Effect of Wendan Decoction on score of TCM syndromes in patients with gastric distention and fullness
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摘要:目的 分析温胆汤对胃痞病患者中医证候积分的影响。方法 选取160例脾胃湿热型胃痞病患者, 将其分为A组53例、B组53例、C组54例。A组采取枸橼酸莫沙必利分散片治疗, B组采取温胆汤加减治疗, C组采取枸橼酸莫沙必利分散片+温胆汤加减治疗。比较3组患者临床疗效、不良反应、治疗前后中医证候总积分以及小便短黄、痞满、大便稀溏积分。结果 C组治疗总有效率较A、B组显著增高, B组治疗总有效率较A组显著增高(P < 0.05)。治疗后4周, 3组患者中医证候总积分较治疗前均显著下降，且C组治疗后总积分较A、B组显著下降，而B组治疗后总积分较A组显著下降(P < 0.05)。相比治疗前, 3组患者治疗后4周小便短黄、痞满、大便稀溏证候积分均显著下降(P < 0.05), 且B、C组治疗后3项积分较A组显著下降(P < 0.05)。与治疗前相比, 3组患者治疗后4周身重困倦、恶心呕吐、胃痛证候积分均显著下降(P < 0.05), 而3组患者治疗后胃痛证候积分的组间比较并无显著差异(P>0.05)。治疗后4周, 3组患者口干口苦证候积分较治疗前均显著下降(P < 0.05), 且C组积分较A组显著下降(P < 0.05), 而A组与B组、B组与C组的组间比较并无显著差异(P>0.05)。3组患者用药期间不良反应发生率无显著差异(P>0.05)。结论 温胆汤加味对脾虚湿热型胃痞病患者具有良好的临床疗效。Abstract:Objective To analyze the effect of Wendan Decoction on score of traditional Chinese Medicine (TCM) syndromes in patients with gastric distention and fullness.Methods Totally 160 patients with gastric distention and fullness differentiated as type of spleen-stomach dampness and heat were selected and divided into group A (n=53), group B (n=53) and group C (n=54). Group A was treated with mosapride citrate dispersible tablets, group B was treated with Wendan Decoction, and group C was treated with mosapride citrate dispersible tablets and Wendan Decoction. The clinical efficacy, adverse reactions, the total score of TCM syndromes before and after treatment, and scores of yellow urine, fullness, loose stool were compared between the two groups.Results The total effective rate of group C was significantly higher than that of group A and group B, and total effective rate of group B was significantly higher than that of group A (P < 0.05). Four weeks after treatment, the total score of TCM syndromes in the three groups were significantly lower than those before treatment, the total score in group C was significantly lower than that in group A and group B after treatment, and the total score in group B was significantly lower than that in group A (P < 0.05). Compared with treatment before, the scores of syndromes such as less and yellow urine, fullness and loose stool in the three groups decreased significantly after 4 weeks of treatment (P < 0.05), and the scores of indexes above in group B and group C decreased significantly when compared to group A (P < 0.05). Compared with treatment before, the scores of syndromes such as heavy drowsiness, nausea, vomiting and stomachache in the three groups decreased significantly after treatment (P < 0.05), but there was no significant difference in score of stomachache among the three groups (P > 0.05). Four weeks after treatment, the scores of syndromes such as xerostomia and bitter mouth in the three groups were significantly lower than those before treatment (P < 0.05), and the scores in group C were significantly lower than those in group A (P < 0.05), but there were no significant differences between group A and B as well as group B and C (P > 0.05). There was no significant difference in the incidence of adverse reactions among the three groups (P > 0.05).Conclusion The modified Wendan Decoction has a good clinical effect in the treatment of patients with gastric distention and fullness differentiated as type of spleen-stomach dampness and heat.
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表 1 3组患者一般资料比较($\bar{x}$±s)
组别 n 男 女 年龄/岁 病程/年 A组 53 29 24 42.06±11.34 2.18±0.66 B组 53 31 22 44.96±13.16 2.35±0.71 C组 54 34 20 43.06±10.94 2.49±0.69 
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表 2 3组患者临床疗效的比较[n(%)]
组别 n 治愈 显效 有效 无效 总有效 A组 53 9(16.98) 18(33.96) 3(5.66) 23(43.40) 30(56.60) B组 53 11(20.75) 25(47.17) 6(11.32) 11(20.75) 42(79.25)* C组 54 16(29.63) 28(51.85) 8(14.82) 2(3.70) 52(96.30)*# 与A组比较, *P < 0.05; 与B组比较, #P < 0.05。
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表 3 3组患者治疗前后中医证候总积分的比较($\bar{x}$±s)
分 组别 n 治疗前 治疗后 A组 53 30.89±4.13 15.94±2.27* B组 53 31.07±5.53 11.74±2.43*# C组 54 30.46±5.05 7.07±1.46*#△ 与治疗前比较, *P < 0.05; 与A组比较, #P < 0.05; 与B组比较, △P < 0.05。
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表 4 3组患者治疗前后中医证候各项积分的比较($\bar{x}$±s)
分 组别 时点 小便短黄 身重困倦 口干口苦 痞满 恶心呕吐 胃痛 大便稀溏 A组(n=53) 治疗前 4.47±0.77 5.03±0.46 4.23±0.84 5.29±0.56 3.95±0.83 4.86±0.72 4.09±0.96 治疗后 3.38±0.95* 2.37±0.65* 3.25±0.55* 4.15±0.37* 2.29±0.64* 2.52±0.66* 2.47±0.43* B组(n=53) 治疗前 4.50±0.79 5.08±0.52 4.17±0.75 5.13±0.68 4.01±0.94 4.72±0.66 4.13±0.84 治疗后 1.89±0.58*# 2.33±0.68* 3.22±0.48* 1.72±0.42*# 2.21±0.57* 2.55±0.52* 1.68±0.47*# C组(n=54) 治疗前 4.57±0.83 5.11±0.49 4.09±0.69 5.05±0.73 3.85±0.73 4.78±0.69 4.16±0.92 治疗后 1.81±0.40*# 2.29±0.61* 2.68±0.41*# 1.63±0.47*# 2.13±0.48* 2.44±0.39* 1.59±0.39*# 与治疗前比较, *P < 0.05; 与A组比较, #P < 0.05。
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