疏肝止泻汤加减治疗腹泻型肠易激综合征的临床观察  

Clinical Observation on Modified Shugan Zhixie Decoction in the Treatment of Diarrhea-predominant Irritable Bowel Syndrome

作　　者：聂山文[1] 赵文霞[2] 吴秀霞[1] NIE Shanwen;ZHAO Wenxia;WU Xiuxia(Department of Hepatobiliary Spleen and Stomach Diseases,Henan Provincial Hospital of Traditional Chinese Medicine,Zhengzhou 450002,China;不详)

机构地区：[1]河南省中医院肝胆脾胃病科,河南郑州450002 [2]河南中医药大学第一附属医院脾胃肝胆科,河南郑州450000

出　　处：《中国医学创新》2025年第6期29-33,共5页Medical Innovation of China

基　　金：第七批全国老中医药专家学术经验继承项目(国家中医药人教函[2022]76号);河南省中医药科学研究专项课题(2022ZY1077)。

摘　　要：目的:探究疏肝止泻汤加减治疗腹泻型肠易激综合征的临床效果及作用机制。方法:将2022年1月—2023年6月河南省中医院的80例腹泻型肠易激综合征患者根据随机数字表法分为两组,每组各包括40例。对照组采用匹维溴铵进行治疗,观察组则采用匹维溴铵联合疏肝止泻汤加减治疗。比较两组的腹泻型肠易激综合征治疗总有效率、复发率、安全性情况、治疗前后的血液指标[胆囊收缩素(CCK)、神经肽Y(NPY)、P物质(SP)、5-羟色胺(5-HT)、胃动素(MOT)及血管活性肠肽(VIP)]、直肠敏感性(直肠感知阈值及排便阈值)及生活质量[肠易激综合征生活质量量表(IBS-QOL量表)]。结果:观察组的腹泻型肠易激综合征治疗总有效率显著高于对照组,复发率显著低于对照组,差异均有统计学意义(P<0.05);两组的安全性情况比较,差异无统计学意义(P>0.05);治疗前两组的血液指标、直肠敏感性及IBS-QOL量表评分比较,差异均无统计学意义(P>0.05),治疗后观察组的血清CCK、SP、5-HT、MOT及VIP均显著低于对照组,血清NPY、直肠敏感性指标及IBS-QOL量表评分均显著高于对照组,差异均有统计学意义(P<0.05)。结论:疏肝止泻汤加减治疗腹泻型肠易激综合征的临床效果较好,其可能通过改善患者的血液指标及直肠敏感性来发挥作用,安全性较高,在腹泻型肠易激综合征患者中的应用价值较高。Objective:To investigate the clinical effect and mechanism of modified Shugan Zhixie Decoction in the treatment of diarrhea-predominant irritable bowel syndrome.Method:A total of 80 patients with diarrheapredominant irritable bowel syndrome in Henan Provincial Hospital of Traditional Chinese Medicine from January 2022 to June 2023 were divided into two groups with 40 cases in each group by the random number table.The control group was treated with Pinaverium Bromide,the observation group was treated with Pinaverium Bromide combined with modified Shugan Zhixie Decoction.Then the total effective rates of diarrhea-predominant irritable bowel syndrome treatment,recurrence rates,safety situation,blood indexes[cholecystokinin(CCK),neuropeptide Y(NPY),substance-P(SP),5-hydroxy tryptamine(5-HT),motilin(MOT)and vasoactine intrestinal peptide(VIP)],rectal sensitivity(rectal perception threshold and defecation threshold)and life qualify(IBS-QOL scale)before and after the treatment of two groups were compared.Result:The total effective rate of diarrhea-predominant irritable bowel syndrome treatment of observation group was significantly higher than that of control group,the recurrence rate was significantly lower than that of control group,the differences were statistically significant(P<0.05);the safety situation of two groups was compared,the difference was not statistically significant(P>0.05);the blood indexes,rectal sensitivity and IBS-QOL scale of two groups before the treatment were compared,the differences were not statistically significant(P>0.05),the serum CCK,SP,5-HT,MOT and VIP of observation group after the treatment were significantly lower than those of control group,the serum NPY,rectal sensitivity indexes and IBSQOL scale scores were significantly higher than those of control group,the differences were statistically significant(P<0.05).Conclusion:The clinical effect of modified Shugan Zhixie Decoction in the treatment of diarrhea-predominant irritable bowel syndrome is better,and it may play role by improvin

关 键 词：疏肝止泻汤加减 腹泻型肠易激综合征 安全性 作用机制 

分 类 号：R259[医药卫生—中西医结合]