柴胡桂枝汤治疗肠易激综合征肝郁脾虚证的疗效观察  

Observation on the Therapeutic Effect of Chaihu Guizhi Decoction(柴胡桂枝汤)on Irritable Bowel Syndrome with Liver Stagnation and Spleen Deficiency Syndrome

作　　者：蔡燕 余炼[2] 叶新萍[1] 宾东华[1] CAI Yan;YU Lian;YE Xinping;BIN Donghua(the First Hospital of Hunan University of Chinese Medicine,Changsha Hunan 410007,China;Hunan University of Chinese Medicine,Changsha Hunan 410208,China)

机构地区：[1]湖南中医药大学第一附属医院,湖南长沙410007 [2]湖南中医药大学,湖南长沙410208

出　　处：《中医药导报》2023年第9期63-67,共5页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：2022年度湖南省中医药科研计划项目(E2022035);湖南省教育厅科学研究项目(21B0395)。

摘　　要：目的:探讨柴胡桂枝汤治疗肠易激综合征(IBS)肝郁脾虚证的疗效。方法:将110例IBS肝郁脾虚证患者随机分为治疗组与对照组,每组55例,两组患者均予以常规对症干预,对照组患者给予复方谷氨酰胺肠溶胶囊治疗,治疗组患者在对照组基础上予以柴胡桂枝汤治疗。统计两组治疗总有效率,比较治疗前后两组患者中医证候积分、肠易激综合征严重程度积分(IBS-SSS)、胃肠激素[血管活性肠肽(VIP)、血清胃动素(MOT)、生长抑素(SS)]、肠道菌群(乳杆菌、双歧杆菌、肠杆菌数量)。结果:对照组使用其他药物退出1例,治疗组自行退出1例,两组均54例完成研究。治疗组总有效率为94.44%(51/54),对照组总有效率为77.78%(42/54),治疗组高于对照组(P<0.05)。两组患者治疗后IBS-SSS评分与中医证候积分均较治疗前降低(P<0.05),且治疗后治疗组患者IBS-SSS评分、中医证候积分均低于对照组(P<0.05)。治疗后两组患者血清VIP、SS均较治疗前降低(P<0.05),血清MOT均较治疗前升高(P<0.05);治疗后治疗组患者血清VIP、SS均低于对照组(P<0.05),血清MOT高于对照组(P<0.05)。治疗后两组患者乳杆菌、双歧杆菌数量均较治疗前升高(P<0.05),肠杆菌数量均较治疗前降低(P<0.05);治疗后治疗组患者双歧杆菌、乳杆菌数量均高于对照组(P<0.05),肠杆菌数量低于对照组(P<0.05)。结论:柴胡桂枝汤治疗IBS肝郁脾虚证患者有较好疗效,能调节肠道菌群,改善胃肠激素水平,缓解临床症状。Objective:To explore the therapeutic effect of Chaihu Guizhi Decoction on irritable bowel syndrome(IBS)with liver stagnation and spleen deficiency syndrome.Method:110 patients with liver stagnation and spleen deficiency syndrome of IBS were randomly divided into the treatment group and the control group,with 55 patients in each group.Both groups received routine symptomatic intervention.The control group received compound glutamine enteric coated capsules for treatment,while the treatment group received Chaihu Guizhi Decoction for treatment on the basis of the control group.The total effective rate of treatment in the two groups was calculated.The traditional Chinese medicine(TCM)syndrome score,IBS symptom severity scale(IBS-SSS),gastrointestinal hormones[serum motilin(MOT),vasoactive intestinal peptide(VIP)and somatostatin(SS)],and intestinal flora(number of lactobacillus,bifidobacterium,and enterobacter)were compared between the two groups before and after treatment.Result:One patient withdrew from the control group using other drugs,while one patient withdrew from the treatment group on their own.54 patients in both groups completed the study.The total effective rate of the treatment group was 94.44%(51/54),while the total effective rate of the control group was 77.78%(42/54).The treatment group was higher than the control group(P<0.05).After treatment,the IBS-SSS score and TCM syndrome score of the two groups decreased compared to before treatment(P<0.05),and the IBS-SSS score and TCM syndrome score of the treatment group were lower than those of the control group(P<0.05).After treatment,the serum VIP and SS of both groups decreased compared to before treatment(P<0.05),while the serum MOT increased compared to before treatment(P<0.05).After treatment,the serum VIP and SS of patients in the treatment group were lower than those in the control group(P<0.05),and the serum MOT was higher than that in the control group(P<0.05).After treatment,the number of lactobacilli and bifidobacteria in both groups increased c

关 键 词：肠易激综合征 肝郁脾虚证 柴胡桂枝汤 复方谷氨酰胺 胃肠激素 肠道菌群 临床研究 

分 类 号：R256.34[医药卫生—中医内科学]