针刺联合参苓健脾胃颗粒治疗肠易激综合征腹泻型的近远期疗效观察  

Short and Long-term Efficacy of Combining Acupuncture and Shenling Jianpiwei Granules in Treatment of Irritable Bowel Syndrome with Diarrhea

作　　者：张超贤[1] 郭李柯[1] 秦咏梅[1] 

机构地区：[1]新乡医学院第一附属医院,河南卫辉453100

出　　处：《中华中医药学刊》2016年第4期854-859,共6页Chinese Archives of Traditional Chinese Medicine

基　　金：河南省教育厅科研基金项目(2011A320015)

摘　　要：目的:观察针刺联合参苓健脾胃颗粒治疗IBSD的近期和远期疗效。方法:来自2011年5月—2014年3月新乡医学院第一附属医院消化科门诊和住院病房的640例确诊的IBSD病人采用随机方法分为4组:针刺组、参苓健脾胃颗粒(Shen ling jian pi wei Granules,SLJPWG)组、联合治疗组及对照组,每组160例。针刺组针刺足三里、肝俞、脾俞、太冲及脐中四边穴,每日2次,共4周;SLJPWG组予SLJPWG 10g口服,每日2次;联合治疗组则予上述针刺及SLJPWG治疗;对照组口服复方地芬诺酯1片,每日2次,蒙脱石散3 g,每日3次,阿米替林25mg,每日两次。评价4组患者治疗前、治疗结束时及治疗结束后60周排便次数、大便性状、伴随症状评分、生活质量评分及不良反应。结果:治疗过程中SLJPWG组剔除3例,脱落2例;联合组和对照组各脱落3例。与治疗前比较,治疗结束时各组排便次数、大便性状和伴随症状评分均明显下降(P<0.01),生活质量评分明显上升(P<0.01),联合治疗组上述指标优于其他组(P<0.05);与治疗结束时比较,治疗后60周上述指标在针刺组和联合治疗组无明显反复(P>0.05),在SLJPWG组和对照组则明显反复(P<0.05),联合治疗组近期和远期疗效率均显著高于其他组的总有效率(P<0.05或P<0.01),各组均无严重不良反应发生。结论:针刺和SLJPWG均能显著减少IBSD患者排便次数,改善大便性状,缓解伴随症状,提高生活质量,但联合用药效果更好,并具有较好的安全性和近远期疗效。Objective： To explore the short and long-term efficacy of combining acupuncture and Shenling Jianpiwei Granules（ SLJPWG） in the treatment of IBSD.Methods： 640 patients with confirmed IBSD from Department of Gastroenterology,the First Affiliated Hospital of Xinxiang Medical University in China from May 2011 to March 2014 were randomly divided into four groups： acupuncture group,SLJPWG group,combination group and control group.There were 160 cases in each group.Each case in acupuncture group was treated with acupuncture at point Zusanli（ ST36）,Ganshu（ BL18）,Pishu（ BL20）,Taichong（ LR36） and Qizhongsibian（ Ex-CA02） once a day for 4weeks while each case in SLJPWG Granules group was treated with 10 g SLJPW three times a day,combination group with above-mentioned acupuncture and SLJPWG,control group with Compound Diphenoxylate 1 tablet,twice a day,3 g montmorillonite powder three times a day and 25 mg amitriptyline twice a day.The defecate frequencies,stool property,accompanying symptom score,life quality score and adverse reaction were calculated before treatment.At the end of treatment and 60 weeks post-treatment we compared the four groups.Results： 3 cases in SLJPWG group were eliminated for did not take medicine strictly according to the research plan and 2 cases were lost to follow-up,while 3 cases in combined group and 3 cases in control group were lost to follow-up.Compared with pre-treatment,the defecate frequencies,stool property score and accompanying symptom scores were all decreased significantly at the end of treatment in each group,while the scores of 9 dimensions of life quality were all increased significantly（ P〈0.01）.Above-mentioned detecting indexes were better in combination group than these in other groups（ P〈0.05）.Compared with the end of treatment,above-mentioned detecting indexes recurred insignificantly to combination group or acupuncture group 60 weeks post-treatment（ P〈0.05）,but these indexes all recurred significantly to SLJPWG Granule or cont

关 键 词：针刺 参苓健脾胃颗粒(Shen ling jian pi wei Granules SLJPWG) 肠易激综合征腹泻型(irritable bowelsyndrome with diarrhea IBSD) 排便次数 大便性状 伴随症状 生活质量 

分 类 号：R442.2[医药卫生—诊断学]