固本益肠汤与食物日志指导饮食调整联合治疗脾虚泄泻的价值

Value of combination therapy with Gubenyichang decoction and food-remedy in patient with diarrhea due to spleen-insufficiency

[目的]观察固本益肠汤与食物日志指导的饮食调整联合治疗脾虚泄泻的价值,探讨脾虚泄泻与食物过敏的关系。[方法]指导684例脾虚泄泻患者做食物日志,将症状与食物明显相关者(326例,47.7%)分为固本益肠汤加饮食调整联合治疗组与单纯中药治疗组,各163例,其中233例行结肠镜检查,56例行胃镜检查未见器质性病变。[结果]联合治疗组4周治愈率60.0%,显效率37.0%,停药后6周及12周症状复发率为3.1%及11.7%,均优于单纯中药治疗组的14.1%、16.6%及31.6%、56.7%,差异有统计学意义均(P<0.01)。[结论]固本益肠汤与食物日志指导的饮食调整联合治疗脾虚泄泻疗效显著。约47.7%的脾虚泄泻与食物过敏所致肠道免疫机制紊乱关系密切。

[Objective]To observe the relationship between diarrhea due to spleen-insufficiency and food allergy and the value of combination therapy with Gubenyichang decoction and food remedy in patient with diarrhea due to spleen-insuffiency. [Methods]Six hundred and eightyfour cases of patients with diarrhea due to spleen- insufficiency were instructed to note food log, three hundred and twenty six cases whose symptoms were found having obviously mutuality with food were divided into two groups： the group treated by combination therapy with Gubenyichang decoction and food remedy and the group treated by Gubenyichang decoction only. Two hundred and thirty three cases with coloscopy and fifty six cases with gastroscopy had no structural disease. Each group had one hundred and sixty three cases. [Results] In the combination therapy group the curative rate and the effective rate was 60. 0%,37. 0% respectively, which was higher than that in the group treated by Gubenyichang decoction only（14. 1%and 16. 6% respectively）, （P〈0. 01）. The recrudescence rate after stopping treatment at 6 wk and 12 wk was 3. 1% and 11.7% in the combination group as well as 31.6 %,56. 7% in the group treated by Gubenyichang decoction only （P〈 0. 01）. [Conclusion ]Combination therapy with Guben Yichang decoction and food remedy is effective to treat diarrhea due to spleen-insufficiency. Approximate 47.7% cases of diarrhea due to spleen- insufficiency are related with food allergy.