目的 探讨达立通颗粒对胆囊切除术后胆汁反流性胃炎(bile reflux gastritis,BRG)患者胃动力和胃肠激素的影响。方法 选取2018-01至2020-04武警安徽总队医院的114例胆囊切除术后BRG患者,随机分为研究组和对照组,每组57例。对照组给予雷贝拉唑、铝镁加混悬液治疗,研究组在对照组治疗的基础上,给予达立通颗粒治疗,两组疗程均为4周;比较两组治疗前后临床有效率和胃排空率、胃电的平均收缩频率(mean frequency of contraction,MFC)和收缩振幅值(amplitude of contraction,AC)、胃动素 (motilin,MTL)和胆囊收缩素(cholecystokinin,CCK)水平。结果 治疗4周后,研究组有效率(92.98%)显著升高,与对照组(77.19%)比较,差异有统计学意义(P<0.05);治疗后研究组的胃排空率[(67.4±7.5)%]、MFC[(4.99±0.51)次/min]、AC[(227.63±24.12)μV]、MTL[(331.32±38.07)pg/ml]明显升高,CCK[(4.66±0.54)pg/ml]明显下降,与对照组的胃排空率[(37.0±8.8)%]、MFC[(2.90±0.39)次/min]、AC[(168.11±24.65)μV]、MTL[(300.44±35.39)pg/ml]、CCK[(6.04±0.69)pg/ml]比较,差异有统计学意义(P<0.05)。结论 达立通颗粒可升高MTL水平,降低CCK水平,提高胃排空率,达立通颗粒联合治疗胆囊切除术后BRG,疗效优于单纯的雷贝拉唑、铝镁加混悬液治疗。

Objective To study the effect of Dalitong granules on gastric motility and gastrointestinal hormones in patients with bile reflux gastritis (BRG) after cholecystectomy. Methods One hundred and fourteen patients with BRG after cholecystectomy treated in Anhui General Hospital of Armed Police between January 2018 and April 2020 were randomly divided into the study group and control group, with 57 cases in each. The course of treatment for both groups was 4 weeks. The clinical effective rate, gastric emptying rate, mean frequency of contraction (MFC), amplitude of contraction(AC), levels of motilin (MTL) and cholecystokinin (CCK) were detected before and after treatment and compared between the two groups. Results After 4 weeks of treatment, the effective rate of the study group (92.98%) was significantly higher than that of the control group (77.19%). The gastric emptying rate [(67.4±7.5)%], MFC[(4.99±0.51) times/min], AC[(227.63±24.12) μV], and MTL[(331.32±38.07) pg/ml] in the study group increased significantly, while CCK[(4.66±0.54) pg/ml] decreased significantly, compared with[(37.0±8.8)%],[(2.90±0.39) times/min],[(168.11±24.65)μv], [(300.44±35.39)pg/ml] and [(6.04±0.69)pg/ml]respectively in the control group. The difference between the two groups was statistically significant (P<0.01). Conclusions Dalitong granules combined with rabeprazole, almagate suspension is significantly more effective in the treatment of patients with bile reflux gastritis after cholecystectomy than the treatment with rabeprazole and almagate suspension alone, which can significantly increase plasma MTL and the gastric emptying rate and decrease CCK.