健脾调肝温肾方对腹泻型肠易激综合征患者生活质量的影响

Influence of Jianpi Tiaogan Wenshen Recipe on the Quality of Life in Patients with Diarrhea-predominant Irritable Bowel Syndrome

目的观察健脾调肝温肾方对腹泻型肠易激综合征(D-IBS)患者临床症状及生活质量的影响。方法选择D-IBS患者80例进行前瞻性随机对照临床试验。治疗组和对照组各40例,治疗组口服健脾调肝温肾方,对照组口服匹维溴铵片。两组疗程均为4周。于治疗前后观察并记录腹痛或腹部不适等症状,并应用简明健康测量量表(SF-36)和IBS特异性生活质量量表(IBS-QOL)对患者的生活质量进行测评。停药4周后对治愈和显效患者进行随访。结果腹痛或腹部不适、腹胀等症状在本组治疗前后及两组间差异均无统计学意义;黏液便治疗后两组间计分有统计学差异(P<0.05),治疗组优于对照组。治疗组和对照组的痊愈率分别为24.3%及19.4%,总有效率为81.1%及80.6%,两组比较无统计学意义(P>0.05)。远期疗效:治疗组和对照组分别有4例和12例复发或加重,两组间差异有统计学意义(P<0.01)。治疗组在躯体疼痛、心理健康和社会功能及改善烦躁焦虑、人际关系方面的疗效优于对照组(P<0.05)。结论健脾调肝温肾方不仅能够改善D-IBS患者症状,并且可显著提高患者的生活质量。

Objective To observe the influence of Jianpi Tiaogan Wenshen Recipe （Recipe for strengthening the spleen,regulating the liver,and warming the kidney） on the clinical symptoms and quality of life of the patients with diarrhea-predominant irritable bowel syndrome （D-IBS）.Methods A prospective,randomize-controlled trial was conducted.The 80 D-IBS patients were equally randomized into 2 groups.The treatment group was administered Jianpi Tiaogan Wenshen Recipe and the control group was prescribed pinaverium bromide tablet for 4 weeks.Before and after treatment,the symptoms of abdominal pain or discomfort were observed and recorded,36-item short-form health survey （SF-36） and IBS quality of life （IBS-QOL） were adopted to evaluate the quality of life of the patients.The cured and remarkably effective cases were followed up four weeks after stopping medicine.Results The difference in in-group and between-group comparison in the symptoms of abdominal pain or discomfort and abdominal distention before and after treatment was not significant.The difference in the scores of mucus stool of two groups after treatment was significant （P0.05）,the treatment group was better than the control group.The curative rate of the treatment group and the control group was 24.3% and 19.4% respectively,and the total effective rate was 81.1% and 80.6% respectively,without significant difference（P0.05）.The long-term effect：there were 4 and 12 cases relapsed or aggravated in the treatment group and control group respectively,the difference was significant （P0.01）.Quality of life：the treatment group was better than the control group in improving the somato pain,mental health,social functioning,dysphoria,and interpersonal relationship （P0.05）.Conclusion Jianpi Tiaogan Wenshen Recipe improves not only the symptoms but also the quality of life of the D-IBS patients.