| Functional dyspepsia is one of common functional diseases in gastrointestinal tact。According to statistics it accounts for one-three of gastrointestinal outpatients. It has clinical syndrome including upper abdominal pain, epigastric distention, early full, belching, poor appetite, nausea, vomiting and so on without organic disease which can cause those syndrome. Its course is more than one month and its symptoms last or recurrent attack. Etiology of functional dyspepsia is unknown, and according to current reports, its occur is mainly related with delay of gastric emptying, decrease of gastric accommodation capacity expansion, increase of gastric sensitivity, infection, psycho-mental factors, genetic predisposition and some gut hormone.It’s treated by gastrointestinal dynamic promoting drugs, Simethicone Emulsion, antianxiety, antidepression, antisecrettory of gastric acid and eradication of helicobacter pylori. Patients always have a lot of symptoms, see different doctors and have many kinds of medicines without organic disorders and bases to explain symptoms, so it is no satisfied effects and impacts patients’ and family members’ physical and mental health. It expends large quantity of medicine resources.Though there is no the disease of functional dyspepsia, according to it’s manifestation, it belongs to "distention and fullness","stomach pain","gastric upset","pantothenic acid" and so on. It is always classified as distention and fullness" to discuss because the main clinic characteristics is upper gastric discomfort, abdominal distention and early full.It’s reported in "Huangdi’s Internal Classics" as "Pi"、"Mang""Pimang"、"Pige" and so on. To this day,There are plenty of therapeutic experiences in about2,000years and multitarget therapy without side effect in modern pharmocology and clinical research, so the curative effect observation on treating functional dyspepsia by tradition Chinese medicine and pharmacy answers for clinical need and will have good social and financial benefits. It occurs by interaction of endopathic and exopathic factors. Its exopathogen is cold, damp and heat devil while endopathic is sentiment imbalance and weakness of the spleen and stomach. There are the syndromes of deficiency-cold of spleen and stomach, stagnation Qi due to liver depression, deficiency of spleen Yin, stagnation of turbid phlegm in middle-Jiao, retention of food and drink, et al. There are much more the syndrome with endoretention of damp and heat in Southe of the five ridges because of damp and heat climate and over-eating of fat and sweet food. The spleen and stomach is the pathological center of damp and heat, so the prescription to damp is always used to treat diseases of digestive system and have significant effects.Three-seed Decotion appears in Detailed Analysis of Epidemic Warm Diseases wrriten by Wu Jutong. It’s composed of Xingren, Huashi, Tongcao, Baikouren, Zhuye, Houpu, Yiren and Banxia. It’s set up to treat the beginning in damp thermosis, which shows headache, aversion to cold, light complexion, heavy and pain in body, fever in the afternoon, chest distress and no hungry. But prescriptions to treat damp and heat can be used to treat diseases of spleen and stomach, it’s pathological center spleen and stomach and always has the deficiency of spleen and stomach. According to its function of clear damp and heat and smooth Qi activity, It was used to treat disease of digestive system with endoretention of damp and heat and Qi stagnation and had significant curative effect. But there was no observation of large sample and mechanism study.Firstly, we analyzed the characteristic of functional dyspepsia’s syndrome and current situation of therapy for summarize differentiating rules in order to improve clinical therapeutic effects and enhance theory of environmen concerned therapy.Secondly, we observed the clinical efficacy of the Functional Dyspepsia with Damp-heat syndrome treated by the Modified Three-seed Decoction to exploit its mechanism of action and provide scientific foundation for its clinical use.Objective To estimate the clinical effect and safty of modified Sanren dectotion in treatment functional dyspepesia with damp-heat syndrome and establish foundation for further clinical and theoretical study.MethodObjects meet with the differentiation standard of damp-heat syndrome and diagnostic criteria of Pimang and functional dyspepsia. Objects were devided into the treatment modified Sanren dectotion and the control group with Cisapride. Examined and compared the clinical efficacy, therapeutic effect of TCM syndrome, and function of gastric emptying, to evaluate the scores of motilin and gastrin in peripheral blood. Grouped data was analyzed by X2test and ranked data was analyzed by rank sum test. Two sample means and were compared by t test or rank sum test. Self circa were compared by matched-pairs t test or rank sum test.Result1. After treatment, signs and symptoms in two groups had meliorated obviously, the difference was significant comparing with before treatment. Between two groups, the difference wasn’t significant in amendment of stomach full, poor appetite, bitter or sticking taste of mouth, dry mouth and tongue, thirsty without drink desire, heavy body and limbs, loose stool and so on. The treatment group had more effective than the control group in meliorating nausea and vomiting and the difference was significant.2. After treatment, MTL and GAS in treatment group had increased obviously, the difference was significant comparing with before treatment. The difference of MTL wasn’t significant between two groups after treatment, but the difference of GAS was significant.3. The gastric emptying in two groups had been promoted and total rate in control group (76.7%) was higher than in treatment group (72.0%), but the difference wasn’t significant after test (P>0.05)4. The total effective rate in treatment group (92.0%) was higher than in control group (80.0%), but the difference wasn’t significant after test (P>0.05)5. All paitents had no side effects and abnormal changes in the index of blood, urina, excrement and liver and kidney function. Clinical research showed that both of drugs had high safty.Conclusion The results show that the Modified Sanren Decoction can meliorate sings and symptoms obviously, the difference was significant comparing with before treatment (P<0.05). It’s improvement to nausea and vomiting surpassed to Cisapride and can improve gastric emptying and had a notable clinical effect.The Modified Sanren Decoction increased the scores of MTL、GAS, which suggested that it can promote gastrointestinal motility and stimulate gastric acid secretion to improve digestive function. This study showed cleaning away heat and promoting damp is the key therapeutical rule of treating functional dyspepsia, but this study can’t bring to light the therapeutical mechanism because just simple clinical observation and index and without long term follow-up visit and monitoring. There aren’t unified index to observe functional syspepsia so experiments about it have poor repetitive. We shall study further and wider and set up unified index and establish more perfect animal experiment model. |
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