补中益气汤加减治疗急迫失禁型低位前切除综合征(脾胃虚损证)的临床研究  

Clinical Study of Modif ied Buzhong Yiqi Decoction(补中益气汤)onUrgent Incontinence Type of Low Anterior Resection Syndrome(Spleen and Stomach Deficiency Syndrome)

作　　者：王兆京[1] 还向坤 吴冠楠 吴晓宇[1] 姚学权[1] WANG Zhao-jing;HUAN Xiang-kun;WU Guan-nan;WU Xiao-yu;YAO Xue-quan(Affiliated Hospital of Nanjing University of Chinese Medicine/Jiangsu Province Hospital of Chinese Medicine,Nanjing Jiangsu 210029,China)

机构地区：[1]南京中医药大学附属医院/江苏省中医院,江苏南京210029

出　　处：《中医药导报》2021年第2期80-83,共4页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：江苏省中医院2019年度院级课题夏桂成基金中医学术研究项目(Y19010)。

摘　　要：目的:探讨补中益气汤加减治疗急迫失禁型低位前切除综合征(脾胃虚损证)的疗效。方法:收集直肠切除术后急迫失禁型低位前切除综合征(脾胃虚损证)患者54例,随机分为对照组26例和治疗组28例。对照组患者予常规盆底肌肉锻炼,治疗组患者在常规盆底肌肉锻炼的基础上口服补中益气汤加减,治疗于直肠切除术后1个月开始,疗程为4周。观察比较两组患者治疗前后LARS症状评分及分级、排便次数、排便复常率、EORTC生命质量QLQ-C30评分等指标。结果:治疗后两组患者LARS症状评分、排便次数均较治疗前降低(P<0.05),LARS症状分级均较治疗前改善(P<0.05)。治疗后治疗组患者LARS症状评分、排便次数均低于对照组(P<0.05),排便复常率高于对照组(P<0.05)。治疗后治疗组患者总体健康领域评分、功能领域评分高于治疗前(P<0.05),且治疗组患者功能领域评分高于对照组(P<0.05)。结论:补中益气汤加减治疗急迫失禁型低位前切除综合征(脾胃虚损证),可减少患者排便次数,缓解患者LARS症状,提高部分患者的生活质量。Objective:To investigate the therapeutic effect of modified Buzhong Yiqi Decoction on patients with the urgent incontinence type of low anterior resection syndrome(spleen and stomach deficiency syndrome).Methods:Totally 54 patients,who suffer from the urgent incontinence type of low anterior resection syndrome(spleen and stomach deficiency syndrome)after rectal surgery,were randomly divided into control group(26 cases)and treatment group(28 cases).Patients were given routine pelvic floor muscle exercise in control group,while patients in treatment group were treated with modified Buzhong Yiqi Decoction on the basis of the routine pelvic floor muscle exercise.The treatment began from the point of a month after rectal operation and with a period of 4 weeks.The LARS symptom score,LARS symptom grading,defecation frequency,recovery rate of defecation and EORTC quality of life QLQ-C30 score were monitored and compared between the two groups before and after treatment.Results:The LARS symptom score and defecation frequency decreased in the two groups after treatment(P<0.05),and the LARS symptom grading was improved than those before treatment(P<0.05).After treatment,the treatment group showed lower LARS symptom score and defecation frequency than control group(P<0.05)and higher normalization rate of defecation than control group(P<0.05).After treatment,the scores of health domain and functional domain in the treatment group were higher than those before treatment(P<0.05),and the treatment group showed higher score of functional domain than control group(P<0.05).Conclusion:Modified Buzhong Yiqi Decoction can reduce defecation frequency of patients with the urgent incontinence type of low anterior resection syndrome(spleen and stomach deficiency syndrome),alleviate LARS symptoms of patients,and improve the quality of life of these patients.

关 键 词：低位前切除综合征 急迫失禁型 脾胃虚损证 补中益气汤 盆底肌肉锻炼 生活质量 

分 类 号：R256.34[医药卫生—中医内科学]