基于“一气周流”理论运用苓蔻人参汤治疗腹泻型肠易激综合征临床研究  

Clinical Study on the Treatment of Diarrhea Predominant Irritable Bowel Syndrome with Lingkou Ginseng Decoction Based on the Theory of“Qi Movement in Loops”

作　　者：高强强 艾霞 姜华 甘会平 尚用冉 谭书法 黄水兰 GAO Qiangqiang;AI Xia;JIANG Hua;GAN Huiping;SHANG Yongran;TAN Shufa;HUANG Shuilan(Affiliated Hospital of Shaanxi University of Chinese Medicine,Shaanxi Xianyang 712000,China;School of Acupuncture and Moxibustion and Massage,Shaanxi University of Chinese Medicine,Shaanxi Xianyang 712000,China;First Clinical School of Shaanxi University of Chinese Medicine,Shaanxi Xianyang 712000,China)

机构地区：[1]陕西中医药大学附属医院,陕西咸阳712000 [2]陕西中医药大学针灸推拿学院,陕西咸阳712000 [3]陕西中医药大学第一临床医学院,陕西咸阳712000

出　　处：《陕西中医药大学学报》2025年第1期119-123,共5页Journal of Shaanxi University of Chinese Medicine

基　　金：陕西省教育厅项目(17JK0214)。

摘　　要：目的基于黄元御的“一气周流”理论,观察其所创苓蔻人参汤治疗肝郁脾虚证腹泻型肠易激综合征的临床疗效,为中医药治疗该病提供新的诊治思路。方法选取68例肝郁脾虚证腹泻型肠易激综合征患者随机分为治疗组34例和对照组34例,对照组口服马来酸曲美布汀胶囊治疗,治疗组在对照组的用药基础上配合苓蔻人参汤治疗,比较两组治疗前后临床疗效、肠道菌群参数、Bristol粪便性状评分、排粪频率(SBM/W)、肠易激综合征病情严重程度量表(IBS-SSS)评分,6周后进行疗效评价。结果对照组和治疗组总有效率分别为73.53%(25/34)、93.75%(31/34),差异有统计学意义(P<0.05)。两组患者在接受治疗后肠道乳酸杆菌、双歧杆菌含量均增多,同时,消化杆菌、肠杆菌数量均减少(P<0.05),且治疗组变化程度大于对照组(P<0.05)。治疗后,Bristol治疗组粪便性状评分、排粪频率(SBM/W)明显优于对照组,差异具有统计学意义(P<0.05)。治疗前,两组IBS-SSS积分差异无统计学意义(P>0.05);治疗后,两组IBS-SSS积分较治疗前均有下降(P<0.05)。两组患者在治疗过程中均未出现胃肠道不良反应。结论苓蔻人参汤联合马来酸曲美布汀可有效调控肠道菌群,显著改善临床症状,提高患者的生活质量,是一种安全有效的治疗方法。Objective Based on HUANG Yuanyu's theory of“Qi Movement in Loops”,this study aims to observe the clinical efficacy of Lingkou Ginseng decoction in treating diarrhea type irritable bowel syndrome with liver depression and spleen deficiency syndrome,and provide new diagnostic and therapeutic ideas for traditional Chinese medicine treatment of this disease.Methods 68 patients with diarrhea type irritable bowel syndrome caused by liver depression and spleen deficiency were randomly divided into a treatment group(n=34)and a control group(n=34).The control group was treated with oral administration of Trimebutine Maleate capsules,while the treatment group was treated with Lingkou Ginseng decoction in addition to the medication used in the control group.The clinical efficacy,gut microbiota parameters,Bristol fecal trait score,defecation frequency(SBM/W),and Irritable Bowel Syndrome Severity Scale(IBS-SSS)score were compared between the two groups before and after treatment.The efficacy was evaluated after 6 weeks.Results The total effective rates of the control group and the treatment group were 73.53%(25/34)and 93.75%(31/34),respectively,with a statistically significant difference(P<0.05).After receiving treatment,both groups of patients showed an increase in the content of lactobacilli and bifidobacteria in their intestines,while the number of digestive and intestinal bacteria decreased(P<0.05),and the degree of change in the treatment group was greater than that in the control group(P<0.05).After treatment,the Bristol treatment group showed significantly better fecal trait scores and defecation frequency(SBM/W)than the control group,with statistical significance(P<0.05).Before treatment,there was no statistically significant difference in IBS-SSS scores between the two groups(P>0.05);After treatment,both groups showed a decrease in IBS-SSS scores compared to before treatment(P<0.05).Both groups of patients did not experience any gastrointestinal adverse reactions during the treatment process.Conclusion The combin

关 键 词：一气周流 肝郁脾虚证 肠易激综合征 黄元御 苓蔻人参汤 

分 类 号：R259[医药卫生—中西医结合]