| Diabetes(Diabetic melliutus, DM) as one of the most common chronic disease in China, with increasing living standards, medical detection means and the people’s health awareness in recent years, the incidence increased year by year, more and more attention to the research of the investment increased year by year. As one of the chronic complications of diabetes, diabetic gastroparesis(Diabetic gastroparesis, DG), refers to the premise of excluding the presence of a mechanical resistance of gastrointestinal, appear caused by delayed gastric emptying of a series of clinical symptoms, no obvious symptoms can be mild, but the examination can be found in stomach emptying disorder, the typical symptoms of DG include anorexia, acid regurgitation, nausea and abdominal distension etc.. Delayed gastric emptying, if not long-term remission, gastric retention can food in serious condition, and even time has good formation; delayed gastric emptying and increase pressure in the stomach can appear gastroesophageal reflux, heartburn, nausea and other symptoms appear. DG is a clinical common disease, after many research although its pathogenesis is not completely clear, but found mainly with autonomic neuropathy, gastrointestinal hormone abnormalities and long-term high blood sugar are closely related.Chinese medicine "Xiaoke" equivalent to modern medicine for diabetes, the basic pathogenesis of "Yin deficiency, yin deficiency, hot piansheng" as the fundamental, hot as the external performance, both long Yang reciprocal causation; Yin deficiency, Yang Sheng of the fire, the fire further suffering fluid, fluid depletion increased blood viscosity for a long time for the development of disease, blood stasis, yin deficiency and the "blood stasis"; long illness must be false, diabetes long combined with Qi, gas transport, Qi to promote blood circulation, blood circulation slows down, also gradually appear blood stasis, Qi deficiency and blood stasis; "blood stasis" of time, formation of various sizes in product that is, the equivalent of modern medicine in his vein thrombosis, deep accumulation, further hinder the blood circulation, which shows the DM variety of large, small vascular complications. The pathogenesis of Professor Sun Yufeng on the basis of diabetes treatment, with Qi, nourishing Yin, and as the main treatment, Radix Astragali, Salvia miltiorrhiza, turtle shell, earthworm medicine compound preparation, benefiting qi and nourishing Yin, eliminating the effect of Tongluo, in rats in the test achieved good effect, this paper will study the party applied to the clinical treatment of DG, to observe the therapeutic effect, and Domperidone Tablets because of its less side effect, has good effect, is currently in clinical drug commonly used to treat DG, to compare the curative effect between.Gastrin(Gastrin, GAS) is a common gastrointestinal hormone secretion, the site of gastric antrum and proximal duodenum mucosa in G cells, secreted by G cells to enter the blood circulation, and then to the stomach, when the food arrives at the pylorus, mechanical stimulation of Helicobacter pylorus, the PH value of alkaline secretion can stimulate GAS. Study of vagus nerve inhibitory control the release of GAS, the vagus nerve can increase the secretion of GAS, this experiment confirmed that DG patients with GAS were significantly higher than those in healthy people. Glucagon(Glucagon) is a polypeptide hormone, can promote hepatic glycogen, inhibiting the synthesis, enhanced gluconeogenesis, secreted by islet alpha cells. Glucagon and insulin antagonistic to each other, and there is a close relationship between the metabolism of blood glucose, Glucagon not only can inhibit insulin secretion, increase blood sugar, but found it can also slow movement of the stomach, can cause gastric electrical rhythm disorder, and the gastric emptying delay. Domperidone by blocking the CTZ dopamine receptor, can play peristalsis and accelerate the recovery of gastric tension, the gastric emptying time shortened, is a drug commonly used to treat clinical DG.Objective:This study through the observation of DG patients taking changes in symptoms and GAS change, the level of Glucagon before and after the Chinese medicine, the curative effects were compared with domperidone, the possibility of the compound Chinese traditional medicine for the treatment of DG and its possible mechanism.Methods:Randomly selected 40 patients from February 2015 to January 2014 in Jizhou city hospital endocrine and digestive department of internal medicine outpatient clinic in type 2 diabetic patients, 24 males, 16 females, were randomly divided into 2 groups: Chinese traditional medicine