痛泻托脾方内服联合灌肠治疗肝郁脾虚型腹泻型肠易激综合征临床观察

Clinical Observation of Using Tongxie Tuopi Decoction Combined with Enema in Treating Diarrhea Type Irritable Bowel Syndrome with Liver Stagnation and Spleen Deficiency Syndrome

目的:观察痛泻托脾方内服联合灌肠治疗肝郁脾虚型腹泻型肠易激综合征(IBS-D)患者的临床效果。方法:将2019年1月~2020年12月96例肝郁脾虚型IBS-D患者根据随机对照原则分为观察组、对照组,每组均为48例。对照组应用谷氨酰胺、双歧杆菌乳杆菌治疗,观察组在以上基础上采用痛泻托脾方内服联合灌肠治疗,比较两组临床疗效,复发率,治疗前后中医证候、生活质量和情绪状态。结果:治疗后观察组总有效率91.67%,高于对照组77.08%(P<0.05)。治疗后观察组复发率6.25%,低于对照组22.92%(P<0.05)。治疗后两组腹痛即泻、泻后痛减,急躁易怒,大便性状,大便频次,腹胀,两胁胀满,倦怠乏力,食欲减退评分均下降;观察组腹痛即泻、泻后痛减,急躁易怒,大便性状,大便频次,腹胀,两胁胀满,倦怠乏力,食欲减退评分均低于对照组(P<0.05)。治疗后两组IBS生活质量量表(IBS-QOL)评分增加,汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评分均下降,观察组IBS-QOL评分增加,HAMA、HAMD评分均低于对照组(P<0.05)。结论:痛泻托脾方内服联合灌肠治疗肝郁脾虚型IBS-D患者临床疗效显著,可降低复发,缓解症状,改善生活质量和情绪状态。

Objective:To observe the clinical effect of using Tongxie Tuopi Decoction combined with enema in the treatment of irritable bowel syndrome-diarrhea type(IBS-D)patients with liver depression and spleen deficiency syndrome.Methods:From January 2019 to December 2020,96 patients with liver depression and spleen deficiency type IBS-D were divided into an observation group and a controlled group according to the principle of randomized control,with 48 cases in each group.The controlled group was treated with Glutamine and Lactobacillus Bifidobacterium,and the observation group was treated with Tongxie Tuopi Decoction combined with enema on the above basis.The clinical efficacy,recurrence rate,TCM syndromes,quality of life and mood before and after treatment were compared between the two groups.Results:After treatment,the total effective rate of the observation group was 91.67%(44/48)higher than that of the controlled group 77.08%(37/48)(P<0.05).After treatment,the recurrence rate of the observation group was 6.25%(3/48)lower than that of the controlled group 22.92%(11/48)(P<0.05).After treatment,the two groups had abdominal pain,namely diarrhea,pain reduction after diarrhea,irritability,stool characteristics,stool frequency,abdominal distension,fullness of the two flanks,fatigue and loss of appetite,and the scores of the observation group decreased.Irritability,stool characteristics,stool frequency,abdominal distension,fullness of both flanks,fatigue,and loss of appetite were all lower than the controlled group(P<0.05).After treatment,the IBS quality of life(IBS-QOL)scores increased in the two groups,and the Hamilton anxiety rating scale(HAMA)and Hamilton depression rating scale(HAMD)scores decreased.The IBS-QOL score of the observation group increased,and the HAMA and HAMD scores were lower than those of the controlled group(P<0.05).Conclusion:Using Tongxie Tuopi Decoction combined with enema in treating IBS-D patients with liver depression and spleen deficiency syndrome has a significant clinical effect,reducing recurrence,relieving symptoms,and improving quality of life and emotional state.