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[目的]探讨疏肝动胃汤治疗功能性消化不良患者肠道气体增多相关症状的疗效及其机制。[方法]根据罗马Ⅲ诊断标准选取功能性消化不良患者40例,予以疏肝动胃汤日服1剂,共4周。在服药前后分别摄立位腹部平片,扫描进入计算机,用图像处理软件选取腹部平片上肠道气体范围,并计算出肠道气体在规定范围内所占的百分比(GVS)。比较治疗前后GVS值的变化,同时对功能性消化不良患者腹痛、腹胀症状的严重程度进行评估。所有患者服药前后抽取静脉血,放射免疫法检测P物质及胃动素水平变化。[结果]治疗后功能性消化不良患者的GVS(0.045±0.016)明显小于治疗前(0.072±0.022)(P<0.01);腹部症状评分较治疗前均有明显的下降。治疗后腹痛症状积分(0.81±0.62)较治疗前(2.02±0.92)有明显下降(P<0.05)。治疗后腹胀症状积分(0.72±0.0.68)与治疗前(1.88±0.90)比较有明显下降(P<0.05);治疗后患者血浆P物质及胃动素水平明显高于治疗前。[结论]疏肝动胃汤能减少功能性消化不良患者肠道气体的潴留,有效缓解肠气相关腹痛及腹胀等症状,可能与其提高P物质及胃动素水平相关。
[Objective] To investigate the curative effect and mechanism of Shugan Doutai Decoction on the symptoms associated with intestinal gas increased in patients with functional dyspepsia. [Method] According to Rome Ⅲ diagnostic criteria, 40 patients with functional dyspepsia were selected and given Shuganmoweitang 1 day for 4 weeks. Before and after taking the medicine, take the abdominal plain film and scan into the computer. Select the range of intestinal gas in abdominal plain film with image processing software and calculate the percentage of intestinal gas (GVS) in the prescribed range. The changes of GVS before and after treatment were compared, and the severity of abdominal pain and abdominal distension symptoms in functional dyspepsia patients were evaluated. Venous blood was taken before and after taking all the patients, and radioimmunoassay was used to detect the changes of substance P and motilin. [Results] The GVS (0.045 ± 0.016) in functional dyspepsia patients after treatment was significantly lower than that before treatment (0.072 ± 0.022) (P <0.01). The scores of abdominal symptoms were significantly lower than those before treatment. The score of abdominal pain symptom after treatment (0.81 ± 0.62) was significantly lower than that before treatment (2.02 ± 0.92) (P <0.05). After treatment, the score of bloating symptom (0.72 ± 0.0.68) was significantly lower than that before treatment (1.88 ± 0.90) (P <0.05). After treatment, the levels of plasma substance P and motilin were significantly higher than those before treatment. [Conclusion] Shugan Action Stomach Decoction can reduce intestinal gas retention in patients with functional dyspepsia and effectively relieve the symptoms such as intestinal gas-related abdominal pain and abdominal distension, which may be related to the increase of substance P and motilin.