本文選題：功能性消化不良 + 香砂養(yǎng)胃湯�。� 參考：《延邊大學(xué)》2017年碩士論文

【摘要】：研究目的:通過香砂養(yǎng)胃湯治療功能性消化不良的臨床與實驗研究,探討臨床上采用朝醫(yī)少陰人方治療功能性胃腸病的有效性、安全性,為臨床應(yīng)用提供更可靠的依據(jù)。研究方法:1.臨床研究:將辨象為少陰人并符合診斷標(biāo)準(zhǔn)及納入標(biāo)準(zhǔn)的60例患者,隨機(jī)分成治療組和對照組,各30例。治療組給予香砂養(yǎng)胃湯,將每味藥量按原方增加1倍,每日1劑水煎分早晚餐前服用。對照組為莫沙必利片,5mg/次,日三次口服。療程為2周。療程結(jié)束后,觀察兩組治療前后的愈顯率、證候總積分、總體有效率、檢測外周血胃動素值等指標(biāo),最終判定該方的臨床療效。2.實驗研究:將60只大鼠隨機(jī)分成6組,即正常對照組、模型對照組、陽性對照組、香砂養(yǎng)胃湯高、中、低劑量組,每組10只,雌雄各半。適應(yīng)性喂養(yǎng)5天后,采用利血平法制造功能性消化不良模型。正常組和模型組每日給予無菌生理鹽水2ml,陽性對照組給予0.3mg/kg體重的莫沙必利片混懸液2ml,香砂養(yǎng)胃湯高、中、低劑量組的給藥量為4.4g/kg、2.2g/kg、1.1g/kg,給藥體積均為2ml,灌喂14天后,禁食不禁水24小時,次日在麻醉狀態(tài)下,進(jìn)行眼球取血,并處理樣本。最后檢測大鼠血清胃動素及胃泌素等指標(biāo),進(jìn)行比較分析。研究結(jié)果:1.臨床試驗研究結(jié)果:(1)香砂養(yǎng)胃湯治療組愈顯率為60%,對照組為51.7%,兩組比較無顯著性差異(P0.05);治療組總有效率為93.3%,對照組為65.5%,兩組比較具有顯著性差異(P0.05),說明香砂養(yǎng)胃湯對功能性消化不良的總體療效優(yōu)于莫沙必利。香砂養(yǎng)胃湯組癥狀總積分以及胃脘疼痛、喜溫喜按、手足不溫、神疲倦怠等癥狀,與對照組比較,有顯著性差異(P0.05),說明香砂養(yǎng)胃湯各項癥狀總體改善程度優(yōu)于對照組,特別是在胃脘疼痛、喜溫喜按、手足不溫、神疲倦怠等癥狀的改善程度明顯優(yōu)于對照組。(2)香砂養(yǎng)胃湯治療前后血清人胃動素濃度差異有統(tǒng)計學(xué)意義(P0.05),說明香砂養(yǎng)胃湯能增高FD患者靜脈血胃動素濃度;香砂養(yǎng)胃湯和莫沙必利治療組治療后血清胃動素濃度進(jìn)行比較,發(fā)現(xiàn)香砂養(yǎng)胃湯增高FD患者靜脈血胃動素濃度的作用優(yōu)于對照組。(3)本研究具體治療前后,對比復(fù)查三大常規(guī),肝、腎功能及心電圖等均未出現(xiàn)明顯異常。2.動物實驗研究結(jié)果:(1)香砂養(yǎng)胃湯對大鼠血清胃動素的影響方面,與模型組相比,香砂養(yǎng)胃湯各劑量組與莫沙必利組差異均有統(tǒng)計學(xué)意義(P0.05),血清胃動素濃度增高,而香砂養(yǎng)胃湯組與莫沙必利組比較無統(tǒng)計學(xué)意義(P0.05),提示香砂養(yǎng)胃湯各劑量與莫沙必利均能增強胃腸蠕動功能,而兩種藥物作用效果無顯著性差異。(2)香砂養(yǎng)胃湯對大鼠血清胃泌素的影響方面,與模型組相比,香砂養(yǎng)胃湯高、中劑量組與莫沙必利組差異均有統(tǒng)計學(xué)意義(P0.05),而香砂養(yǎng)胃湯組與對照組比較無統(tǒng)計學(xué)意義(P0.05),提示香砂養(yǎng)胃湯高、中劑量組與莫沙必利組均能增高血清胃泌素濃度,而兩種藥物作用效果無顯著性差異。結(jié)論:通過臨床試驗,香砂養(yǎng)胃湯在功能性消化不良患者各項癥狀總體改善程度優(yōu)于對照組,還能提高功能性消化不良患者靜脈血胃動素濃度,從而可以有效地去除患者的不適癥狀,提高有效率。通過動物實驗,發(fā)現(xiàn)香砂養(yǎng)胃湯增加大鼠血清胃動素及胃泌素含量,從而增強胃腸蠕動,調(diào)節(jié)胃腸功能。臨床試驗和動物實驗過程中均未出現(xiàn)明顯異常反應(yīng)及毒副反應(yīng),說明香砂養(yǎng)胃湯方無毒副作用,用藥安全可靠。
[Abstract]:Objective: To explore the clinical and experimental study on functional dyspepsia treated by Xiang Sha Yangwei decoction, and to explore the effectiveness and safety of treating functional gastrointestinal diseases with the treatment of Shao Yin people in clinical medicine, and to provide more reliable basis for clinical application. 1. clinical studies: the diagnosis is to identify less Yin people and conform to the standard of diagnosis and the standard of inclusion. 60 patients were randomly divided into the treatment group and the control group, each 30 cases. The treatment group was given the Xiang sand nourishing stomach soup, the dosage of each flavor was increased by 1 times, and 1 doses of water were taken every day before the meal. The control group was mosapride tablets, 5mg/ times, and three times on the day for 2 weeks. After the course of treatment, the healing rate of two groups before and after treatment was observed and the syndrome score, total score, was observed. The overall efficiency, detection of peripheral blood motilin value and other indicators, the final determination of the clinical efficacy of the.2. experimental study: 60 rats were randomly divided into 6 groups, namely the normal control group, the model control group, the positive control group, the fragrant sand Yangwei decoction, the middle, low dose group, each group of 10, and male and male each. After 5 days of adaptive feeding, the use of reserpine method to make the function The normal group and the model group were given the aseptic saline 2ml daily, the positive control group gave the 0.3mg/kg weight of Mosapride suspension 2ml, the fragrant sand nourishing stomach soup high, the medium, the low dose group was 4.4g/kg, 2.2g/kg, 1.1g/kg, the dosage was 2ml, 14 days after feeding, the fasting could not help water for 24 hours, the next