柴胡桂枝干姜汤治疗腹泻型肠易激综合征(肝郁脾虚证)临床研究  

Clinical Study on Chaihu Guizhi Ganjiang Decoction in Treating IBS-D with Liver Stagnation and Spleen Deficiency

作　　者：何锦轶 黄适[2] 周尧红 王凯[1] 谢小玲 覃川峰 董星 李莹莹 胡伟 黄鹏 He Jinyi;Huang Shi;Zhou Yaohong;Wang Kai;Xie Xiaoling;Qin Chuanfeng;Dong Xing;Li Yingying;Hu Wei;Huang Peng(Guangxi University of Traditional Chinese Medicine,Guangxi,Nanning 530001,China)

机构地区：[1]广西中医药大学,广西南宁530001 [2]广西中医药大学附属瑞康医院,广西南宁530011

出　　处：《中国中医急症》2021年第4期645-648,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81560754);广西中医药大学双一流课题(0S019018H5);广西中医药大学硕士研究生教育创新计划项目(YCSY20190016)。

摘　　要：目的观察柴胡桂枝干姜汤治疗腹泻型肠易激综合征(IBS-D)(肝郁脾虚证)患者临床疗效及其安全性。方法将患者60例随机分为治疗组和对照组各30例。治疗组患者用柴胡桂枝干姜汤原方口服治疗,而对照组患者口服匹维溴铵片治疗,两组的治疗周期均为4周。比较两组患者的临床疗效及治疗前后症状严重程度量表评分、中医症状总积分、汉密尔顿焦虑量表评分、汉密尔顿抑郁量表评分、IBS生活质量问卷评分、血浆中降钙素基因相关肽(CGRP)和血管活性肠肽(VIP)水平。结果在整体临床疗效上观察组较其对照组有明显提高(P <0.05)。治疗后两组患者在中医症状总积分、IBS-SSS评分均显著好于治疗前(P <0.05)。治疗后观察组在中医症状总积分、IBS-SSS评分方面显著好于对照组(P <0.05)。治疗后,观察组的IBS-QOL评分高于对照组,HAMA、HAMD评分均低于对照组(P <0.05)。并且两组患者治疗后的HAMA、HAMD评分均低于治疗前,IBS-QOL评分均高于治疗前(P <0.05)。治疗后两组患者血浆CGRP,VIP均下降,差异有统计学意义(P <0.05)。治疗后,观察组患者血浆CGRP,VIP明显低于对照组,差异有统计学意义(P <0.05)。两组患者均在治疗时间范围内未出现相关药物的不良反应。结论使用柴胡桂枝干姜汤可以对IBS-D(肝郁脾虚证)症状方面改善取得良好的效果,同时安全性高。Objective:To explore the application of Chaihu Guizhi Ganjiang Decoction in the treatment of patients with irritable bowel syndrome(IBS-D)with liver depression and spleen deficiency,and to observe its clinical efficacy and safety.Methods:A total of 60 patients were randomly divided into the treatment group and control group,30 cases in each group.The treatment group was treated with Chaihu Guizhi Ganjiang Decoction orally,while the control group was treated with pinaverium bromide tablets.The treatment period of both groups was 4 weeks.The clinical efficacy,IBS symptom severity scale(IBS-SSS)scores,the total scores of TCM symptoms,the Hamilton Anxiety Scale(HAMA)score,the Hamilton Depression Scale(HAMD)score,the IBS quality of life questionnaire(IBS-QOL)score,and the plasma calcitonin gene-related peptide(CGRP)and Vasoactive Intestinal Peptide(VIP)level changes of the two groups before and after treatment were observed and compared.Results:The overall clinical efficacy of the treatment group was significantly improved compared with the control group(P<0.05).After treatment,the total scores of TCM symptoms and IBS-SSS scores of the two groups were significantly better than those before treatment(P<0.05),and the scores of the treatment group were significantly better than those of the control group(P<0.05).The IBS-QOL score of the treatment group was higher than that of the control group,and the HAMA and HAMD scores were lower than those of the control group(P<0.05);the HAMA and HAMD scores of the two groups after treatment were both lower than those before treatment,and the IBS-QOLscores were higher than those before treatmen(tP<0.05).The plasma CGRP and VIP levels of the two groups de-creased,and the difference was statistically significant(P<0.05);the plasma CGRP and VIP levels of the treat-ment group were significantly lower than those of the control group,and the difference was statistically significant(P<0.05).In this study,the two groups had no adverse reactions of related drugs within the treatment period a

关 键 词：腹泻型肠易激综合征 柴胡桂枝干姜汤 肝郁脾虚型 

分 类 号：R574.4[医药卫生—消化系统]