烏貝散治療十二指腸潰瘍之臨床研究

Clinical Study of Chinese Drug Formula Wu Pei San in the Treatment of Duodenal Ulcer

烏貝散由烏員長骨及所貝母二味中藥組成，方義簡單清楚，為中醫治療胃脫疼痛之重要處方。本研究之目的乃利用現代醫學方法來評估烏貝散對十二指腸潰散之臨床療效。60例經內視鏡撿查診斷為活動性十二指腸潰瘍之病例隨機分為中華烏貝散(W.P.S)組32例及西藥善胃得(Zantac)組28例，兩組平均年齡分別為45 .4士5.2 及43.0 士6.4歲。男女之比分別為21: 11及20:8。十二指腸潰瘍最好發於球部之前壁53.3%(32/60)，較少發生於下壁10.0%(6/60)，潰揚的大小兩組平均為12.0 mrn × 8.9 rnrn 及10 .4 rnrn × 8.3 mrn 0 烏貝散組經治療4 週後之癒合率為37.5%，治療8週後之癒合率烏71.9%，而西單善胃得組之癒合率4週為50.0%，8週為78.6%，兩組療效無統計學上之差異(P>0.05)。關於上腹疼痛消失率，兩組皆有優異之效果。在一週內即可緩解疼痛者，烏貝散組為50.0%(16/32)，善胃得組為57.1%(16/28)。兩組在療程中和療程結束後，均未發現有明顯之副作用。同時本研究發現抽煙與潰瘍之癒合有密切的關係。兩組共有28例有抽煙，治療8 週後共有60.7%(17/28)癒合，11例未癒合，而未抽煙者32例，治療8週後有87.5%(28/32)癒合，只有4例未癒合。同時兩組治療前後血球容積比及電解質鈉、鉀、氯、鈣皆無變化。故由以上結果可知中藥烏貝散是治療十二指腸潰瘍之一有效、安全之處方。

Wu Pei San (烏貝散，W.P.S.) is composed of cuttlefish bone (wu zei gu) and Zhechiang fritillaria (zhe bei mu). It is one of the basic formulas for treatment of epigastralgia in Chinese Medicine. The purpose of this study is to evaluate the efficacy of W.P.S. in the treatment of duodenal ulcer with panendoscopic examination. Sixty consecutive cases of active duodenal ulcer diagnosed by panendoscopic examination, randomized into W.P.S. group, 32 cases and Zantac group, 28 cases. The mean ages were 45.5±5.2 and 43.0±6.4 respectively. The ratio of males and females of both group was 21: 11 and 20: 8 respectively. The healing rate of W.P.S. group is 37.5% after 4 weeks treatment and 71.9% after 8 weeks treatment. In Zantac group, the healing rate is 50.0% after 4 weeks treatment and 78.6% after 8 weeks treatment. There is no significant difference between these two groups statistically (P＞0.05). The epigastralgia relief rate is excellent in both groups. The epigastralgia relieved within one week in 50.0% (16/32) in W.P.S. group and 57.1% (16/28) in Zantac group. There is no prominant side-effect noted during and after the course of treatment in both groups. Concomitantly, we found smoking has a close relationship with the healing of ulcer in this study. After 8 weeks treatment, the healing rate for the 28 smokers in both groups was 60.7% (17/28), while that for the 32 non-smokers was 87.5% (28/32). There was no change in hemoglobin and electrolytes in serum before and after treatment in both groups. Our results indicate that: W.P.S. may be an effective, safe formula for the treatment of duodenal ulcer.