day in the anesthetic state. The results of the 1. clinical trials were as follows: (1) the healing rate of the treatment group was 60%, the control group was 51.7%, and the control group was 51.7% (P0.05); the total effective rate was 93.3% in the treatment group and 65.5% in the control group. The two groups had significant difference (P0.05), which showed that the overall effect of Xiang sand Yangwei Decoction on functional dyspepsia was better than that of Mosapride. The symptoms total integral of the group of Xiang sand Yangwei decoction, epigastric pain, warm and happy press, untemperature of hand and foot, deity tired and so on, compared with the control group, there were significant differences (P0.05), indicating the symptoms of Xiang sand nourishing stomach soup. The overall improvement degree was better than the control group, especially in the epigastric pain, hsiwen Xi press, hand and foot temperature, deity tiredness and other symptoms improved significantly better than the control group. (2) the difference of serum motilin concentration in serum was statistically significant (P0.05) before and after the treatment of Xiang sand Yangwei decoction, which indicated that Xiang sand Yangwei decoction could increase the concentration of motilin in venous blood of FD patients; The serum motilin concentration in the Yangwei Decoction and the mosapride treatment group was compared, and the effect of the concentration of motilin in the venous blood of FD patients was better than that of the control group. (3) before and after the specific treatment, three routine examinations were compared, and the liver, renal function and electrocardiogram had no obvious abnormal.2. animal experiment results: (1) Compared with the model group, the effect of Xiang sand Yangwei Decoction on Motilin in rat serum was statistically significant (P0.05), and the concentration of serum motilin was higher than that in the model group (P0.05), but there was no statistically significant difference between the Xiang sand Yangwei Decoction group and the mosapride group (P0.05), suggesting that the dosage of the Xiang sand Yangwei Decoction and the mosapride were different. The effect of the two drugs had no significant difference. (2) the effect of Xiang sand Yangwei Decoction on serum gastrin in rats was higher than that in the model group, and the difference between the medium dose group and the mosapride group was statistically significant (P0.05), but there was no significant difference between the group and the control group (P0. 05), suggesting that Xiang sand nourishing stomach soup is high, both medium dose group and Mosapride group can increase serum gastrin concentration, but the effect of two kinds of drugs have no significant difference. Conclusion: through clinical trial, the overall improvement degree of Xiang sand nourishing stomach soup in functional dyspepsia is better than that of the control group, and it can also improve the static patients with functional dyspepsia. The concentration of motilin in blood can effectively remove the discomfort symptoms and improve the efficiency of the patients. Through animal experiments, it is found that the fragrant sand nourishing stomach soup increases the serum motilin and gastrin content in rats, thus enhancing the gastrointestinal peristalsis and regulating the gastrointestinal function. There is no obvious abnormal reaction and side effects in the clinical trials and animal experiments. It shows that Xiang Sha Yangwei decoction has no toxic side effects and is safe and reliable.
【學(xué)位授予單位】：延邊大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259
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本文編號：1906316