目的 探究半夏泻心汤对功能性消化不良患者胃黏膜肥大细胞及血浆胃动素的影响.方法 选择2012年4月至2016年4月在我院就治的功能性消化不良患者98例,根据随机数表法分为对照组和观察组,每组49例.对照组使用吗丁啉药物治疗,观察组使用半夏泻心汤治疗,疗程均为4周.比较两组患者嗳气、恶心、上腹疼痛等临床症状改善情况,应用免疫组化和ELISA免疫法测定治疗前和治疗4周后两组患者胃黏膜肥大细胞和胃动素的变化.结果 观察组患者嗳气、上腹饱胀、上腹疼痛、上腹灼烧等症状的改善情况明显优于对照组,差异均有统计学意义(P<0.05);观察组患者的餐后不适综合征(postprandial distress syndrome,PDS)治疗效率为92.31%,上腹痛综合征(eplgastric para syndrome,EPS)的治疗效率为91.30%,均高于对照组(79.31%、80.00%,P<0.05);观察组患者的治疗总有效率为91.84%,明显高于对照组的79.59%,差异有统计学意义(P<0.05);观察组患者治疗后的胃黏膜肥大细胞数量和胃排空时间分别为(20.88±1.24)个和(25.86±4.96)min,明显低于对照组的(26.09±5.31)个和(32.11±5.02)min,差异均有统计学意义(P<0.05);观察组患者的饮温水和空腹状态血浆胃动素分别为(479.12±89.96)pg/mL和(410.12±79.94)pg/mL,明显高于对照组的(446.47±90.34)pg/mL和(386.42±81.62)pg/mL,差异均有统计学意义(P<0.05).结论 采用半夏泻心汤治疗功能性消化不良能降低患者胃黏膜肥大细胞的数量,缩短胃排空的时间,升高血浆胃动素的水平,临床疗效显著.
Objective To investigate the effect of Banxia Xiexin Decoction (Pinelliae Decoction for Purging Stomach-Fire) on gastric mucosal mast cells and plasma motilin in patients with functional dyspepsia. Methods From April 2012 to April 2016, 98 patients with functional dyspepsia were randomly divided into two groups:control group and observation group (n=49 each). The control group was treated with domperidone, and the observation group was treated with Banxia Xiexin Decoction, with four weeks as a treatment course. The improvement of clinical symptoms such as belching, nausea and epigastric pain were observed. The changes of gastric mucosal mast cells and motilin were detected by immunohistochemistry and ELISA immunoassay before treatment and 4 weeks after drug treatment. Results Patients in the observation group had significant improvement in the symptoms of belching, upper abdomi-nal fullness, epigastric pain and epigastric burning (P<0.05). The therapeutic efficiencies of postprandial distress syn-drome (PDS) and eplgastric para syndrome (EPS) in the observation group were significantly higher than those in the control group (92.31%vs 79.31%, 91.30%vs 80.00%, P<0.05), and the total effective rate of the observation group was significantly higher than that of the control group (91.84% vs 79.59%, P<0.05). The number of gastric mucosal mast cells (20.88 ± 1.24) and gastric emptying time (25.86 ± 0.24) in the observation group were significantly lower or shorter than (26.09±5.31) and (32.11±5.02) min in the control group, P<0.05. The plasma motilin levels in the warm water and fasting state of the observation group were (479.12±89.96) pg/mL and (410.12±79.94) pg/mL, which were significantly higher than (446.47±90.34) pg/mL and (386.42±81.62) pg/mL in the control group (P<0.05). Conclusion Treatment of functional dyspepsia with Banxia Xiexin Decoction can reduce the number of gastric mucosal mast cells, shorten the time of gastric emptying, elevate the level of plasma motilin, and the clinical curative effect is remarkable.