加味芪榔方治疗气阴两虚型药物依赖性便秘疗效及对血清炎症因子的影响  

Curative effect of modified Qilang Decoction on drug-dependent constipation of type of Qi-yin deficiency and its influence on serum inflammatory factors

作　　者：周蒙恩 晏旎 陈懿榕 林柳兵[1] 李勇[1] ZHOU Meng’en;YAN Ni;CHEN Yirong;LIN Liubing;LI Yong(Shanghai Municipal Hospital of Traditional Chinese Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China)

机构地区：[1]上海中医药大学附属市中医医院,上海200071

出　　处：《现代中西医结合杂志》2021年第19期2058-2062,2114,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：上海市科学技术委员会科研计划项目(18401904000)。

摘　　要：目的观察加味芪榔方治疗气阴两虚型药物依赖性便秘患者的临床疗效及对血清炎症因子的影响。方法纳入2019年5—12月上海中医药大学附属市中医医院诊治的气阴两虚型药物依赖性便秘患者74例,随机分为2组,最终对照组35例、治疗组37例完成研究。对照组予加味芪榔方模拟剂+乳果糖口服液治疗,治疗组予加味芪榔方+乳果糖口服液模拟剂治疗,2组疗程均为8周。比较2组患者治疗前后便秘主要症状(粪便性状,排便费力,排便时间,下坠、不尽、胀感,排便频率,腹胀)积分、中医症状(排便次数、大便干结、排便无力、纳呆、腹胀、乏力、排便不尽、心烦少眠)积分及血清炎症因子核因子-κB(NF-κB)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-12(IL-12)水平,统计2组临床疗效及随访4周后复发率。结果治疗后2组便秘主要症状积分和中医症状积分均较治疗前明显降低(P均<0.05);治疗后除下坠、不尽、胀感积分和排便不尽积分外,治疗组其他各项症状积分均明显低于对照组(P均<0.05)。治疗后2组血清NF-κB、TNF-α、IL-6、IL-12水平均明显降低(P均<0.05),且治疗组均明显低于对照组(P均<0.05)。治疗组总有效率为94.3%(33/35),对照组总有效率为81.1%(30/37),治疗组明显高于对照组(P<0.05);治疗组复发率为18.2%(6/33),对照组复发率为53.3%(16/30),治疗组明显低于对照组(P<0.05)。结论加味芪榔方治疗气阴两虚型药物依赖性便秘可明显减轻症状,疗效优于乳果糖口服液,且复发率低,推测减轻炎症反应是其治疗机制之一。Objective:It is to observe the clinical efficacy of modified Qilang Decoction on drug-dependent constipation of type of Qi-yin deficiency and its influence on serum inflammatory factors.Methods A total of 74 patients with drug-dependent constipation of type of Qi-yin deficiency diagnosed and treated in Shanghai Municipal Hospital of Traditional Chinese Medicine Affiliated to Shanghai University of Traditional Chinese Medicine from May to December 2019 were randomly divided into 2 groups.Finally,35 patients in the control group and 37 patients in the treatment group completed the study.The control group was treated with modified Qilang Decoction mimetic agent+lactulose oral liquid,and the treatment group was treated with modified Jiawei Qilang Decoction+lactulose oral liquid.The treatment course of both groups was 8 weeks.The scores of main symptoms of constipation(fecal traits,laborious defecation,defecation time,feeling of falling,incompleteness,bloating,defecation frequency,abdominal distension)and TCM symptoms(times of defecations,dry stools,atony of defecation,poor appetite,abdominal distension fatigue,incomplete defecation,upset and sleepless)and the levels of serum inflammatory factors nuclear factor-κB(NF-κB),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-12(IL-12)of the patients of both groups were compared before and after treatment,the clinical efficacy of the 2 groups and the recurrence rate after 4 weeks of follow-up were calculated.Results After treatment,the scores of main symptoms of constipation and TCM symptoms in the two groups were significantly lower than those before treatment(P<0.05);except for the scores of feeling of falling,incompleteness,bloating and incomplete defecation,the scores of the other symptoms of the treatment group were significantly lower than those of the control group(P<0.05).After treatment,the levels of serum NF-κB,TNF-α,IL-6,and IL-12 in the two groups were significantly reduced(all P<0.05),and the treatment group was significantly lower than the c

关 键 词：加味芪榔方 药物依赖性便秘 气阴两虚型 乳果糖 炎症因子 

分 类 号：R442.2[医药卫生—诊断学]