参苓白术散加减联合脐灸法治疗脾虚型肠息肉摘除术后伴肠道功能紊乱的临床观察  

Clinical Observation of Modified Shenling Baizhu Powder Combined with Umbilical Moxibustion in the Treatment of Spleen-deficiency Intestinal Dysfunction Patients after Intestinal Polypectomy

作　　者：柯可 冯群虎[2] KE Ke;FENG Qun-Hu(Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Shenzhen Bao’an Traditional Chinese Medicine Hospital,Shenzhen 518101 Guangdong,China)

机构地区：[1]广州中医药大学,广东广州510405 [2]深圳市宝安区中医院,广东深圳518101

出　　处：《广州中医药大学学报》2021年第9期1821-1828,共8页Journal of Guangzhou University of Traditional Chinese Medicine

摘　　要：【目的】观察参苓白术散加减联合脐灸法治疗脾虚型肠息肉摘除术后伴肠道功能紊乱患者的临床疗效。【方法】将62例行电子结肠镜检查及结直肠息肉摘除术,术后伴有肠道功能紊乱,中医证型为脾虚型的患者随机分为治疗组和对照组,每组各31例。2组患者均给予调整饮食及营养支持等对症治疗,在此基础上,对照组给予酪酸梭菌活菌胶囊口服治疗,治疗组给予参苓白术散加减方口服联合脐灸法治疗,疗程为2周。观察2组患者治疗前后中医证候量化积分、生活质量健康调查简表(SF-36)评分的变化情况,比较2组患者的首次止泻时间及治疗后1个月随访的复发情况,评价2组患者的临床疗效和安全性。【结果】(1)治疗2周后,治疗组的总有效率为100.0%(31/31),对照组为83.9(26/31);组间比较(秩和检验),治疗组的疗效明显优于对照组(P<0.01)。(2)治疗后,2组患者的主要证候积分、次要证候积分及证候总积分均较治疗前明显降低(P<0.01),且治疗组的降低作用均明显优于对照组(P<0.01)。(3)治疗后,2组患者SF-36量表的躯体疼痛、精力、健康变化等维度积分及总分均较治疗前明显提高(P<0.05或P<0.01),且治疗组的提高作用均明显优于对照组(P<0.05或P<0.01)。(4)治疗组患者的首次止泻时间为(5.04±0.81)d,明显短于对照组的(7.79±1.35)d,差异有统计学意义(P<0.01)。(5)疗程结束1个月后随访,治疗组的复发率为9.7%(3/31),明显低于对照组的64.5%(20/31),差异有统计学意义(P<0.05)。(6)研究期间,2组患者均未出现身体麻木、眩晕、头痛等不良反应或过敏反应情况,患者的生命体征(体温、脉搏、呼吸、心率、血压)和肝、肾功能等安全性指标均无异常变化。【结论】参苓白术散加减联合脐灸法治疗脾虚型肠息肉摘除术后伴肠道功能紊乱患者疗效显著,可有效改善症状,提高生活质量和防治复发。Objective To observe the clinical effect of modified Shenling Baizhu Powder combined with umbilical moxibustion in the treatment of spleen-deficiency intestinal dysfunction patients following intestinal polypectomy.Methods Sixty-two patients who underwent electronic colonoscopy and colorectal polypectomy, and were accompanied by bowel dysfunction and differentiated as spleen deficiency type were randomly divided into treatment group and control group,with 31 cases in each group. The patients of two groups were given dietary adjustment and symptomatic treatments such as nutritional support. Additionally,the control group was given oral use of Clostridium butyricum live Capsules,while the treatment group was given modified Shenling Baizhu Powder combined with umbilical moxibustion treatment, the treatment lasting 2 weeks. The changes of TCM syndrome quantification integral and the 36-item short-form health survey(SF-36)scores in the two groups were observed before and after treatment. The time for firstly stopping diarrhea and the recurrence rate during one month follow-up after treatment were compared between the two groups,and the clinical effect and safety of the two groups were evaluated. Results(1)After 2 weeks of treatment, the total effective rate of the treatment group was 100.0%(31/31),and that of the control group was 83.9%(26/31). The intergroup comparison by rank sum test showed that the efficacy of the treatment group was significantly superior to that of the control group(P< 0.01).(2)After treatment,the scores of primary syndromes,secondary syndromes and overall scores of the syndromes in the two groups were significantly lower than those before treatment(P< 0.01),and the effect on decreasing the syndrome scores in the treatment group was significantly superior to that in the control group(P< 0.01).(3) After treatment,the scores of bodily pain(BP),vitality(VT),health status and other dimensions of SF-36 and total scores of SF-36 in the two groups were significantly higher than those before treatment(P

关 键 词：参苓白术散 脐灸法 肠息肉摘除术后 肠道功能紊乱 脾虚型 生活质量 

分 类 号：R269.569[医药卫生—中西医结合] R246.2[医药卫生—中医外科学]