【作者】 张宁；

【导师】 李岩；

【作者基本信息】 中国医科大学 ， 内科学， 2004， 硕士

【摘要】 目的 1．比较不同浓度阳春砂挥发油与水提液对健康小鼠胃肠运动功能的影响，探讨其量效关系。2．观察和胃冲剂2号(暂命名，由砂仁、鸡内金、神曲、麦芽组成)对动力障碍样功能性消化不良患者胃肠动力作用，包括用药前后标准餐的胃排空及小肠推进功能变化、症状的改善程度及胃电变化等，以期开发出一种新型的促胃动力中药。 方法 1．健康小鼠按体重分层，随机分组，每组20只，灌胃一周，禁食24小时，以葡聚糖蓝-2000为标记物，以紫外分光光度计定量法，观察不同浓度阳春砂的挥发油对小鼠胃排空及小肠推进功能的影响；2．对动力障碍样功能性消化不良患者采用一次口服不透X标记物于5h、72h拍摄腹平片的方法，检测用药前后胃肠残留钡条数，并进行比较。同时做胃电节律检查，进行心理测评，询问消化不良各症状，并通过用药前后上述指标的变化评价药物的疗效。 结果 1、不同浓度阳春砂挥发油以5％挥发油组相对胃内色素残留率最低(50.36±17.24)，随着浓度升高，其胃内色素残留率逐渐升高，30％挥发油及挥发油浓缩液组与对照组无明显差异(P＞0.05)，100％挥发油浓缩液组相对胃内残留率最高(210.36±115.51)，与对照组及西沙必利组均有显著性差异(P＜0.01)；不同浓度阳春砂水提液以10％水提液组胃内色素残留率最低(52.71±37.14)，随着浓度升高，其胃内相对色素残留率逐渐升高，100％水提液组与对照组无明显差异(100.94±80.00，P＞0.05)；挥发油组与水提液组比较，5％挥发油组胃内色素残留率最低；同浓度挥发油组与水提液组比较，除5％浓度组以外，其余均以水提液组胃内色素残留率最小，挥发油浓缩液组最大;对于小肠推进功能，5%浓度的阳春砂挥发油组及各水提液组与对照组无明显差异(P>0.05)，余均有统计学意义(P<。.05)，各组间无明显量效关系。 2、运动障碍样功能性消化不良患者有40%伴有抑郁，17.14%伴有焦虑，14.29%二者皆有，患者胃排空时间与抑郁和焦虑的测评分呈正相关(P<0.05)。患者餐后正常胃电百分比减少(33.03%土24.35)，5小时胃钡条排空率(6.58%士8.69)明显低于对照组(94.00%*8.06，p<0.01)，服用和胃冲剂2号后患者腹胀、早饱、暖气等症状有明显改善，胃排空率明显增加(32.26%士12.57，P<0.05)，餐后胃电正常百分比增加(53.37%土30.98，P<0.05)，与西沙必利组无明显差异(P>0.05)，胃排空时间与餐后正常百分比无显著的相关性(r二0.1479，P>0.05)。和胃冲剂2号对患者肠运动功能无明显影响。结论 1.阳春砂挥发油对健康小鼠胃排空具有双向调节作用，低浓度促进胃排空，高浓度抑制胃排空。而阳春砂水提液低浓度有促进作用，高浓度无明显影响。挥发油与水提液比较，5%挥发油组促胃排空作用最强;对于小肠推进功能，5%挥发油组及各水提液组无明显影响，余均有促进作用。 2.和胃冲剂2号可以改善FD患者症状，有效地促进FD患者的胃排空功能，对肠排空功能无明显影响，并可以调节FD患者胃电节律，增加胃正常慢波百分比，是一种有效的促胃动力中药。更多还原

【Abstract】 1) To investigate the effects the volatilizable oil and the decoction of Chinese herb Amomum villosum Lour with varied concentration on gastrointestinal motility in heathy mice and to demonstrate the relationship between dose and effect of this herb.2) To evaluate the effects of Chinese herb No. 2 Heiweichongji ( No. 2HWCJ) on gastrointestinal motility in functional dyspepsia patients, including the changes of gastric emptying and intestinal propulsion, symptoms and parameters of EGG before and after treatmemt. We aimed to found a new Chinese herb in treatment of functional dyspepsia.Methods1) We used the different concentrations of Amomum villosum Lour decoction and volatilizable oil to make experiments. The effects on gastric emptying and intestinal propulsion were investigated by measuring gastric remainder rates and intestinal propulsion rates of Blue Dextron (BD) 2000. 2) Fifteen healthy volunteers and 35 FD patients were enrolled in this study. Each subject ingested 20 ROMs and abdominal X - rays were obtained at 5h and 72h to record the gastric clearance of ROMs. FD patients scored seven dyspeptic symptoms and completed self - rating scales which were used to measure psychological distress and anxiety. Digitrapper EGG was assessed for 30 min in the fasting and postprandi-al period simultaneously. Then 20 patients were treated with HWCJ as a treated group and others with cisapride as a contral group for a week respectively. All tests were repeated after treatmemt.RemitsCompared with control group, the rales of gastric emptying in 5% volaliliz-able oil group and 10% decoction group were all significantly increased (P <0. 01). There was no significant difference between the two groups and cisapride group (P >0. 05). As the concentrations of Amomum villosum Lour increased, the rates of gastric emptying were deleted gradually, and the lowest was the group of 100% volatilizable oil and conentrate. As to the prompting gastrointestinal motility, there were prokinetic effects but for the 5% volatilizable oil group and decoction groups, but they had no relationship between dose and effect.FD patients were often scored higher on SDS and SAS which measured psychological disturbance and lower on normal rhythm in postprandial stage (33. 03% +24. 35). Compared with control group, the rate of gastric clearance of ROMs was significandy lower(6. 58% + 8. 69, P <0. 01). After treatment with No. 2HWCJ,patients had significandy improved on symptoms and normal rhythm in postprandial stage (53. 38% +30. 98) and the rate of gastric clearance of ROMs (32.26% + 12. 57). There were no statistically difference between No. 2HWCJ and cisapride( P >0.05). No. 2HWCJ had no effects on prompting gastrointestinal motility .Conclusion1. The volatilizable oil of Amomum villosum Lour had bimutual effects on gastric emptying in heahthy mice; the higher concentration of the herb could improve but the lower could inhibite;The lower concentrationof decoction could accelerate the gastric emptying , but the higher had no effect. As to the intestinal propulsion,the 5% volatilization oil group and decoction groups had no effects, others could accelerate.2. No. 2HWCJ could increase the normal rhythm in postprandial stage in EGG and prove the gastric emptying in FD patients,but it had no effects on intestinal motility. No. 2HWCJ was effective in treatment of functional dyspepsia.更多还原