疏木培土隔药灸干预腹泻型肠易激综合征及负性情绪的临床研究  

Clinical study on effect of Shumu Peitu herb-partitioned moxibustion on diarrhea-predominant irritable bowel syndrome and negative emotions

作　　者：戴彦祺 郭秀君[2] 吴琼[2] 杨勤[3] 曾钰[4] 黄莉 Dai Yanqi;Guo Xiujun;Wu Qiong;Yang Qin;Zeng Yu;Huang Li(School of Nursing,Nanjing University of Chinese Medicine,Nanjing 210023,China;Department of Nursing,Nanjing Hospital of Chinese Medicine,Nanjing 210022,China;Department of Spleen and Stomach Diseases,Nanjing Hospital of Chinese Medicine,Nanjing 210022,China;Department of Anorectal Treatment Center,Nanjing Hospital of Chinese Medicine,Nanjing 210022,China)

机构地区：[1]南京中医药大学护理学院,南京210023 [2]南京市中医院护理部,南京210022 [3]南京市中医院脾胃病科,南京210022 [4]南京市中医院肛肠诊疗中心,南京210022

出　　处：《中国实用护理杂志》2023年第17期1294-1300,共7页Chinese Journal of Practical Nursing

基　　金：南京市卫生科技发展专项资金项目(GBX21327);镇江市中医脾胃病临床医学研究中心开放课题基金资助项目(SSPW2022-KF02)。

摘　　要：目的探究疏木培土隔药灸对腹泻型肠易激综合征(肝郁脾虚证)患者临床症状及负性情绪的干预效果。方法选取2021年9月至2022年6月在南京市中医院脾胃病科就诊的72例肝郁脾虚证腹泻型肠易激综合征患者进行随机对照研究,采用随机数字表法将患者随机分为观察组(脱落2例,共34例)和对照组(脱落1例,共35例),对照组予以口服痛泻要方治疗,观察组在对照组的基础上予隔药灸治疗,2组均连续治疗4周。比较2组患者治疗后临床疗效、中医证候积分、肠易激综合征生命质量量表(IBS-QOL)评分、肠易激综合征病情严重程度量表(IBS-SSS)评分、粪便性状评分及医院焦虑抑郁量表(HADS)评分。结果治疗后观察组的治疗总有效率为94.12%(32/34),显著高于对照组的71.43%(25/35),差异有统计学意义(χ^(2)=6.18,P<0.05)。治疗后观察组的中医证候积分为(7.62±4.08)分,显著低于对照组的(9.89±4.71)分,差异有统计学意义(t=2.14,P<0.05)。治疗后3 d观察组患者的生命质量评分在心境恶劣、行为障碍、健康担忧、进食逃辟及社会功能5个维度方面分别为(82.44±11.46)、(80.25±11.67)、(76.23±12.67)、(59.80±15.14)和(79.23±11.59)分,均显著高于对照组的(73.57±12.39)、(72.35±15.48)、(69.76±13.11)、(50.00±16.17)和(73.04±13.11)分,差异均有统计学意义(t值为-3.09~-2.08,均P<0.05)。治疗后3 d观察组IBS-SSS评分和Bristol粪便性状评分分别为(118.24±40.64)、(5.09±0.62)分,均显著低于对照组的(146.86±60.09)、(5.51±0.66)分,差异均有统计学意义(t=2.31、2.76,均P<0.05)。治疗后3 d观察组的HADS-A、HADS-D评分分别为(6.26±1.75)、(5.29±1.47)分,与同期对照组的(7.26±2.19)、(6.17±2.11)分相比,差异均有统计学意义(t=2.08、2.00,均P<0.05)。结论疏木培土隔药灸可有效改善肝郁脾虚证腹泻型肠易激综合征,缓解患者临床症状,减轻负性情绪,提高生命质量。Objective To explore the intervention effect of Shumu Peitu herb-partitioned moxibustion on clinical signs and symptoms and negative emotions of diarrhea-predominant irritable bowel syndrome(IBS-D)patients with liver-stagnation and spleen-deficiency pattern.Methods A total of 72 patients with IBS-D of liver-stagnation and spleen-deficiency pattern treated in the Department of Gastroenterology of Nanjing Vniversity of Chinese Medicine from September 2021 to June 2022 were selected for randomized controlled trial.The patients were randomly divided into the observation group(2 cases dropped off,34 cases in total)and control group(1 case dropped off,35 cases in total)by random number table method.The patients in control group were treated with Tongxieyaofang(TXYF).The patients in observation group were treated with oral administration of TXYF and Shumu Peitu herb-partitioned moxibustion,and both groups were treated for 4 weeks.The clinical efficacy,Traditional Chinese Medicine(TCM)syndrome integral,IBS Quality of Life Questionnaire(IBS-QOL),IBS Symptom Severity Scale(IBS-SSS),Bristol Stool Form Scale and Hospital Anxiety and Depression Scale(HADS)were compared before and after treatment.Results After treatment,the total effective rate of the observation group was 94.12%(32/34),which was higher than the 71.43%(25/35)in the control group,the difference was significant(χ^(2)=6.18,P<0.05).After treatment,the TCM syndrome integral in the observation group was(7.62±4.08),which was lower than the(9.89±4.71)in the control group,the difference was significant(t=2.14,P<0.05).After treatment of 3 days,the scores of quality of life in the five dimensions of dysthymia,behavior disorder,health worry,avoidance of eating and social function in the observation group were(82.44±11.46),(80.25±11.67),(76.23±12.67),(59.80±15.14)and(79.23±11.59)points,which were different with the(73.57±12.39),(72.35±15.48),(69.76±13.11),(50.00±16.17)and(73.04±13.11)points in the control group,the difference were significant(t values were-3.0

关 键 词：肠易激综合征 腹泻 焦虑 抑郁 隔药灸 

分 类 号：R248.1[医药卫生—中医临床基础]