左金丸合四逆散辨证治疗腹泻型肠易激综合征72例临床观察  

Clinical Observation on Zuojin Pills(左金丸) Combined with Sini Powder(四逆散) in the Treatment of 72 Cases of Diarrhea-Predominant Irritable Bowel Syndrome Based on Syndrome Differentiation

作　　者：李力强[1,2] 张贵锋[1,2] 曾艺文 王芳[1,2] 温鸿源[2] 宾建平 

机构地区：[1]肇庆医学高等专科学校中医系 [2]肇庆医学高等专科学校附属医院 [3]肇庆市中医院

出　　处：《中医杂志》2016年第14期1214-1217,共4页Journal of Traditional Chinese Medicine

基　　金：肇庆市科技创新指导类项目(2015040304-9)

摘　　要：目的观察左金丸合四逆散加减辨证治疗腹泻型肠易激综合征(IBS-D)的临床疗效。方法将144例IBS-D患者随机分为治疗组和对照组各72例,治疗组分肝郁脾虚、脾虚湿困、脾肾阳虚和肠道湿热4类证型,均给予左金丸合四逆散加减辨证治疗,水煎服,隔日1剂;对照组口服奥替溴铵片每日3次,每次40 mg。两组均15天为1个疗程,连续治疗4个疗程。治疗前后观察两组患者腹痛及不适、腹泻频率、伴随症状积分,并于治疗结束后判定各症状疗效以及综合疗效。结果治疗后两组患者单项症状积分均较本组治疗前明显降低(P<0.05),且治疗组腹痛及不适、伴随症状积分明显低于对照组(P<0.05)。治疗组腹痛及不适、伴随症状疗效均显著优于对照组(P<0.05);治疗组综合疗效总有效率86.11%,显著高于对照组的79.17%(P<0.01);治疗组各证型间综合疗效总有效率差异具有统计学意义(P<0.05),肝郁脾虚证总有效率最高。结论左金丸合四逆散加减辨证能有效治疗IBS-D,对肝郁脾虚证治疗效果较好。Objective To observe clinical curative effects of modification of Zuojin Pills（左金丸） combined with Sini Powder（四逆散） in the treatment of diarrhea-predominant irritable bowel syndrome（ IBS-D） based on syndrome differentiation. Methods Randomly divided 144 cases of IBS-D into a treatment group and a control group,with 72 cases in each. The treatment group was divided into 4 syndrome patterns,including stagnation of liver Qi and spleen deficiency,dampness stagnancy due to spleen deficiency,spleen and kidney Yang deficiency,and intestinal hot and dampness,which were all given modification of Zuojin Pills combined with Sini Powder for treatment based on syndrome differentiation. The herbs were decocted in water for oral dose,one dose every other day. The control group took Otilonium Bromide Tablets 40 mg each time,three times per day. Two groups both took 15 days as one treating course,and were continuing treated for 4 courses. Abdominal pain and discomfort,frequency of diarrhea,simultaneous phenomenon scores of patients in two groups were observed before and after treatment. Curative effects on each symptom and comprehensive curative effects after treatment were judged. Results Single symptom scores of patients in two groups remarkably decreased after treatment compared with that before treatment（ P 〈 0. 05） Abdominal pain and discomfort,as well as simultaneous phenomenon scores in the treatment group were remarkably less than that in the control group（ P 〈 0. 05）. The curative effects on abdominal pain and discomfort,as well as simultaneous phenomenon in the treatment group were remarkably superior to that in the control group（ P 〈 0. 05）; Total effective rate of comprehensive curative effects was 86. 11% in the treatment group,remarkably higher than 79. 17% in the control group（ P 〈 0. 01）. There is statistical significant difference in total effective rates of comprehensive curative effects between each syndrome pattern in the treatment group（ P 〈 0. 05）. The tot

关 键 词：肠易激综合征 腹泻 气机升降 左金丸 四逆散 

分 类 号：R259[医药卫生—中西医结合]