目的 探讨功能性消化不良（FD）脾虚湿盛患者可能发病机制及藿香正气软胶囊的干预作用。方法 选择100例FD脾虚湿盛患者，治疗组给予藿香正气软胶囊＋淀粉片，阳性对照组给予多潘立酮＋治疗模拟剂，治疗28 d，观察治疗前后症状积分、药效判定标准、胃排空观测、胃动素（MTL）、胃泌素（GAS）、一氧化氮（NO）、五羟色胺（5-HT）等指标，同时与阳性对照、健康对照比较。结果 藿香正气软胶囊治疗组治疗后上腹胀满、早饱、口黏腻、恶心、呕吐、大便积分明显降低（P<0.05），而食欲不振、嗳气积分无明显降低（P>0.05）；与多潘立酮治疗组治疗后上腹胀满、早饱、口臭、口黏腻积分无明显差异（P>0.05），藿香正气软胶囊对FD患者胃排空有明显的促进作用（P<0.01），藿香正气软胶囊及多潘立酮治疗后两组5-HT水平明显增加，其中藿香正气软胶囊组治疗增加显著（P<0.05），藿香正气软胶囊组治疗后NO水平明显增加（P<0.05），藿香正气软胶囊及多潘立酮组治疗后GAS无明显变化（P>0.05），藿香正气软胶囊增加MTL作用明显（P<0.05）。结论 藿香正气软胶囊能够改善FD脾虚湿盛患者临床症候、促进胃排空、调节胃肠激素水平。

Objective To explore the possible pathogenesis for functional dyspepsia (FD) patients with spleen deficiency and predominant dampness and investigate the intervention by Huoxiang Zhengqi Soft Capsule (HZSC). Methods One hundred FD patients with spleen deficiency and predominant dampness were divided in two groups: the control and treatment groups. The patients in the treatment group were given HZSC + starch tablets and those in the control group were given Domperidone + simulated agent for treatment. After 28 d, the indexes of the symptom scores before and after the treatment, the efficacy judgement standard, gastric emptying, motilin (MTL), gastrin (GAS), nitric oxide (NO), and 5-hydroxytryptamine (5-HT) were observed and compared with the positive and healthy controls. Results After the treatment by HZSC, the scores of epigastric fullness, early satiety, mouth sticky, nausea, vomiting, and defecate for patients were obviously decreased (P < 0.05), while the scores of appetite lossing and belching were not decreased (P > 0.05). In the Domperidone treatment group there was no difference in the scores of epigastric fullness, early satiety, mouth sticky, nausea, vomiting, and defecate for patients (P > 0.05). HZSC showed the significantly promoting effects on the gastric emptying of FD patients (P < 0.01). The 5-HT levels of the patients in the two groups were increased after the treatment by HZSC and Domperidone. There was more significant in the HZSC treatment group (P < 0.05), and was the NO in the HZSC treatment group (P < 0.05), while there were no obvious changes of GAS in HZSC and Domperidone treatment groups (P > 0.05). HZSC could increase MTL content obviously (P < 0.05). Conclusion HZSC could ameliorate the clinical symptoms in FD patients with spleen deficiency and predominant dampness, improve the gastric emptying, and regulate the gastrointestinal hormone levels.

天津市科委科技创新专项基金项目（07FDZDSH01001）