健脾温肾巴布剂穴位贴敷法治疗脾肾阳虚型腹泻型肠易激综合征临床观察  

Clinical observation on diarrhea-type irritable bowel syndrome with yang deficiency of spleen and kidney treated with acupoint application of Spleen-strengthening and Kidney-warming Cataplasm

作　　者：周滔[1] 谭海成 杨仲婷 王洪[1] 赵晓丹 焦云涛 陈林 张立宏 武琛 牛柯敏 ZHOU Tao;TAN Hai-cheng;YANG Zhong-ting;WANG Hong;ZHAO Xiao-dan;JIAO Yun-tao;CHEN Lin;ZHANG Li-hong;WU Chen;NIU Ke-min(Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010,China;Shunyi Hospital of Beijing Hospital Traditional Chinese Medicine,Beijing 101300,China;Beijing Traditional Chinese Medicine Clinical College,Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京中医医院,北京100010 [2]北京中医医院顺义医院,北京101300 [3]北京中医药大学北京中医临床医学院,北京100029

出　　处：《中华中医药杂志》2020年第11期5858-5862,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：北京市科委“首都特色”项目(No.Z161100000516028);第四批全国中医(临床、基础)优秀人才研修项目(No.国中医药人教发[2017]24号);北京市卫生系统高层次卫生技术人才培养计划(No.2015-3-114);北京市属医院科研培育计划项目(No.PZ2016021)。

摘　　要：目的:观察健脾温肾巴布剂穴位贴敷治疗脾肾阳虚型腹泻型肠易激综合征(IBS-D)的临床疗效。方法:将146例脾肾阳虚型IBS-D患者随机分为观察组和对照组,并分别用健脾温肾巴布剂穴位贴敷和安慰剂穴位贴敷治疗,疗程4周,随访4周。观察中医证候学指标(证候积分)、IBS-D大便性状问卷(DSQ)、IBS症状严重程度量表(IBS-SSS)积分、生活质量积分(IBS-QOL专用量表)及证候疗效、大便性状疗效。结果:治疗4周后观察组大便性状、腹泻次数、腹痛、腹胀积分较治疗前显著下降(P<0.05),且优于对照组(P<0.05)。治疗4周后观察组排便最多次数、10d中排便急迫感的天数、大便性状积分均较前下降(P<0.05),且优于对照组(P<0.05)。治疗4周后,观察组IBS-D患者的IBS-SSS积分显著下降(P<0.05),且优于对照组(P<0.05)。治疗4周后观察组生活质量积分较前显著升高(P<0.05),且优于对照组(P<0.05)。观察组、对照组中医证候总有效率分别为89.04%(65/73)和42.47%(31/73)(P<0.05),大便性状总有效率分别为87.67%(64/73)和35.62%(26/73)(P<0.05)。结论:健脾温肾巴布剂穴位贴敷法治疗脾肾阳虚型IBS-D具有良好的临床疗效。Objective:To observe the clinical effect of point-application of spleen-strengthening and kidney-warming cataplasm on diarrhea-predominant irritable bowel syndrome(IBS-D)of yang deficiency of spleen and kidney.Methods:A total of 146 IBS-D patients with yang deficiency of spleen and kidney were randomly divided into the observation group and the control group,and were treated with point-application of spleen-strengthening and kidney-warming cataplasm and placebo respectively.The course of treatment was 4 weeks and the follow-up was 4 weeks after treatment.The scores of TCM syndrome index(symptom score),IBS-D stool trait questionnaire(DSQ),the IBS symptom severity scale(IBS-SSS),quality of life score(IBS-QOL scale),and syndrome efficacy and stool trait efficacy were all observed.Results:After 4 weeks of treatment,stool trait,diarrhea frequency,abdominal pain,abdominal distension score in the observation group decreased significantly compared with that before treatment(P<0.05),and was better than that in the control group(P<0.05).After 4 weeks of treatment,the maximum number of defecation,the number of defecation urgency days in the 10 days,and the stool trait score in the observation group all decreased(P<0.05),and was superior to the control group(P<0.05).After 4 weeks of treatment,IBS-SSS scores of IBS-D patients in the observation group decreased significantly compared with that before treatment(P<0.05),which was better than that in the control group(P<0.05).After 4 weeks of treatment,the life quality scores of the observation group were significantly higher(P<0.05),and was better than that of the control group(P<0.05).The total effective rates of TCM syndrome were 89.04%(65/73)and 42.47%(31/73)respectively.The total effective rates of stool traits were 87.67%(64/73)and 35.62%(26/73)respectively(P<0.05).Conclusion:Acupoint-application of spleen-strengthening and kidney-warming cataplasm for IBS-D of yang deficiency of spleen and kidney has good clinical efficacy.

关 键 词：腹泻型肠易激综合征 中医药 健脾温肾巴布剂 穴位贴敷 外治法 脾肾阳虚 

分 类 号：R259[医药卫生—中西医结合]