目的 基于寒热并调法探讨乌梅丸加减治疗糖尿病胃轻瘫（DGP）的疗效及对胰岛素样生长因子-1（IGF-1）、跨膜蛋白16A（ANO1）的影响。 方法 将2022年1月至2025年6月宣城市人民医院中医科收治的108例DGP患者，通过随机数字表法分为对照组（n = 54）、乌梅丸组（n = 54）。对照组予以莫沙必利分散片治疗，乌梅丸组予以莫沙必利分散片+乌梅丸加减治疗，疗程均为4周。比较两组治疗4周后的临床疗效，并于治疗前及治疗4周后分别评估、比较其中医证候积分、肠道菌群、糖代谢、IGF-1、ANO1、胃肠激素及胃排空水平，同时记录与比较治疗期间的安全性。 结果 治疗4周后乌梅丸组总有效率为88.89%（48/54），高于对照组的72.22%（39/54）（P < 0.05）。与治疗前比较，治疗4周后两组血清胃蛋白酶原Ⅰ（PGⅠ）、胃蛋白酶原Ⅱ（PGⅡ）、IGF-1水平、粪便样本双歧杆菌、乳杆菌、拟杆菌数菌落数量均升高，且乌梅丸组更高（P < 0.05）。与治疗前比较，治疗4周后两组中医证候积分（胃脘痞满、反酸、便溏）、血清胃泌素、空腹血糖及餐后2 h血糖、ANO1水平、粪便样本肠杆菌、酵母菌菌落数量均降低，且乌梅丸组更低（P < 0.05）。与治疗前比较，治疗4周后两组胃排空时间缩短，且乌梅丸组更短（P < 0.05）。两组患者血尿粪常规、肝肾功能无异常，未见皮肤过敏、头晕、恶心等不良反应发生。 结论 在莫沙必利分散片基础上，基于寒热并调法应用乌梅丸加减治疗DGP的疗效较好，可改善中医证候，可调节胃肠激素表达及肠道菌群，改善糖代谢，提高IGF-1水平，降低ANO1水平，促进胃排空，安全性良好。

Objective To investigate the therapeutic effect of a modified Wumei Pill in the treatment of diabetic gastroparesis （DGP） and its impact on insulin-like growth factor-1 （IGF-1） and transmembrane protein 16A （ANO1）， based on the theory of regulating both cold and heat conditions. Methods A total of 108 patients with DGP who were admitted to the Department of Traditional Chinese Medicine of Xuancheng People's Hospital from January 2022 to June 2025 were randomly divided into the control group （n = 54） and the Wumei Pill group （n = 54） by using a random number table. The control group received treatment with Mosapride Dispersible Tablets， whereas the Wumei Pill group was treated with Mosapride Dispersible Tablets plus modified Wumei Pill. The treatment course for both groups was 4 weeks. The clinical efficacy of the two groups after 4-week treatment was compared. The Traditional Chinese Medicine （TCM） syndrome score， intestinal flora， glucose metabolism， IGF-1， ANO1， gastrointestinal hormones， and gastric emptying levels were evaluated and compared respectively before treatment and 4 weeks after treatment. Meanwhile， the safety during the treatment period was recorded and compared. Results After 4 weeks of treatment， the total effective rate of the Wumei Pill group reached 88.89% （48/54）， which was significantly higher than that of the control group （72.22%， 39/54） （P < 0.05）. When compared with the pre - treatment status， after 4 weeks of treatment， the levels of serum pepsinogen Ⅰ （PG Ⅰ）， pepsinogen Ⅱ （PG Ⅱ）， and IGF-1， as well as the colony numbers of Bifidobacterium， Lactobacillus， and Bacteroides in fecal samples， increased in both groups. Moreover， these values were significantly higher in the Wumei Pills group （P < 0.05）. In comparison to the pre - treatment situation， after 4 weeks of treatment， the TCM syndrome scores （including epigastric fullness， acid reflux， and loose stools）， serum gastrin （GAS）， fasting blood glucose （FBG）， 2-hour postprandial blood glucose （2hPG）， ANO1 levels， and the colony numbers of Enterobacterium and yeast in fecal samples decreased in both groups. Notably， the levels in the Wumei Pill group were significantly lower （P < 0.05）. When compared with the pre-treatment period， the gastric emptying time of both groups was shortened after 4 weeks of treatment， and it was significantly shorter in the Wumei Pill group （P < 0.05）. Conclusions Based on mosapridi dispersive tablets， the application of modified Wumei Pills in the treatment of DGP using the cold-heat combined regulation method has a better therapeutic effect. It could regulate the expression of gastrointestinal hormones and intestinal flora， improve glucose metabolism， increase the level of IGF-1， reduce the level of ANO1， improve traditional Chinese medicine syndromes， and promote gastric emptying， with good safety.