.05].③胃液体半排空时间:治疗组治疗后较治疗前有明显改善(P＜0 01).④SF-36生活质量改善情况:治疗后,治疗组总体健康、躯体疼痛、活力及精神健康维度的得分明显高于治疗前(P＜0.05);对照组总体健康和精神健康维度得分明显高于治疗前(P＜0.05).⑤安全性评估:治疗组治疗后实验室检查与治疗前比较,差异均不明显(P＞0.05).结论:胃动康治疗糖尿病性胃轻瘫具有良好的临床疗效和安全性. 揹景:現代醫學對糖尿病性胃輕癱的髮病機製尚未完全闡明,應用胃動康治療可能穫得一定的療效.目的:觀察胃動康治療糖尿病性胃輕癱的臨床療效,併與嗎丁啉的療效進行對比.設計:病例-對照觀察.單位:重慶師範大學校醫院中醫科,重慶市中醫研究院.對象:選擇2001-04/2005-12重慶師範大學校醫院和重慶市中醫研究院門診及住院的糖尿病性胃輕癱患者60例,隨機分為兩組:①治療組(n=30):男20例,女10例,年齡31～58 歲,病程0.5～26 年.②對照組(n=30):男18例,女12例;年齡30～69 歲,病程0.5～20 年.所有患者對實驗均知情同意.方法:治療組口服胃動康水煎劑(由厚樸、枳實、檳榔、大黃、柴鬍、白術、石斛組成,100 mL/瓶,含生藥100 mg,由重慶市中醫研究院製劑室提供),3次/d,30 mL/次;對照組用嗎丁啉,10 mg/次,3次/d.用藥4週.分彆于治療前後觀察兩組患者的癥狀積分、胃液體半排空時間、療效評價、生活質量得分及安全性.主要觀察指標:兩組治療前後的癥狀積分、胃液體半排空時間、療效評價、生活質量得分及安全性比較.結果:60例糖尿病性胃輕癱患者全部進入結果分析.①消化不良癥狀改善情況:治療後,兩組的癥狀積分和總積分均明顯低于治療前(P＜0.01),治療組的上腹脹滿、噁心嘔吐、食欲減退及上腹痛癥狀積分均明顯低于對照組(P＜0.05～0.01).②臨床療效:治療組總有效率90.0%(27/30),明顯高于對照組[73.3%(22/30),P＜0.05].③胃液體半排空時間:治療組治療後較治療前有明顯改善(P＜0 01).④SF-36生活質量改善情況:治療後,治療組總體健康、軀體疼痛、活力及精神健康維度的得分明顯高于治療前(P＜0.05);對照組總體健康和精神健康維度得分明顯高于治療前(P＜0.05).⑤安全性評估:治療組治療後實驗室檢查與治療前比較,差異均不明顯(P＞0.05).結論:胃動康治療糖尿病性胃輕癱具有良好的臨床療效和安全性.
배경:현대의학대당뇨병성위경탄적발병궤제상미완전천명,응용위동강치료가능획득일정적료효.목적:관찰위동강치료당뇨병성위경탄적림상료효,병여마정람적료효진행대비.설계:병례-대조관찰.단위:중경사범대학교의원중의과,중경시중의연구원.대상:선택2001-04/2005-12중경사범대학교의원화중경시중의연구원문진급주원적당뇨병성위경탄환자60례,수궤분위량조:①치료조(n=30):남20례,녀10례,년령31～58 세,병정0.5～26 년.②대조조(n=30):남18례,녀12례;년령30～69 세,병정0.5～20 년.소유환자대실험균지정동의.방법:치료조구복위동강수전제(유후박、지실、빈랑、대황、시호、백술、석곡조성,100 mL/병,함생약100 mg,유중경시중의연구원제제실제공),3차/d,30 mL/차;대조조용마정람,10 mg/차,3차/d.용약4주.분별우치료전후관찰량조환자적증상적분、위액체반배공시간、료효평개、생활질량득분급안전성.주요관찰지표:량조치료전후적증상적분、위액체반배공시간、료효평개、생활질량득분급안전성비교.결과:60례당뇨병성위경탄환자전부진입결과분석.①소화불량증상개선정황:치료후,량조적증상적분화총적분균명현저우치료전(P＜0.01),치료조적상복창만、악심구토、식욕감퇴급상복통증상적분균명현저우대조조(P＜0.05～0.01).②림상료효:치료조총유효솔90.0%(27/30),명현고우대조조[73.3%(22/30),P＜0.05].③위액체반배공시간:치료조치료후교치료전유명현개선(P＜0 01).④SF-36생활질량개선정황:치료후,치료조총체건강、구체동통、활력급정신건강유도적득분명현고우치료전(P＜0.05);대조조총체건강화정신건강유도득분명현고우치료전(P＜0.05).⑤안전성평고:치료조치료후실험실검사여치료전비교,차이균불명현(P＞0.05).결론:위동강치료당뇨병성위경탄구유량호적림상료효화안전성.
