痛泄要方缓解肝郁脾虚证腹泻型肠易激综合征患者内脏高敏的临床疗效  

Clinical Efficacy of Tongxie Yaofang on Diarrhea-predominant Irritable Bowel Syndrome(IBS-D)Patients with Liver Depression and Spleen Deficiency

作　　者：王栩芮 傅文斌 孙弋淇[1] 黄安清[1] 杨超[1] 李明玥 周沁 WANG Xu-rui;FU Wen-bin;SUN Yi-qi;HUANG An-qing;YANG Chao;LI Ming-yue;ZHOU Qin(Sichuan Provincial People's Hospital,Chendgu 610000,China;Hospital of Chengdu University of Traditional Chinese Medicine,Chendgu 610000,China)

机构地区：[1]四川省人民医院,成都610000 [2]成都中医药大学附属医院,成都610000

出　　处：《中国实验方剂学杂志》2022年第9期97-102,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然基金面上项目(81373644);四川省中医药管理局项目(2014D12)。

摘　　要：目的:探讨痛泻要方缓解肝郁脾虚证腹泻型肠易激综合征(IBS-D)患者的临床疗效及作用机制。方法:选取2017年8月至2021年6月就诊的168例肝郁脾虚型IBS-D患者,以随机数字表法分为观察组及对照组,两组各84例。观察组采用痛泻要方免煎颗粒口服治疗,对照组患者采用匹维溴铵口服治疗,2组患者均治疗4周。比较2组患者治疗前后IBS主要症状如腹痛程度、排便性状的变化情况、肝郁气滞证中医证候评分(TCM-PES)、IBS生活质量问卷评分(IBS-QOL)、IBS病情严重程度量表(IBS-SSS)、患者心理状况评分如焦虑自评量表(SAS)积分及抑郁自评量表(SDS);采用尼莫地平法以肝郁气滞证中医证候评分的变化评价治疗效果;采用酶联免疫吸附测定法(ELISA)检测患者治疗前后血浆白细胞介素-10(IL-10)、白细胞介素-12(IL-12)的水平。结果:治疗4周后,观察组腹痛应答率92.86%(78/84)高于对照组腹痛应答率82.14%(69/84),差异具有统计学意义(χ^(2)=6.254,P<0.05)。观察组腹泻应答率为91.67%(77/84),高于对照组腹泻应答率77.38%(65/84),差异具有统计学意义(χ^(2)=8.214,P<0.01)。观察组治疗后TCM-PES、IBS-QOL评分高于对照组,IBS-SSS积分低于对照组(P<0.05);观察组患者中医证候疗效有效率高于对照组(P<0.05);观察组治疗后SAS、SDS评分低于对照组(P<0.05);观察组治疗后血浆IL-10高于对照组,IL-12低于对照组(P<0.05)。结论:痛泻要方可缓解肝郁脾虚型IBS-D患者腹痛、腹泻,减轻不良情绪,提高患者生活质量,这可能与内脏高敏缓解有关。Objective:To explore the clinical efficacy and mechanism of Tongxie Yaofang in treating diarrhea-predominant irritable bowel syndrome(IBS-D)patients with liver depression and spleen deficiency.Method:A total of 168 IBS-D patients with liver depression and spleen deficiency who were treated from August 2017 to June 2021 were divided into observation group and control group by random number table,84 in each group.The observation group was administrated with Tongxie Yaofang decoction-free granules orally,and the control group received oral treatment of pinaverium bromide,both for 4 weeks.The main symptoms of IBS were compared before and after treatment,such as the degree of abdominal pain,stool changes,traditional Chinese medicine pattern curative effect scoring system(TCM-PES),IBS quality of life questionnaire(IBSQOL),IBS symptom severity scale(IBS-SSS),self-rating anxiety scale(SAS),and self-rating depression scale(SDS).Nimodipine was used to evaluate the efficacy based on TCM syndrome score of liver depression and Qi stagnation.Enzyme-linked immunosorbent assay(ELISA)was conducted to detect the plasma interleukin-10(IL-10)and IL-12 before and after treatment.Result:After 4 weeks of treatment,the response rate of abdominal pain in observation group was 92.86%(78/84),higher than that in control group(82.14%,69/84)(χ^(2)=6.254,P<0.05).The response rates of diarrhea in observation group and control group were 91.67%(77/84)and 77.38%(65/84),respectively(χ^(2)=8.214,P<0.01).TCM-PES and IBS-QOL scores of observation group after treatment were higher and IBS-SSS score was lower than those of control group(P<0.05).The efficacy rate of TCM syndromes in observation group was higher than that of control group(P<0.05).Additionally,after treatment,the observation group had lower SAS and SDS scores(P<0.05)and IL-12 level(P<0.05)and higher plasma IL-10level than the control group(P<0.05).Conclusion:Tongxie Yaofang can relieve abdominal pain and diarrhea in IBS-D patients with liver depression and spleen deficiency,reduce negat

关 键 词：痛泻要方 肠易激综合征腹泻型 内脏高敏 疗效 

分 类 号：R242[医药卫生—中医临床基础] R285.5[医药卫生—中医学]