目的 探討達(dá)立通顆粒聯(lián)合米曲菌胰酶片治療功能性消化不良的臨床療效。方法 選取2021年3月—2023年3月在荊州市中醫(yī)醫(yī)院收治的82例功能性消化不良患者，根據(jù)用藥方案不同分為對(duì)照組和治療組，每組各41例。對(duì)照組口服達(dá)立通顆粒，6 g/次，3次/d；治療組在對(duì)照組基礎(chǔ)上口服米曲菌胰酶片，1片/次，3次/d。兩組均經(jīng)14 d治療。觀察兩組的臨床療效，比較臨床癥狀改善時(shí)間、相關(guān)量表評(píng)分、胃腸功能指標(biāo)、胃腸激素指標(biāo)、血清細(xì)胞因子。結(jié)果 治療后，治療組的總有效率是97.56%，遠(yuǎn)高于對(duì)照組的80.49%（P＜0.05）。治療后，治療組上腹痛、早飽感、惡心、腹脹等癥狀改善時(shí)間上均顯著短于對(duì)照組（P＜0.05）。治療后，兩組胃腸功能分級(jí)評(píng)定表（GSRS）評(píng)分、SID評(píng)分均較治療前顯著降低，而生存質(zhì)量測(cè)定量表（WHOQOL-100）評(píng)分、NDI評(píng)分均顯著升高（P＜0.05）；且治療后各量表評(píng)分均以治療組改善更為顯著（P＜0.05）。治療后，兩組胃運(yùn)動(dòng)指數(shù)、收縮頻率、收縮幅度均較同組治療前顯著提高（P＜0.05）；且治療后，治療組胃腸功能指標(biāo)改善優(yōu)于對(duì)照組（P＜0.05）。治療后，兩組血清C反應(yīng)蛋白（CRP）、促腎上腺皮質(zhì)激素釋放因子（CRF）、白細(xì)胞介素-6（IL-6）水平均較同組治療前顯著降低，而神經(jīng)肽S受體1（NPSR1）、降鈣素基因相關(guān)肽（CGRP）顯著升高（P＜0.05）；治療后，治療組血清學(xué)指標(biāo)水平改善優(yōu)于對(duì)照組（P＜0.05）。治療后，兩組胃動(dòng)素（MTL）、P物質(zhì)（SP）、胃泌素-17（G-17）、胃泌素（GAS）水平均較治療前顯著升高，而一氧化氮（NO）水平顯著降低（P＜0.05）；治療后，治療組胃腸激素指標(biāo)改善優(yōu)于對(duì)照組（P＜0.05）。結(jié)論 米曲菌胰酶片聯(lián)合達(dá)立通顆粒治療功能性消化不良可有效改善臨床癥狀，降低機(jī)體炎癥反應(yīng)，促進(jìn)胃腸動(dòng)力，促進(jìn)患者生活質(zhì)量提高，有良好的臨床應(yīng)用價(jià)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

湖北省中醫(yī)藥管理局中醫(yī)藥科研項(xiàng)目（ZY2023F096）；嚴(yán)光俊全國(guó)名老中醫(yī)藥專家傳承工作室建設(shè)項(xiàng)目（國(guó)中醫(yī)藥人教函[2022]75號(hào)）