BACKGROUND: Modern medicine has not completely clarified the pathogenesis of diabetic gastroparesis, and Weidong Kang may have certain efficacy.OBJECTIVE: To observe the clinical efficacy and safety of Weidong Kang on diabetic gastroparesis, and compare with the efficacy of Motilium.DESIGN: A case-controlled observation.SETTINGS: Department of Traditional Chinese Medicine, Affiliated Hospital of Chongqing Normal University; Chongqing Institute of Traditional Chinese Medicine.PARTICIPANTS: Sixty outpatients and inpatients with diabetic gastroparesis were selected from the Affiliated Hospital of Chongqing Normal University and Chongqing Institute of Traditional Chinese Medicine from April 2001 to December 2005. They were randomly divided into two groups: ① treatment group (n =30): 20 males and 10 females; 31-58 years of age, the disease courses ranged from 0.5 to 26 years; ② control group (n =30): 18 males and 12 females; 30-69 years of age, the disease courses ranged from 0.5 to 20 years. Informed contents were obtained from all the subjects.METHODS: In the treatment group, the patients were treated with oral Weidong Kang decoction, three times a day,30 mL per time; Weidong Kang decoction consisted of official magnolia bark, immature bitter orange, betel nut, rhubarb,Chinese thorowax root, largehead atractylodes rhizome, dendrobium stem, 100 mL/bottle, containing 100 mg crude drug,provided by the Department of Pharmacy, Chongqing Institute of Traditional Chinese Medicine). In the control group, the patients with treated with Motilium, three times a day, 10 mg per time. All the patients were treated for four weeks as a course. The scores of dyspeptic symptoms and the time of gastric semi-emptying of liquid (T/2) were observed, the efficacy, the score of quality of life (QOL) and safety were evaluated before and after treatment.MAIN OUTCOME MEASURES: Scores of dyspeptic symptoms; Time of gastric semi-emptying of liquid (T/2); Evaluation of efficacy; score of QOL; Safety.RESULTS: All the 60 patients with diabetic gastroparesis were involved in the analysis of results. ① Amelioration of dyspeptic symptoms: After treatment, the scores of dyspeptic symptoms an total score were all obviously lower than those before treatment in both groups (P ＜ 0.01), the scores of epigastric satiety, nausea and vomiting, decreased appetite and epigastric pain in the treatment group were all obviously lower than those in the control group (P ＜ 0.05-0.01). ② Clinical efficacy: The total effective rate in the treatment group was obviously higher than that in the control group [90.0% (27/30); 73.3% (22/30), P ＜ 0.05]. ③ Time of gastric semi-emptying of liquid (T/2): In the treatment group,it was obviously ameliorated after treatment as compared with that before treatment (P ＜ 0.01). ④ Amelioration of QOL by symptom frequency-36 health survey (SF-36): In the treatment group, the scores of general health, somatic pain,vigor and mental health after treatment were obviously higher than those before treatment (P ＜ 0.05). In the control group, the scores of general health and mental health after treatment were obviously higher than those before treatment (P ＜ 0.05). ⑤ Evaluation of safety: In the treatment, there were no obvious differences in the blood and urine routine examinations, liver function and kidney function before and after treatment (P ＞ 0.05).CONCLUSION: Weidong Kang is an effective and safe drug for alleviating dyspeptic symptoms in patients with diabetic gastroparesis.