group(Chinese traditional medicine, TCM), domperidone group(Domperidone), the Chinese traditional medicine group were 22 people, treated with Supplementing Qi and nourishing Yin, removing dredge meridians, take the medicine two times a day, continuous taking 2 weeks; 18 patients were given domperidone group, by oral Domperidone Tablets Xi’an Yang Sen pharmaceutical production, 15-30 minutes before meals after 2 weeks of continuous medication. Selected 7 healthy volunteers as healthy control group(Normal) during the test, two groups of patients were taking other drugs can avoid influence gastrointestinal peristalsis. Before and after treatment were detected in the gastric emptying rate of test object, and compared before and after treatment symptoms, fasting blood GAS, Glucagon levels and before and after treatment, and compared with the healthy control group.Results:1 Chinese traditional medicine group and domperidone group of patients with gastroparesis symptoms contrast.The results showed: healthy control group found no delayed gastric emptying; compared with healthy control group, Chinese traditional medicine group and domperidone group before treatment were 6 hour postprandial gastric barium capsule has significant residual, two patients in the treatment group were significantly delayed gastric emptying(P< 0.05), between the two groups was no significant difference(P>0.05); compared with before treatment, after treatment of Chinese traditional medicine group, domperidone group of patients with gastric emptying were significantly improved(P< 0.05). According to the efficacy criteria of Chinese traditional medicine group, the total effective rate was 95.5%, the cure rate was 40.9%; domperidone group total effective rate was 77.8%, the cure rate was 11.1%; the Chinese traditional medicine group total effective rate and cure rate were significantly better than domperidone group(P< 0.05).2 Chinese traditional medicine group and domperidone group before and after treatment, the change of Glucagon level GAS.Detection of the Chinese traditional medicine group, domperidone group patients GAS level before treatment, there were no significant difference between the two groups(P> 0.05), can be compared; compared with healthy control group before treatment, two treatment group GAS levels were significantly higher(P< 0.05), suggesting that DG patients have high blood gastrin. Compared with before treatment, after treatment of Chinese traditional medicine group, domperidone group GAS were significantly decreased(P< 0.05), but still higher than the healthy control group(P< 0.05); comparison between the two groups, Chinese traditional medicine group decreased more significantly than domperidone group(P< 0.05). Tips: two improved drugs for the treatment of diabetic gastroparesis gastric emptying rate may be related to reducing the blood GAS level of patients; the curative effect is better than that of Chinese traditional medicine compound Domperidone Tablets.Detection of the Chinese traditional medicine group, domperidone group Glucagon before treatment, there were no significant difference between the two groups(P> 0.05), can be compared; compared with healthy control group before treatment, two treatment group Glucagon increased significantly(P< 0.05), suggesting that DG patients have elevated Glucagon. Compared with before treatment, after treatment of Chinese traditional medicine group, domperidone group Glucagon levels showed no significant change(P > 0.05), and the comparison between the two groups showed no significant difference(P> 0.05). Note: May has nothing to do with the Glucagon two drug treatment DG curative effect.Conclusion:1 Delayed gastric emptying in patients with DG; Supplement qi and nourish yin resolve masses and dredge meridians treatment medicine can significantly improve the patient’s appetite, nausea, bloating, early satiety, promote gastric emptying in patients with DG, better than Domperidone Tablets.2 DG patients have abnormal secretion of gastrointestinal hormone, blood GAS, Glucagon levels were significantly increased; by Supplement qi and nourish yin resolve masses and dredge meridians treatment compound Chinese traditional medicine and Domperidone Tablets can significantly reduce the level of GAS of Chinese medicine, the effect is more obvious, while the Glucagon level was not affected. Suggest Supplement qi and nourish yin resolve masses and dredge meridians treatment compound Chinese traditional medicine treatment of DG may be related to reducing the blood GAS level of patients, curative effect is better than that of Domperidone Tablets. |
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