不同产地白术组成四君子汤治疗脾胃气虚证的临床疗效观察及其物质基础初探

目的观察不同产地白术组成四君子汤治疗脾胃气虚证的临床疗效,测定不同产地白术组成四君子汤的主要成分含量,探究四君子汤的物质基础。方法158例脾胃气虚证患者为研究对象,①随机抽取50例,再随机分为五组,每组10例。采购安徽、浙江、湖南、河北、河南产地的白术,贵州的茯苓、吉林的人参、新疆的甘草,组成5种不同产地的白术及相同产地的茯苓、人参、甘草四君子汤,分别给予五组患者服用,治疗14 d后计算五组的改善积分。其中,浙江产地的白术四君子汤改善积分最高,河南产地的白术四君子汤改善积分最低。②将剩余的108例患者随机分为观察1组(38例)、观察2组(38例)、对照组(32例)。对照组给予常规对症治疗,观察1组给予常规对症+浙江产地的白术四君子汤治疗,观察2组给予常规对症+河南产地的白术四君子汤治疗。四君子汤方剂组成及治疗时间同上。比较观察1组、观察2组、对照组的治疗效果,观察不同产地白术的四君子汤成分含量检测结果。结果观察1组的总有效率为94.74%,观察2组的总有效率为78.95%,对照组的总有效率为56.25%。观察1组与观察2组的总有效率均高于对照组,观察1组的总有效率高于观察2组,差异具有统计学意义(P<0.05)。浙江产地白术的四君子汤中的白术内酯Ⅰ、白术内酯Ⅱ、白术内酯Ⅲ含量及总量均最高,河南产地白术的四君子汤中的总量最低。结论推测白术内酯Ⅰ、白术内酯Ⅱ、白术内酯Ⅲ是四君子汤治疗脾胃气虚证的物质基础。

Observation on the clinical efficacy of Sijunzi decoction composed of atractylodes macrocephala from different origins in the treatment of spleen and stomach Qi deficiency syndrome and preliminary study on its material basis

Objective To observe the clinical efficacy of Sijunzi decoction composed of atractylodes macrocephala from different origins in the treatment of spleen and stomach Qi deficiency syndrome,determine the content of the main components of Sijunzi decoction composed of atractylodes macrocephala from different origins,so as to explore the material basis of Sijunzi decoction.Methods 158 patients with spleen and stomach Qi deficiency syndrome were studied.①50 cases were randomly divided into five groups,with 10 cases in each group.Atractylodes macrocephala from Anhui Province,Zhejiang Province,Hunan Province,Hebei Province and Henan Province,Poria cocos from Guizhou Province,ginseng from Jilin Province and licorice from Xinjiang Province were purchased to form 5 kinds of atractylodes macrocephala from different origins,along with poria cocos,ginseng and licorice from the same origin,they were given to five groups respectively.The improvement points of the five groups were calculated after 14 d of treatment.Among them,Sijunzi decoction composed of atractylodes macrocephala from Zhejiang Province had the highest improvement points,and Sijunzi decoction composed of atractylodes macrocephala from Henan Province had the lowest improvement points.②The remaining 108 patients were randomly divided into observation group 1(38 cases),observation group 2(38 cases),and control group(32 cases).The control group was treated with conventional symptomatic treatment,the observation group 1 was treated with conventional symptomatic treatment+Sijunzi decoction composed of atractylodes macrocephala from Zhejiang Province,and the observation group 2 was treated with conventional symptomatic treatment+Sijunzi decoction composed of atractylodes macrocephala from Henan Province.The composition and treatment time of Sijunzi decoction were the same as above.The therapeutic effects of observation group 1,observation group 2,and control group were compared,and the detection results of Sijunzi decoction consisted of atractylodes macrocephala from different origins were observed.Results The total effective rate of observation group 1 was 94.74%,the total effective rate of observation group 2 was 78.95%,and the total effective rate of control group was 56.25%.The total effective rate of the observation group 1 and the observation group 2 was higher than that of the control group,and the total effective rate of the observation group 1 was higher than that of the observation group 2,and the difference was statistically significant(P<0.05).AtractylodesⅠ,atractylodesⅡ,and atractylodesⅢcontent and total amount in Sijunzi Decoction consisted of atractylodes macrocephala produced in Zhejiang Province were the highest,and the total amount in Sijunzi Decoction consisted of atractylodes macrocephala produced in Henan Province was the lowest.Conclusion It is speculated that that atractylolideⅠ,atractylolideⅡ,atractylolideⅢare the material basis of Sijunzi Decoction in the treatment of spleen and stomach Qi deficiency syndrome.