调肝理脾补肾固肠法治疗腹泻型肠易激综合征疗效观察  

Obervation of the therapeutic effects of mehthods of liver-dispersing,spleen-invigorating,kidneyreinforcing and intestine-strengthening on diarrhea-predominant irritable bowel syndrome

作　　者：王继东 杨仲婷 邱新萍 牛柯敏 申青艳 周滔 

机构地区：[1]北京中医医院顺义医院,北京101300 [2]北京中医药大学,北京100029

出　　处：《北京中医药》2017年第8期696-699,共4页Beijing Journal of Traditional Chinese Medicine

基　　金：北京市科委"首都临床特色应用研究"专项课题(Z141107002514082;Z161100000516028);北京市卫生系统高层次卫生技术人才培养计划项目(2015-3-114);北京市属医院科研培育计划项目(PZ2016021;PZ2017016);北京中医医院-北京中医医院顺义医院科研合作基金项目(SYZY-201410;SYYJ201507)

摘　　要：目的探讨调肝理脾补肾固肠法治疗腹泻型肠易激综合征(IBS-D)的临床疗效。方法将162例肝郁脾虚证IBS-D患者随机分为观察组和对照组,并分别用调肝理脾补肾固肠法和曲美布汀治疗,疗程4周,随访4周。观察主要临床症状,包括腹泻次数、大便性状、腹痛、腹胀等积分、中医证候积分、BSS评分系统积分及总体疗效。结果治疗4周后,观察组IBS-D患者的腹泻次数、大便性状、腹痛、腹胀等主要临床症状计分明显下降,差异有统计学意义(P<0.01),且优于对照组(P<0.01)。治疗4周观察组中医证候积分较治疗前明显下降,差异有统计学意义(P<0.01),且优于对照组(P<0.01)。治疗4周后观察组腹痛日数、腹痛程度、排便满意度、生活干扰积分均较治疗前明显下降,差异有统计学意义(P<0.01),且优于对照组(P<0.01)。观察组、对照组总有效率分别为95.1%和76.5%,2组间差异有统计学意义(P<0.01)。结论调肝理脾补肾固肠法治疗IBS-D具有良好的临床疗效。Objective To observe the clinical efficacy of mehthods of liver-dispersing, spleen-invigorating, kidney-reinforcing and intestine-strengthening on diarrhea-predominant irritable bowel syndrome （IBS-D）. Methods 162 IBS-D cases with liver stagnation and spleen deficiency were randomized into the observation gorup treated with the methods of liver-dispersing, spleen-invigorating, kidney- reinforcing and intestine-strengthening, and the control group treated with Trimebutine. The course of treatment was 4 weeks, and the follow-up was performed 4 weeks after treatment. The scores of main clinical symptoms including diarrhea frequency, defecate characters, abdominal pain and abdominal distension, the TCM syndrome scores, the integrals of BSS scoring system and the total effectiveness were all observed. Results After 4 weeks of treatment, the scores of diarrhea frequency, defecate characters, abdominal pain and abdominal distension of the observation group were decreased obviously, the difference was statistically significant （P 〈 0.01 ） , and it was better than that of the control group （ P 〈0. 01 ）. After 4 weeks of treatment, the TCM syndrome scores were reduced compared with that before the treatment, the difference was statistically significant, and it was better than that of the control group （P 〈 0.01 ）. After 4 weeks of treatment, the integrals of abdominal pain frequency, severity of abdominal pain, defecation satisfaction, life interference and the total integrals were all dropped apparently, the difference was statistically significant and it was better than that of the control group （P 〈0. 01 ）. The total effective rate of the observation group and the control group were 95.06% and 76. 54% respectively and the difference of two groups was statistically significant （P 〈 0. 01 ）. Conclusion The methods of liver-dispersing, spleen-invigorating, kidney-reinforcing and intestine-strengthening for IBS-D show better clincal efficacy.

关 键 词：腹泻型肠易激综合征 中医药 调肝理脾补肾固肠法 BSS评分系统 

分 类 号：R259[医药卫生—中西医结合]