基于“利小便以实大便”用五苓散治疗肝源性腹泻的临床研究  

Clinical Study of Wuling Powder in Treating Patients with Hepatogenic Diarrhea Based on the Theory of “Treating Diarrhea by Promoting Urination”

作　　者：林煜榆 钟毅[2] 郭红[2] LIN Yu-Yu;ZHONG Yi;GUO Hong(Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Guangdong Second Traditional Chinese Medicine Hospital,Guangzhou 510095 Guangdong,China)

机构地区：[1]广州中医药大学,广东广州510405 [2]广东省第二中医院,广东广州510095

出　　处：《广州中医药大学学报》2022年第12期2782-2787,共6页Journal of Guangzhou University of Traditional Chinese Medicine

摘　　要：【目的】观察基于“利小便以实大便”用五苓散治疗肝源性腹泻的临床疗效。【方法】将67例肝源性腹泻脾虚湿盛证患者随机分为治疗组33例和对照组34例。入组患者在护肝、营养支持治疗的基础上,对照组患者给予口服双歧杆菌三联活菌肠溶胶囊治疗,治疗组患者给予服用五苓散治疗,疗程为2周。观察2组患者治疗前后中医证候积分的变化情况,并评价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93.94%(31/33),对照组为70.59%(24/34);组间比较,治疗组的总体疗效(Mann-Whitney U检验)和总有效率(Fisher精确检验)均明显优于对照组,差异均有统计学意义(P<0.01)。(2)治疗后,2组患者的大便性状、排便频率、脘腹痞满、肢体困倦、食欲不振、精神状况、水谷不化、肠鸣等各项中医证候积分及总积分均较治疗前明显改善(P<0.05),且治疗组的改善作用均明显优于对照组,差异均有统计学意义(P<0.05)。(3)治疗过程中,2组患者均未出现腹胀、腹泻加重等不良反应。【结论】对于肝源性腹泻脾虚湿盛证患者,在护肝、营养支持治疗的基础上,口服双歧杆菌三联活菌肠溶胶囊或口服五苓散均能缓解肝源性腹泻症状,改善大便性状及排便频率,提高患者生活质量,而五苓散治疗组的总体疗效更为显著。Objective To investigate the clinical efficacy of Wuling Powder in treating patients with hepatogenic diarrhea based on the theory of“treating diarrhea by promoting urination”.Methods Sixty-seven patients with hepatogenic diarrhea of predominant dampness due to spleen deficiency syndrome were randomly divided into treatment group(33 cases)and control group(34 cases).On the basis of liver-protection and nutritional support treatment,patients in the control group were treated with oral use of Enteric-coated Bifid Triple Viable Capsules,while patients in the treatment group were treated with Wuling Powder orally.The course of treatment lasted for2 weeks.The changes of traditional Chinese medicine(TCM)syndrome scores were observed in the two groups before and after treatment,and the clinical efficacy and safety of the two groups were also evaluated.Results(1)After 2 weeks of treatment,the overall effective rate of the treatment group was 93.94%(31/33)and that of the control group was 70.59%(24/34).The intergroup comparison showed that the overall efficacy(by Mann-Whitney U test)and the overall effective rate(by Fisher’s precise test)of the treatment group were significantly superior to those of the control group,and the differences were statistically significant(P<0.01).(2)After treatment,the scores of the TCM symptoms of stool features,frequency of defecation,abdominal fullness and oppression,lassititue,poor appetite,mental status,indigestion,and bowel rumbling as well as the total TCM syndrome scores in the two groups were all significantly improved compared with those before treatment(P<0.05).The treatment group had stronger effect on improving the scores than the control group,and the differences were statistically significant(P<0.05).(3)During the treatment,there were no adverse reactions such as aggravation of abdominal distension and diarrhea occurring in the two groups.Conclusion For the patients with hepatogenic diarrhea of predominant dampness due to spleen deficiency syndrome,the treatment should be

关 键 词：肝源性腹泻 脾虚湿盛证 五苓散 利小便 实大便 临床疗效观察 

分 类 号：R256.34[医药卫生—中医内科学]