Clinical Study Of Weifukang Granule Combined With Bifidobacterium Triple Viable Capsule In Treating Spleen-stomach Damp-heat Type FD With SIBO

Objective: To explore the clinical efficacy,mechanism and application value of Weifukang granule combined with Bifidobacterium triple viable capsule in treating functional dyspepsia(FD)with small intestinal bacterial overgrowth(SIBO),and to clarify the correlation between FD and SIBO.Methods: 105 cases of Spleen-stomach damp-heat FD with SIBO were randomly divided into three groups.The traditional Chinese medicine group was treated with Weifukang granule,the western medicine group was treated with Bifidobacterium triple viable capsule,and the combined group was treated with Weifukang granule and Bifidobacterium triple viable capsule.The course of treatment was 4 weeks.The plasma motilin(MTL)level was measured before and after treatment,and lactulose hydrogen breath test(LHBT)was checked after treatment.To observe the improvement of TCM syndromes,SIBO,orocaecal transit time(OCTT)and plasma MTL levels before and after treatment in the three groups.Results:(1)Clinical efficacy: The total effective rate of the Chinese medicine group was 81.8%,that of the western medicine group was 67.6%,and that of the combined group was 90.9%.There were significant differences among the three groups(P<0.05).The combined group was better than the Chinese medicine group and the western medicine group,and the Chinese medicine group was better than the western medicine group.(2)TCM syndromes integral:(1)There was significant difference in TCM syndromes total integral between the three groups after treatment(P<0.05).The combined group was better than the traditional Chinese medicine group and the western medicine group,and the curative effect of the traditional Chinese medicine group was better than that of the western medicine group.There was significant difference in the scores of single TCM syndromes among the three groups after treatment(P<0.05).There was significant difference between the combined group and the TCM group in abdominal fullness,dementia,nausea and vomiting(P<0.05).The combined group was superior to the TCM group;the TCM group had significant difference in stomach ache pain,dry mouth,dry mouth,no desire to drink,short urine and yellow urine(P<0.05),and the TCM group had significant difference compared with the western medicine group(P<0.05).The combination group was superior to the western medicine group,and there was significant difference in each single TCM syndrome between the combination group and the western medicine group(P<0.05),and the combination group was superior to the western medicine group.(2)Intra-group comparison: After treatment,the total scores of TCM syndromes in the three groups were significantly reduced,and there was significant difference compared with before treatment(P<0.05).Except for the bitter mouth,dry mouth,no desire to drink and short urine in the western medicine group,there was no significant improvement after treatment(P>0.05),the scores of single TCM syndromes in the three groups were significantly reduced,and there was significant difference compared with those before treatment(P<0.05).(3)SIBO negative conversion rate: 42.2% in traditional Chinese medicine group,44.1% in western medicine group and 66.7% in combination group.There was significant difference between the three groups(P<0.05).The combination group was better than traditional Chinese medicine group and Western medicine group.There was no significant difference between traditional Chinese medicine group and Western medicine group(P>0.05).(4)Improvement of OCTT:(1)Comparison among the three groups: There was significant difference in OCTT after treatment(P<0.05),in which the combined group was better than the traditional Chinese medicine group and the western medicine group,and the traditional Chinese medicine group was better than the western medicine group;(2)Intra-group comparison: OCTT time of the three groups after treatment was significantly reduced,and there was significant difference compared with before treatment(P<0.05).(5)MTL level in plasma:(1)Comparison among groups: There was significant difference in plasma MTL level among three groups after treatment(P<0.05).The combined group was better than the traditional Chinese medicine group and the western medicine group,and the traditional Chinese medicine group was better than the western medicine group.(2)Intra-group comparison: MTL in plasma increased significantly after treatment in the three groups,and the difference was statistically significant compared with that before treatment(P<0.05).Conclusion:(1)Weifukang granule combined with Bifidobacterium triple viable capsule has significant clinical efficacy in treating spleen-stomach damp-heat FD patients with SIBO.It can significantly inhibit SIBO,improve OCTT and raise plasma MTL level.The therapeutic effect of combination of traditional Chinese medicine and Western medicine is better than that of traditional Chinese medicine or western medicine alone.(2)The mechanism of Weifukang granule and Bifidobacterium triple viable capsule in treating spleen-stomach damp-heat FD with SIBO may be related to inhibiting SIBO to regulate the levels of OCTT and plasma MTL,suggesting that there is a certain correlation between SIBO and FD.