徐氏抑肝扶脾方治疗肝郁脾虚证腹泻型肠易激综合征的临床研究  

Clinical study on the treatment of irritable bowel syndrome with diarrhea of liver depression and spleen deficiency by XUs'Yigan Fupi Formula

作　　者：赵旦娅 郑浩 宋昌娟 卢海霞 曾树宏 刘婷[1] 孙月婷 陆为民[1] ZHAO Dan-ya;ZHENG Hao;SONG Chang-juan;LU Hai-xia;ZENG Shu-hong;LIU Ting;SUN Yue-ting;LU Wei-min(Affliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,China)

机构地区：[1]南京中医药大学附属医院,南京210029

出　　处：《中华中医药杂志》2022年第12期7491-7494,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家中医药管理局“国医大师徐景藩学术经验传承研究室”建设项目(No.国中医药人教发[2010]59号)。

摘　　要：目的:评价徐氏抑肝扶脾方治疗肝郁脾虚证腹泻型肠易激综合征(IBS-D)临床疗效及探究作用机制。方法:将60例肝郁脾虚证IBS-D患者随机分为对照组与治疗组,每组30例。对照组予双歧杆菌三联活菌胶囊联合匹维溴铵片;治疗组予抑肝扶脾方。治疗4周后,评估IBS症状严重程度积分(IBS-SSS)、中医证候积分、Bristol粪便性状、医院焦虑量表(HAD-A)、医院抑郁量表(HAD-D)及血清促肾上腺皮质激素释放因子(CRF)、D-乳酸(D-LA)、二胺氧化酶(DAO)、白介素-1β(IL-1β)、白介素-6(IL-6)、肿瘤坏死因子α(TNF-α)。结果:治疗组总有效率96.67%(29/30)显著高于对照组83.33%(25/30)(P<0.05);两组治疗后IBS-SSS、Bristol、HAD-A、HAD-D积分,中医证候积分及血清CRF、D-LA、DAO、IL-1β、IL-6、TNF-α水平均较治疗前显著降低(P<0.01),且除Bristol粪便积分外治疗组降低更显著(P<0.01,P<0.05)。结论:调节脑肠轴,改善肠屏障功能,缓解肠黏膜低度炎症,可能是徐氏抑肝扶脾方治疗IBS-D的作用机制之一。Objective:To investigate the effects and mechanism of XUs'Yigan Fupi Formula in treatment of irritable bowel syndrome with diarrhea(IBS-D)syndrome of liver depression and spleen deficiency.Methods:Sixty patients with IBS-D syndrome of liver depression and spleen deficiency were randomly divided into control group and treatment group.The control group was given Bifidobacterium triple live capsule combined with Piveconium Bromide Tablet,while the treatment group was given Yigan Fupi Formula.After 4 weeks,IBS severity scoring system(IBS-SSS),TCM syndrome score,Bristol fecal traits,hospital anxiety and depression-anxiety(HAD-A),hospital anxiety and depression-depression(HAD-D),and serum corticotropin-releasing factor(CRF),D-lactic acid(D-LA),diamine oxidase(DAO),interleukin 1β(IL-1β),interleukin 6(IL-6)and tumour necrosis factor-alpha(TNF-α)were detected.Results:The total effective rate of the treatment group was 96.67%(29/30),higher than that of the control group 83.33%(25/30)(P<0.05).After treatment,IBS-SSS,Bristol,HAD-A,HAD-D scores,total scores of TCM syndromes and serum levels of CRF,D-LA,DAO,IL-1β,IL-6 and TNF-αwere significantly decreased in both groups compared with before treatment(P<0.01).Besides Bristol scores,the reduction was more significant in the treatment group(P<0.01,P<0.05).Conclusion:Regulating the brain-intestinal axis,improving the intestinal barrier function,and alleviating low-grade intestinal mucosal inflammation may be one of the mechanisms of XUs'Yigan Fupi Formula in the treatment of IBS-D.

关 键 词：徐景藩 抑肝扶脾方 腹泻型肠易激综合征 脑肠轴 肠黏膜低度炎症 

分 类 号：R259[医药卫生—中西医结合]