腹泻型肠易激综合征病例证素分布及用药规律研究  

Retrospective Study on the Distribution of Traditional Chinese Medicine Syndrome Elements and Medication Rules for the Patients with Diarrhea-predominant Irritable Bowel Syndrome

作　　者：林欣蓉 郭绍举[2] 李海文 张伟健 潘华峰[1] LIN Xin-Rong;GUO Shao-Ju;LI Hai-Wen;ZHANG Wei-Jian;PAN Hua-Feng(Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Shenzhen Traditional Chinese Medicine Hospital,Shenzhen 518033 Guangdong,China;The Fourth Clinical Medical School of Guangzhou University of Chinese Medicine,Shenzhen 518033 Guangdong,China)

机构地区：[1]广州中医药大学,广东广州510405 [2]深圳市中医院,广东深圳518033 [3]广州中医药大学第四临床医学院,广东深圳518033

出　　处：《广州中医药大学学报》2022年第3期485-490,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省基础与应用基础研究基金项目(编号:2020A1515110947);广东省重点领域研发项目(编号:2020B1111100011);广东省中医药局科研项目(编号:20213015)。

摘　　要：【目的】分析腹泻型肠易激综合征(IBS-D)患者的性别、年龄、中医证型、证素的分布特点及用药规律,为岭南地区诊治该病提供参考。【方法】统计分析深圳市中医院2011~2019年门诊治疗的IBS-D病例的性别、年龄、中医证型、证候要素和用药频次。【结果】(1)共纳入相关病例1726例,其中20~39岁年龄段患者最多(943例,54.63%)。(2)中医证型12种,频次最高的3种证型为脾虚湿盛(569次,32.29%)、肝郁脾虚(552次,31.33%)、脾胃虚寒(325次,18.44%)。(3)病位证素6个,频次前3位的分别为脾(1552次,59.67%)、肝(582次,22.38%)、胃(367次,14.11%);病性证素6个,频次前3位的分别为气虚(1129次,65.40%)、湿(681次,39.50%)、气滞(582次,23.88%)。(4)涉及中药224味,频次较高的依次为白术(1488次,86.21%)、茯苓(1414次,81.92%)、陈皮(1404次,81.34%)等。【结论】脾虚湿盛为IBS-D的始动因素,肝郁为其发展过程的核心病机,中后期易夹杂阴虚、阳虚等复杂证候表现。治疗上常以健脾祛湿、疏肝为原则,祛邪不忘固本,常根据病情发展及寒热虚实辨证运用祛湿药、疏肝药并配伍涩肠药、安神药、健脾药等。Objective To investigate the distribution of gender,age,traditional Chinese syndrome(TCM)syndrome types and syndrome elements in the patients with diarrhea-predominant irritable bowel syndrome(IBS-D)and to explore the medication rules,so as to provide reference for the diagnosis and treatment of IBS-D in Lingnan area.Methods The gender,age,TCM syndrome types,syndrome elements and medication frequency in IBS-D patients admitted in Shenzhen Traditional Chinese Medicine Hospital from 2011 to 2019 were statistically analyzed.Results(1)A total of 1726 cases of IBS-D were included,of which 943 cases(54.63%)were in the 20-39 age group.(2)There were 12 TCM syndrome types occuuring in the studying subjects,and the 3 syndrome types with the highest frequency were the syndrome of predominant dampness due to spleen deficiency(569 times,32.29%),syndrome of liver depression and spleen deficiency(552 times,31.33%),and syndrome of deficiencycold of spleen and stomach(325 times,18.44%).(3)Six diseases-location syndrome elements were presented in the studying subjects and the top three were spleen(1552 times,59.67%),liver(582 times,22.38%)and stomach(367 times,14.11%).Six disease-nature syndrome elements were presented in the studying subjects and the top three were qi deficiency(1129 times,65.40%),dampness(681 times,39.50%)and qi stagnation(582 times,23.88%).(4)A total of 224 Chinese herbs were involved,and the herbs with high frequency were Rhizoma Atractylodis Macrocephalae(1488 times,86.21%),Poria(1414 times,81.92%),Pericarpium Citri Reticulatae(1404 times,81.34%),etc.Conclusion Predominant dampness due to spleen deficiency is the initial factor of the occurrence and development of IBS-D,liver depression is the core pathogenesis of the disease,and the complex syndromes mixed with yang deficiency or yin deficiency are common in the middle and later stage.The treatment should be based on the principles of invigorating spleen,removing dampness,and soothing liver,and supporting healthy qi while eliminating pathogens.The compatibil

关 键 词：腹泻型肠易激综合征(IBS-D) 证素 中医辨证 健脾祛湿 疏肝 用药规律 白术 茯苓 

分 类 号：R259.744[医药卫生—中西医结合]