香砂六君子汤合四磨汤加减治疗功能性腹泻肝气乘脾证临床研究  

Clinical Study on Modified Xiangsha Liujunzi Tang and Simo Tang for Functional Diarrhea with Syndrome of Liver Qi Over-Restricting Spleen

作　　者：吴泱 张翔[1] 叶丹[1] 吴杰[2] WU Yang;ZHANG Xiang;YE Dan;WU Jie

机构地区：[1]浙江中医药大学附属温州市中西医结合医院,浙江温州325000 [2]华中科技大学附属武汉市中心医院,湖北武汉430014

出　　处：《新中医》2021年第11期55-58,共4页New Chinese Medicine

基　　金：浙江省医药卫生科技计划项目(2017KY629)。

摘　　要：目的:观察香砂六君子汤合四磨汤加减治疗功能性腹泻(FD)肝气乘脾证的临床疗效及对患者血清胃泌素(GAS)及血浆胃动素(MTL)、血管活性肠肽(VIP)水平的影响。方法:选取72例FD肝气乘脾证患者,按随机数字表法分为对照组和治疗组各36例。对照组给予马来酸曲美布汀片联合双歧杆菌四联活菌片治疗,治疗组给予香砂六君子汤合四磨汤加减治疗。比较2组临床疗效及治疗前后胃肠激素水平、临床症状评分。结果:治疗组总有效率为91.67%,明显高于对照组的66.67%,差异有统计学意义(P<0.05)。治疗后,2组血清GAS水平均较治疗前升高(P<0.05),血浆MTL、VIP水平均较治疗前降低(P<0.05);治疗组血清GAS水平高于对照组(P<0.05),血浆MIL、VIP水平均低于对照组(P<0.05)。治疗后,2组腹痛、腹胀、腹泻评分及症状总分均较治疗前降低(P<0.05),治疗组腹痛、腹胀、腹泻评分及症状总分均低于对照组(P<0.05)。结论:香砂六君子汤合四磨汤加减治疗FD肝气乘脾证,可改善患者的临床症状,调节胃肠激素水平,疗效优于西药治疗。Objective:To observe the clinical effect of mdoified Xiangsha Liujunzi tang and Simo tang on functional diarrhea(FD)with syndrom of liver qi over-restricting spleen and its effect on levels of gastrin(GAS)in serum,motilin(MTL)and vasoactive intestinal peptide(VIP)in plasma.Methods:A total of 72 FD patients with syndrome of liver qi over-restricting the spleen were selected and divided into the control group and the treatment group according to the random number table method,36 cases in each group.The control group was treated with trimebutine maleate tablets combined with bifidobacterium tetra-live tablets,and the treatment group was treated with modified Xiangsha Liujunzi tang and Simo tang.The clinical effect,levels of gastrointestinal hormone and scores of clinical symptom in the two groups were compared before and after treatment.Results:The total effective rate was 91.67%in the treatment group,significantly higher than that of66.67%in the control group,the difference being significant(P<0.05).After treatment,the levels of GAS in serum in both groups were increased when compared with those before treatment(P<0.05),the levels of MTL and VIP in plasma in both groups were decreased when compared with those before treatment(P<0.05);the levels of GAS in serum in the treatment group was higher than that in the control group(P<0.05),the levels of MTL and VIP in plasma in the treatment group were lower than those in the control group(P<0.05).The scores of abdominal pain,abdominal distension and diarrhea and the total scores of symptoms in both groups were decreased when compared with those before treatment(P<0.05),and the above scores in the treatment group were lower than those in the control group(P<0.05).Conclusion:The therapy of modified Xiangsa Liujunzi tang combined with Simo tang can improve the clinical symptoms of FD patients with syndrome of liver qi over-restricting the spleen and regulate the level of gastrointestinal hormone,whose therapeutic effect is better than that of western medicine.

关 键 词：功能性腹泻 肝气乘脾证 香砂六君子汤 四磨汤 胃泌素 胃动素 血管活性肠肽 

分 类 号：R256.34[医药卫生—中医内科学]