Association Between The Bianzhen Of Functional Dyspepsia In TCM And Gastrointestinal Motility And Motilin

Objective:Functional dyspepsia(FD) is a very common disease in clinic.its machanism of pathophysiology is complicated,involving gastric acid secretion -, gastrointestinal dyskinesisx helicobacter pylori infection > gastrointestinal hormone N psychological factor> bowel sensitive and environmental factor etc.Among them the gastrointestinal dyskinesis and hormone abnormality are more and more paid close attention to.But the research about the types of FD in traditional Chinese medicine(TCM) and gastrointestinal motility and gastrointestinal hormone was not yet reported.This study wants to clarify the machanism of pathophysiology of different types of FD in TCM, provide objective evidence for the bianzhen of FD, and raise die clinical effect in the end.Participants:30 dyskinetic functional dyspepsia were all inpatients or outpatients ofthe department of gastroenterology of the second hospital affiliated to GuangzhouUniversity of Traditional Chinese Medicine from March,2001 to March.,2002. Among themthere were 16 stagnation of liver-qi type (GROUP 2) and 14 deficiency of spleen type(GROUP 3 ) .20 healthy volunteers (GROUP 1) served as controls.Methods:The gastric emptying was detected by barium meal axamination.All participants had received fasting gastrointestinal manometry examination for migrating motor complex(MMC),cutaneous electrogastrogram(EGG) were measured simultaneously, and samples from peripheral venous blood were collected at fasting and measured for the plasma motilin(MTL) levels.Collect the final datas.do statistics by using SPSSlO.O.One-Way ANOYA was adopted for numerical vanables.Chi-square statistics was for categorical variables.Results:This study showed that gastric emptying of GROUP 3 was normal, 31.25% GROUP 2 had disturbances of gastric emptying, while 64.29% GROUP 3 had it.The three groups have statistical differences (P<0.05) .GROUP 2 showed that the time of MMC IIphase was longer than other groups (P<0. 01), while that of I phase^ III phase was normal; there were six patients without III phase, and three had antidromic conduction; GROUP 3 showed that the time of MMC I phase was longer than other groups (P<0. 01) .while that of II phase ^ III phase was shorter; there were nine patients without III phase, and two had antidromic conduction. The two types of FD showed that the amplitude of wave and contraction exponent of MMC II phase were both decreased, while the contraction frequency of MMCIII phase was normal, but its amplitude of wave and coordination contraction of gastrointestinal motilitywere both decreased. The amplitude of wave and contraction exponent of MMC II phase and the amplitude of wave of MMCIII phase of GROUP 3 were all lower than GROUP 2, the two groups were significantly different, and that can be one of the objective evidences of the bianzhen of FD in TCM.The cutaneous EGG of group 2 showed that dysrhythmias was the main rhythm(occupying 62.5%) , and the main rhythm of group 3 was bradygastria(occupying 57.1%). Comparing group 1, group 3 had lower POP (P<0. 01) , but group 1 and 2 had no statistic differences on POP. whether it' s because of less participants' number, that needs adding number and more investigation in the future.In the study, the plasma motilin level of the two types of FD were both lower than that of healthy subjects (P<0. 01) , among them the MOT level of group 3 was lower than that of group 2 (P<0. 01) .And the development changes of MOT needs more investigation.Conclusions:these findings suggested that gastric emptying> MMC, EGG, MOT and the types of FD in TCM maybe have correlation, yet that needs multi-center and large exponent investigation by doctrine of evidence based medicine.