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目的 观察莫沙必利联合穴位按摩治疗老年人2型糖尿病胃轻瘫的临床疗效. 方法 选择150例确诊为2型糖尿病胃轻瘫患者,数字抽签随机分为3组,给予胰岛素降糖治疗(常规组)35例,给予莫沙必利治疗(对照组)52例、给予莫沙必利联合穴位按摩治疗(试验组)63例,所有患者均给予常规治疗,疗程为6周.比较患者治疗前后,临床疗效、胃排空率、空腹血糖和血清胃泌素(GAS)含量变化,并半年后随访,观察分析患者不良反应和复发情况. 结果 试验组患者总有效率为58例(92.1%),高于常规组18例(51.4%)和对照组38例(73.1%)(P<0.05);3组患者治疗前胃排空率、空腹血糖和GAS水平与治疗后比较差异有统计学意义(P<0.05),且试验组治疗后与常规组和对照组比较,治疗后胃排空率、血糖和GAS水平均有改善,差异有统计学意义(均P<0.05).治疗后随访结果显示,试验组患者的不良反应和复发率低于常规组和对照组(均P<0.05). 结论 莫沙必利联合穴位按摩治疗治疗老年人2型糖尿病胃轻瘫,临床疗效显著,复发率低,安全性高,值得推广.

Objective To investigate the clinical effect of mosapride combined acupoint massage on diabetic gastroparesis(DGP)in elderly patients with type 2 diabetes.Methods 150 cases of DGP in our hospital from April 2015 to May 2016 were collected and randomly divided into three groups:the conventional treatment group(n=35,in insulin treatment),the control group(n=52,in mosapride treatment),and the experimental group(n=63,in mosapride combined with acupoint massage treatment).All patients received the conventional diabetic therapy.Clinical efficacy,gastric emptying rate and the levels of serum gastrin and fasting blood glucose were observed and compared before versus after treatment among the three groups.Results After treatment,the total effective rate was 92.1% in the experimental group,versus 51.4% and 73.1% in the conventional treatment group and control group respectively,showing a statistically significant difference(P<0.05).There were significant differences in gastric emptying rate,the levels of serum gastrin and fasting blood glucose among the 3 treatment groups before versus after treatment.And gastric emptying rate,the levels of serum gastrin and fasting blood glucose were improved in the experimental groups compared with the conventional treatment and control groups(all P<0.05).The follow-up results showed that the adverse reactions and the recurrence rates were significantly lower in the experimental group than in conventional treatment group and control group(all P<0.05).Conclusions Mosapride combined with acupoint massage in the treatment of diabetic gastroparesis have significant clinical effect,low recurrence rate and high safety,and is worthy of promotion.