疏肝健脾法与健脾化湿法治疗腹泻型肠易激综合征对比疗效观察

Curative effect of dispersing stagnated liver-qi and invigorating spleen versus invigorating spleen for eliminating dampness on diarrhea predominant irritable bowel syndrome

目的:对比观察基于随证加减的疏肝健脾法和健脾化湿法治疗腹泻型肠易激综合征(IBS-D)的疗效。方法:156例IBS-D患者随机分为疏肝健脾、健脾化湿和匹维溴胺组,疗程4周,随访3个月。结果:疾病疗效评价,疏肝健脾组总有效率为90.6%,健脾化湿组为81.6%,匹维溴胺组为70.4%;症状积分变化:治疗结束和治疗结束后第3个月随访时,疏肝健脾组疗效最佳,与健脾化湿组和匹维溴胺组比较,具有显著性差异(P<0.05)。中医证候治疗后及3个月随访时,疏肝健脾组总有效率为81.1%,健脾化湿组为71.4%,匹维溴胺组为70.4%;疏肝健脾组优于健脾化湿组和匹维溴胺西药组。各组均能有效改善腹胀腹痛、大便次数、大便性状等主要单项症状,但在改善大便次数和大便性状上疏肝健脾组明显优于健脾化湿组及匹维溴胺组(P<0.05)。结论:基于随证加减疏肝健脾法治疗IBS-D具有较好临床疗效,优于健脾化湿中药和匹维溴胺西药。

Objective： To evaluate the curative effect of dispersing stagnated liver-qi and invigorating spleen versus invigorating spleen for eliminating dampness on diarrhea predominant irritable bowel syndrome（IBS-D）. Methods： 156 patients with IBS-D were divided randomly, 53 patients were treated with the decoction of dispersing stagnated liver-qi and invigorating spleen, 49 with invigorating spleen for eliminating dampness, others with Pinaverium Bromide. Course of treatment was 4 weeks and the follow-up was 3 months. Results：① Curative effect assessment systerm： the total effective rate of dispersing stagnated liver-qi and invigorating spleen group was 90.6%, invigorating spleen for eliminating dampness was 81.6% while western medicine was 70.4%. Effect after treatment and follow-up observation, dispersing stagnated liver-qi and invigorating spleen group was superior to other groups significantly（P〈0.05）. The effect assessnent of accumulating scores of TCM pattern. Effect after treatment and follow-up observation. ② Curative effect assessment system of TCM pattern, the total effective rate of dispersing stagnated liver-qi and invigorating spleen was 81.1%, invigorating spleen for eliminating dampness was 71.4%, Pinaverium Bromide was 70.4%. Effect after treatment and follow-up observation, dispersing stagnated liver-qi and invigorating spleen was also superior to other groups. ③Each group can effectively improve main symptoms such as abdominal pain, distention, the frequency of defecation and character of stool. Dispersing stagnated liver-qi and invigorating spleen was the best in the improvement of the frequency of defecation and the character of stool（P〈0.05）. Conclusion： The dispersing stagnated liver-qi and invigorating spleen had good clinical curative effect in treating IBS-D. It was better than invigorating spleen for eliminating dampness and Pinaverium Bromide.