加味痛泻要方改善肝郁脾虚型肠易激综合征腹泻型肛管直肠测压作用机制研究  

Study on the Mechanism of Modified Tongxie Yaofang in Improving Diarrhea-Type Anorectal Manometry in Irritable Bowel Syndrome with Liver Stagnation and Spleen Deficiency

作　　者：鲁龙生 刘景 周新灿[1] 李小玛 刘凤 LU Long-sheng;LIU Jing;ZHOU Xin-can;LI Xiao-ma;LIU Feng(The First People's Hospital of Huaihua City,Huaihua 418000,China)

机构地区：[1]怀化市第一人民医院,湖南怀化418000

出　　处：《云南中医中药杂志》2022年第7期57-60,共4页Yunnan Journal of Traditional Chinese Medicine and Materia Medica

基　　金：2020年湖南省中医科研计划课题(2020136)。

摘　　要：目的对加味痛泻要方改善肝郁脾虚型肠易激综合征腹泻型肛管直肠测压进行临床观察,探讨其可能作用机制。方法采用信封抽签随机、单盲、对照前瞻性试验方法,按信封抽签将合格受试者分配至观察组与对照组,其中观察组52例,对照组45例;对照组采用双歧杆菌三联活菌内服加生理盐水保留灌肠治疗,观察组采用加味痛泻要方内服加保留灌肠治疗。观察2组患者治疗后总体疗效、治疗前后相关肛管直肠测压指标变化以及治疗前后安全性指标。结果观察组治疗后总体疗效优于对照组(P<0.05);观察组治疗前后相关肛管直肠测压指标改善优于对照组(P<0.05);观察组与对照组治疗前后安全性指标比较,差异无统计学意义(P>0.05)。结论加味痛泻要方内服加保留灌肠治疗肝郁脾虚型腹泻型,可有效降低肛管静息压,提高肛管最大收缩压以及直肠最大感觉阈值,逐渐缓解患者肛门坠胀感,推测其作用机制可能与解除消化道平滑肌痉挛、增强肛管括约肌收缩力、降低直肠肛管敏感性相关。Objective:To make clinical observation on the improvement of anorectal manometry in diarrhea-type irritable bowel syndrome due to liver stagnation and spleen deficiency,and to study its possible mechanism.Methods:The randomized,single-blind,controlled prospective test method was adopted by envelope drawing lots,and the qualified subjects were assigned to the observation group and the control group according to the envelope lottery,including 52 cases in the observation group and 45 cases in the control group.The control group was given bifidobacterium triple oral administration of viable bacteria and retention enema with normal saline while the observation group was given oral administration of modified Tongxie Yaofang and retention enema.The overall curative effect,the changes of related anorectal manometry indexes before and after treatment and the safety indexes before and after treatment in the two groups were observed.Results:The overall curative effect of the observation group after treatment was better than that of the control group(P<0.05).The improvement of related anorectal manometry indexes before and after treatment in the observation group was better than that of the control group(P<0.05).The safety indexes of the observation group and the control group before and after treatment were compared,and the difference was not statistically significant(P>0.05).Conclusion:The oral administration of Modified Tongxie Yaofang and retention enema in the treatment of diarrhea due to liver stagnation and spleen deficiency can effectively reduce the anal canal resting pressure,increase the maximum anal systolic blood pressure and the maximum rectal sensory threshold,and gradually relieve the patient's anal bulge.The mechanism of action may be related to the release of gastrointestinal smooth muscle spasm,enhancement of anal sphincter contractility and reduction of anorectal sensitivity.

关 键 词：痛泻要方 肠易激综合征 肝郁脾虚 肛管直肠测压 

分 类 号：R256.34[医药卫生—中医内科学]