目的 探讨达立通颗粒联合米曲菌胰酶片治疗功能性消化不良的临床疗效。方法 选取2021年3月—2023年3月在荆州市中医医院收治的82例功能性消化不良患者，根据用药方案不同分为对照组和治疗组，每组各41例。对照组口服达立通颗粒，6 g/次，3次/d；治疗组在对照组基础上口服米曲菌胰酶片，1片/次，3次/d。两组均经14 d治疗。观察两组的临床疗效，比较临床症状改善时间、相关量表评分、胃肠功能指标、胃肠激素指标、血清细胞因子。结果 治疗后，治疗组的总有效率是97.56%，远高于对照组的80.49%（P＜0.05）。治疗后，治疗组上腹痛、早饱感、恶心、腹胀等症状改善时间上均显著短于对照组（P＜0.05）。治疗后，两组胃肠功能分级评定表（GSRS）评分、SID评分均较治疗前显著降低，而生存质量测定量表（WHOQOL-100）评分、NDI评分均显著升高（P＜0.05）；且治疗后各量表评分均以治疗组改善更为显著（P＜0.05）。治疗后，两组胃运动指数、收缩频率、收缩幅度均较同组治疗前显著提高（P＜0.05）；且治疗后，治疗组胃肠功能指标改善优于对照组（P＜0.05）。治疗后，两组血清C反应蛋白（CRP）、促肾上腺皮质激素释放因子（CRF）、白细胞介素-6（IL-6）水平均较同组治疗前显著降低，而神经肽S受体1（NPSR1）、降钙素基因相关肽（CGRP）显著升高（P＜0.05）；治疗后，治疗组血清学指标水平改善优于对照组（P＜0.05）。治疗后，两组胃动素（MTL）、P物质（SP）、胃泌素-17（G-17）、胃泌素（GAS）水平均较治疗前显著升高，而一氧化氮（NO）水平显著降低（P＜0.05）；治疗后，治疗组胃肠激素指标改善优于对照组（P＜0.05）。结论 米曲菌胰酶片联合达立通颗粒治疗功能性消化不良可有效改善临床症状，降低机体炎症反应，促进胃肠动力，促进患者生活质量提高，有良好的临床应用价值。

Objective To explore the clinical effect of Dalitong Granules combined with Oryz-Aspergillus Enzyme And Pancreatin Tablet in treatment of functional dyspepsia. Methods A total of 82 patients with functional dyspepsia admitted to Jingzhou Hospital of Traditional Chinese Medicine from March 2021 to March 2023 were selected and divided into control group and treatment group according to different medication regiments, with 41 cases in each group. Patients in the control group were po administered with Dalitong Granules, 6 g/time, three times daily. Patients in the treatment group were po administered with Oryz-Aspergillus Enzyme and Pancreatin Tablets on the basis of the control group, 1 tablet/time, three times daily. Both groups were treated for 14 d. The clinical effects of the two groups were observed, and the improvement time of clinical symptoms, scores of relevant scales, gastrointestinal function indexes, gastrointestinal hormone indexes and serum cytokines were compared. Results After treatment, the total effective rate of the treatment group was 97.56%, much higher than that of the control group (80.49%) (P < 0.05). After treatment, the improvement time of upper abdominal pain, early satiety, nausea and abdominal distension in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, gastrointestinal function Rating Scale (GSRS) scores and SID scores were significantly decreased, but Quality of Life Scale (WHOQOL-100) scores and NDI scores were significantly increased in both groups (P < 0.05). After treatment, the scores of all scales were improved more significantly in the treatment group (P < 0.05). After treatment, gastric motility index, contraction frequency and contraction amplitude in 2 groups were significantly increased compared with before treatment (P < 0.05). After treatment, gastrointestinal function indexes in the treatment group were better than those in the control group (P < 0.05). After treatment, serum C-reactive protein (CRP), adrenocorticotropin releasing factor (CRF) and interleukin-6 (IL-6) levels in 2 groups were significantly decreased compared with before treatment, while neuropeptide S receptor 1 (NPSR1) and calcitonin gene-related peptide (CGRP) were significantly increased (P < 0.05). After treatment, serological indexes in the treatment group were better than those in the control group (P < 0.05). After treatment, the levels of motilin (MTL), Substance P (SP), gastrin-17 (G-17) and gastrin (GAS) in 2 groups were significantly increased compared with before treatment, while the levels of nitric oxide (NO) were significantly decreased (P < 0.05). After treatment, gastrointestinal hormone indexes in the treatment group were better than those in the control group (P < 0.05). Conclusion Oryz-aspergillus enzyme and pancreatin combined with Dalitong Granules in treatment of functional dyspepsia can effectively improve clinical symptoms, reduce body inflammation, promote gastrointestinal motility, and improve patients’ quality of life, which has good clinical application value.

R975

湖北省中医药管理局中医药科研项目（ZY2023F096）；严光俊全国名老中医药专家传承工作室建设项目（国中医药人教函[2022]75号）