肠易激综合征的影响因素分析及补脾固涩法治疗其脾肾阳虚证腹泻型的疗效观察  

Analysis of the Influencing Factors of Irritable Bowel Syndrome and the Therapeutic Effect of Spleen-Invigorating and Astringent Therapy in Treating Diarrhea of Spleen-Kidney Yang Deficiency Syndrome

作　　者：邹济源 谭海诚 武琛 张冬梅 宋方芳 ZOU Ji-yuan;TAN Hai-cheng;WU Chen;ZHANG Dong-mei;SONG Fang-fang(Shunyi Hospital of Beijing Traditional Chinese Medicine Hospital,Beijing 101300)

机构地区：[1]北京中医医院顺义医院,北京101300

出　　处：《世界中西医结合杂志》2022年第1期192-195,共4页World Journal of Integrated Traditional and Western Medicine

基　　金：马万千全国基层名老中医药专家传承工作室(国中医药人教教育便函[2017]325号);北京市属医院科研培育计划(PZ 2017016)。

摘　　要：目的探究影响肠易激综合征(Irritable bowel syndrome,IBS)病情的相关因素,并观察补脾固涩法治疗脾肾阳虚证腹泻型肠易激综合征(IBS-D)的疗效。方法选取2018年3月—2020年3月期间于北京中医医院顺义医院就诊的120例IBS患者,其中包含IBS-D 91例,采用单因素分析和Logistic回归模型分析IBS病情的影响因素。91例IBS-D患者按照中医证型又分为脾肾阳虚证IBS-D(66例)和其他类证型IBS-D(25例),采用随机数字表法将66例脾肾阳虚证IBS-D患者分为对照组和观察组,每组各33例。对照组予调节肠道菌群、改善胃肠动力、调节胃肠功能等对症支持治疗。观察组在对照组基础上,加用补脾固涩法治疗。两组患者均接受治疗4周。治疗后,观察比较两组患者临床疗效及治疗前后IBS严重程度度量表(IBS symptom severity scale,IBS-SSS)评分情况。结果单因素分析显示,患者年龄、抑郁、焦虑、头痛均与IBS病情有关(P<0.05);多因素Logistic分析表明,抑郁、焦虑是IBS病情的独立影响因素(P<0.05)。治疗后观察组总有效率为93.55%(29/31)高于对照组的74.19%(23/31),差异有统计学意义(P<0.05)。治疗后两组腹痛程度、腹痛频率、腹胀程度、排便满意度、对生活的影响程度以及症状总积分均较治疗前降低,差异有统计学意义(P<0.05);且观察组治疗后腹痛程度、腹痛频率、排便满意度以及症状总积分均较对照组明显降低,差异有统计学意义(P<0.05)。结论抑郁、焦虑对IBS病情影响较大,补脾固涩法能有效改善脾肾阳虚证IBS-D疗效和临床症状,值得推广应用。Objective To explore the influencing factors of irritable bowel syndrome(IBS),and observe the therapeutic effect of invigorating spleen and fixing astringency on diarrhea predominant irritable bowel syndrome(IBS-D)of spleen and kidney yang deficiency syndrome.Methods A total of 120 patients with IBS who were treated in Shunyi Hospital of Beijing Traditional Chinese Medicine Hospital from March 2018 to March 2020 were selected,including 91 cases of IBS-D.Univariate analysis and logistic regression model were used to analyze the influencing factors of IBS.91 cases of IBS-D patients were further divided into IBS-D(66 cases)and other types of IBS-D(25 cases)according to TCM syndrome types.The patients with IBS-D syndrome were divided into control group and observation group,33 cases in each group.The control group received symptomatic and supportive treatments such as regulating intestinal flora,improving gastrointestinal motility,and regulating gastrointestinal function.On the basis of the control group,the observation group was additionally treated with the method of invigorating the spleen and solidifying astringency.Both groups received treatment for 4 weeks.After treatment,the clinical efficacy and IBS symptom severity scale(IBS-SSS)scores before and after treatment were observed and compared between the two groups.Result Single factor analysis showed that age,depression,anxiety and headache were all related to IBS(P<0.05).Multivariate Logistic analysis showed that depression and anxiety were independent influencing factors of IBS disease(P<0.05).After treatment,the total effective rate in the observation group was 93.55%(29/31),which was higher than that in the control group,which was 74.19%(23/31),and the difference was statistically significant(P<0.05).After treatment,the degree of abdominal pain,frequency of abdominal pain,degree of abdominal distension,satisfaction with defecation,degree of influence on life and total symptom score in the two groups were all lower than those before treatment,and the differe

关 键 词：肠易激综合征 影响因素 腹泻型 脾肾阳虚证 补脾固涩法 

分 类 号：R442.2[医药卫生—诊断学]