中医治疗便秘型肠易激综合征的临床观察

Clinical Observation on Chinese Medicine Treatment of Constipation-predominant Irritable Bowel Syndrome

目的:中医疏肝理气通便法治疗便秘型肠易激综合征,以西药聚乙二醇4000为对照,从肠道症状和生活质量两方面观察其临床疗效。方法:符合罗马Ⅲ诊断标准的70例肠易激综合征患者,随机分为疏肝理气通便法治疗组(35例)和聚乙二醇4000对照组(35例),2组服药疗程为4周。采用症状等级评分表和SF-36生活质量评价作为判定依据,观察治疗前后各组患者肠道症状及生活质量的变化。结果:①疏肝理气通便法治疗能有效改善便秘型肠易激综合征患者的肠道症状,且优于西药对照组,具有统计学意义(P<0.05)。②治疗组的治疗有效率明显优于对照组,差异有显著性(P<0.05)。③治疗组治疗前后患者躯体疼痛(BP)、总体健康(GH)、活力(VT)、社会功能(SF)、精神健康(MH)维度的积分均有明显提高,具有统计学意义(P<0.05),对照组患者仅活力维度的生活质量得到显著改善,具有统计学差异(P<0.05)。结论:中医疏肝理气润肠通便法治疗便秘型肠易激综合征疗效确切,在肠道症状的改善和生活质量的提高两方面都显著优于西药治疗组,值得进一步推广。

Objective ： To treat constipation - predominant irritable bowel syndrome with liver - soothing and Qi - regu- lating and constipation - relieving treatment of traditional Chinese medicine with the control of polyethylene glycnl 4000 of Western medicine, and to observe the intestinal symptoms and quality of life. Methods ： In accordance with Rome III diagnostic criteria, 70 cases of patients with IBS were randomly divided into the liver - soothing and Qi - regulating and constipation - relieving treatment group （ 35 cases） and the control group with polyethylene glycol 4000 （ 55 cases）. Both groups took the medicine treatment for four weeks. Intestinal symptoms and quality of life of patients in each group were observed before and after treatment by using the Symptoms Rating Scale and the SF- 36 as determine basis. Result ： （1）The liver - soothing and Qi - regulating and constipation - relieving treatment can effectively improve the constipation - predominant IBS patients＇ intestinal symptoms, which was significant higher than that of the control （P 〈 0.05 ）. （2）The treatment efficiency of liver - soothing and Qi - regulating and constipation - relieving treatment group was much better than that of the control group, and had significant differences （ P 〈 0.05）. （3）The liver - soothing and Qi - regulating and constipation - relieving treatment group significantly got better in SF - 36 in pain （ BP）, general health （ GH）, vitality （VT） , social, function（SF） and mental health（GH） （ P 〈 O. 05 ）. Conclusion： The liver - soothing and Qi - regulating and constipation -.relieving treatment of traditional Chinese medicine is more effective on constipation - predominant irri- table bowel syndrome than polyethylene glycol 4000 in both conditions of intestinal symptoms and quality of life. It is wor- thy of further promotion.